Seasonal variation in the prevalence of acute undernutrition among children under five years of age in east rural Ethiopia: a longitudinal study

BACKGROUND: Malnutrition is a deficiency state of both macro and micronutrients (under - nutrition) and their over consumption (over- nutrition) causing measurable adverse effects on human body structure and function, resulting in specific physical and clinical outcomes. Little has been known about the seasonal variation in the magnitude of acute child under-nutrition and its determinants in low and middle-income countries making difficult the choice of a better nutrition intervention. The objective of this study was to determine the prevalence of acute under-nutrition and its associated factors on children aged 6 to 36 months in east rural Ethiopia in wet and dry seasons. METHODS: A longitudinal study was conducted on children aged 6 to 36 months and their mothers (mother–child pairs) from July/August 2010/2011 to January/ February 2011/2012 in east rural Ethiopia. Data were collected from 2,132 mother–child pairs using a pretested structured questionnaire and the UNICEF recommended anthropometric measuring instruments after standardization. The Odds Ratio with 95% confidence interval was estimated to identify the predictors of acute child under nutrition (wasting) using a conditional fixed- effects logistic regression. RESULTS: The prevalence of acute child under-nutrition was 7.4%; 95% CI: (6.3%, 8.5%) in wet and 11. 2%; 95% CI: (9.8%, 12.5%) in dry seasons. Child wasting was more common among children of poor households who had no cooperative bank saving accounts [AOR (95% CI) = 8.2. (1.8, 37.6)], and access to health facilities [AOR (95% CI) = 2.2 (1.4, 3.6)]. CONCLUSION: Acute child under-nutrition was relatively higher in the dry season. Although season was not significantly associated with child under - nutrition, poverty and poor access to health services were important predictors of wasting in the study setting. Thus, effective community–based nutrition interventions that require a multi - disciplinary approach should be scaled up to curb childhood under-nutrition

Prevalence of Underweight and Associated Factors among Children Aged 6 to 59 Months in Areka Town, Wolaita Zone, Southern Ethiopia

Background: Underweight remains one of the most common causes of morbidity and mortality among children in low-income countries. Over two-thirds of these deaths, which are often associated with inappropriate feeding practices, occur during the first five years of life. The study was to assess the prevalence of malnutrition and associated factors among children aged 6 to 59 months in Areka town, Wolaita Zone, Southern Ethiopia.Methods: A community based cross-sectional survey design was used among randomly selected 379 children and their mothers / care givers (mothers-child pair). Socio- demographic data were collected using an interviewer administered pretested structured questionnaire. Moreover, anthropometric data were collected using digital weight scale, length and height boards. Data were entered in EPI-info Version 3.5.2 and then exported to SPSS version 21.0.  The World Health Organization (WHO) anthros software was used to analyze   anthropometric data to determine Z-score.  Both descriptive and inferential statistics were used to analyze the data.  Odds ratio along with 95% CI was estimated to identify factors associated with child underweight using multivariable logistic regression. The level of statistical significance was declared at p –value less - than 0.05.Results: - The prevalence of underweight was 13.5%. In multivariable logistic regression analysis having no formal education [(AOR=5.7, 95%CI= (1.9-16.7)] was associated with underweight. Having large family size (7+) was associated with underweight [(AOR=7.9, 95%CI=2.7-17.6)]. Mother’s occupation (being unemployed) [(AOR=4.5, 95%CI= (1.8-11.2)], child’s age (6-36 months) [(AOR=2.2, 95%CI= (1.08-4.8)] were also found to be factors associated with underweight.Conclusion: The prevalence of child underweight was found to be moderate   in the study area.  Educational status of mothers, family size, dietary diversity score, and occupation of mother and age of the child remain key risk factors for underweight. Therefore; immediate interventions targeted to community management of acute malnutrition might be appropriate to manage underweight which is an indication of acute malnutrition in the study area. Keywords: underweight, malnutrition, under five childre

Dietary Diversity Practice and Associated Factors Among Infants and Young Children in Haramaya Town, Ethiopia

Optimum child feeding is crucial for growth, development, and better health in later life. Dietary diversity is a critical part of the feeding practices. However, there is limited evidence on dietary diversity practice in low-income countries, like Ethiopia. This study assessed dietary diversity practice and associated factors among mothers of infants and young children aged 6-23 months in Haramaya Town, Eastern Ethiopia. Community based cross-sectional study design was used and study participants were selected by simple random sampling. Data were collected using a pre-tested questionnaire by face-to-face interview. The collected data were entered to EpiData version 3.1 and exported to SPSS version 22.0 for analysis. Characteristics of the study participants were described by using frequencies, percentages, summary measures, and tables. Bi-variable and multi-variable analyses were used to identify the associated factors. Statistical significance was declared at p-value < 0.05. The study included 635 participants yielding to a response rate of 98.1%. The prevalence of dietary diversity practice was 25.2%. Mothers learned up to secondary level or above [(AOR=2.97, 95% CI: (1.26, 6.99)], mothers who had job [(AOR=3.21, 95% CI: (1.41, 7.29)], older children [(AOR=2.51, 95% CI: (1.45, 4.34)], male children [(AOR= 2.08, 95% CI: (1.29, 3.33)], healthy children [(AOR=2.65, 95% CI: 1.36, 5.16)] and richest households [(AOR=4.45, 95% CI: 1.94, 10.22)] were associated with dietary diversity practice. Generally, the dietary diversity practice was low. Therefore, attention should be given to mothers with no formal education and efforts should be done to improve the socioeconomic status of the households

Prevalence of Anemia and Associated Factors among PHIVs Attendants Antiretroviral Therapy Clinics in Public Health Institutions in Dire Dawa Town, East Ethiopia

Background: Anemia is one of the most commonly observed hematological abnormalities and an independent prognostic marker of Human Immunodeficiency virus (HIV) disease progression in people living with HIV. However, there is limited evidence on the magnitude and its correlates among attendants of Antiretroviral Therapy (ART) in low-income countries including Ethiopia. Objective: The aim this study was to determine Prevalence of anemia and associated factors among PHIVs attendants Antiretroviral Therapy clinics in public health institutions in Dire Dawa Town, East Ethiopia Methods: An institution based cross - sectional study design was used from mid January to mid February 2014.The study participants were selected by using simple random sampling technique. A pre- tested structured questionnaire was used to collect data. Both bivariate and multivariable logistic regressions were used to identify associated factors. Hematological and immunological data were collected by using blood samples. Odds ratio along with 95% confidence interval was estimated to identify factors associated with anemia among the study population using a multivariable logistic regression. Results: The prevalence of anemia was 41.2%, 95% CI (36.7%, 45.9%). In multivariable logistic regression analysis, being female[AOR=1.95, 95% CI (1.22, 3.11)], use of different types of  zidovudine (AZT) based Highly Active Antiretroviral Therapy (HAART) : 1c:AZT+3TC+ neverapine [ AOR=2.56 , 95% CI (1.28,5.12) ] , and 1d: AZT+3TC + Evaferenz [ AOR=2.99 , 95% CI(1.27,7.03)] , overall ART category: zidovudine - based HAART  [ AOR=2.98, 95% CI (1.27,6.99)] ,  WHO’s HIV  clinical  stage III [AOR=2.49, 95% CI: (1.24, 5.01)] and stage IV [AOR= 5.92, 95% CI (1.26, 27.8)] , and lower CD4 count [AOR=2.34, 95% CI (1.10,4.98)]  were  independently associated with anemia .Conclusion: Macrocytic anemia was common among patients taking Antiretroviral Therapy. The likelihood of developing anemia increases with disease progression associated decreased immunological state and use of zidovudin-based HAART. Therefore, those factors associated with anemia among PHIVs would be emphatically considered comprehensive care and treatment for PHIVs by including anemia treatment and prevention strategies by police makers in collaboration with others responsible bodies. Keywords: Anemia, Antiretroviral Therapy, Ethiopia, Dire Dawa , Macrocytosis, Zidovudin

Predictors of stunting among pediatric children living with HIV/AIDS, Eastern Ethiopia

Globally, there were about 3.4 million pediatric children (<15 years of age) who were living with HIV/AIDS. Ethiopia has one of the highest rates of malnutrition in Sub-Saharan Africa. As of 2013, there were about 160,000 pediatric children living with HIV/AIDS in Ethiopia. Even though undernutrition makes it difficult to combat HIV/AIDS, there is paucity of information on the magnitude of stunting and its predictors among seropositive pediatric children in low-income countries like Ethiopia. Institution based quantitative cross sectional study design was employed on 414 randomly selected pediatric (5-15 years) children living with HIV/AIDS in Harari Region and Dire Dawa City Administration Public Hospitals, Eastern Ethiopia. Pretested interviewer administered questionnaire and patient card review was held to collect data. Data were entered through Epi-data and exported to SPSS for analysis. The WHO Anthros plus software was used to calculate the anthropometric indices. Bivariate and Multivariable analysis along with 95%CI were done to identify predictors of stunting. Level of statistical significance was declared at P-value <0.05. The prevalence of stunting was found to be 30.9% (95%CI: 26.0-36.0%). Rural residence [AOR=4.0, (95%CI: 2.22, 7.17)], family monthly income of ≤500 ETB [AOR=5.79, (95%CI: 2.82, 11.60)], being anemic [AOR=3.17, (95% CI: 2.13, 4.93)] and the presence of diarrhea [AOR=6.21, 95% (CI: 3.39, 9.24)] were predictors of stunting. Thus, collaborative measures should be undertaken (to decrease frequent infections and to improve the economic status) to combat chronic malnutrition during HIV/AIDS treatment

Khat chewing in pregnant women associated with prelabor rupture of membranes, evidence from eastern Ethiopia

Introduction: prelabor rupture of membranes (PROM) is a major factor that affects pregnancy outcome. Results from previous studies have suggested that there is an association between pregnant women, khat chewing and preterm birth, but evidence of association with PROM is sparse. This study therefore aims at identifying association between khat chewing in pregnancy and premature rupture of membranes in eastern Ethiopia. Methods: A health facility-based cross-sectional study was conducted among 1688 pregnant women who came for delivery service in Harar town, Eastern Ethiopia between June to October in 2016. Data were collected using a pre-tested structured questionnaire and checklist to extract data from the medical record. The association between khat and PROM was examined using logistic regression analysis. A statistical significance was declared at p-value < 0.05. Results: Of the 1688 pregnant women who participated in the study, 397 had prelabor rupture of the membranes, representing a proportion of 23.5% [(95% CI: (21.5, 25.6%)]. Of these 397 prelabor rupture of the membranes 198 (31.53%) were from Khat chewing mothers and, 199(18.77%) were from non-khat chewing mothers. After controlling for potential confounders, the multivariable logistic regression analysis revealed the odds of PROM was 1.51 times higher among khat chewed pregnant women [AOR = 1.51; 95% CI; (1.11, 2.07)] were had no khat chewing. Conclusion: this study found a significant association between khat chewing in pregnancy and PROM. Efforts to reduce PROM need to consider prevention of khat chewing in pregnancy. A specific strategy need to protect pregnant women from khat chewing

Overweight and Undernutrition in the Cases of School-Going Adolescents in Wolaita Sodo Town, Southern Ethiopia: Cross-Sectional Study

Background. This study aimed to assess the prevalence of malnutrition and associated factors among school adolescents in Wolaita Sodo town, Southern Ethiopia. Methods. A school-based cross-sectional study was conducted from May 18–June 10, 2015. A multistage sampling was used to select a random sample of 690 adolescents from selected schools. Data on sociodemographic information were collected by using an interviewer-administered questionnaire, and anthropometric measurements were made by using a digital Seca scale and height measuring board by trained data collectors. Data were entered into Epi-Data version 3.1 software and exported to SPSS version 20. World Health Organization (WHO) Anthro-plus software was used to analyze anthropometric data. Both binary and multinomial logistic regression analyses were done to identify factors associated with the malnutrition of adolescents. Result. The overall prevalence of thinness, stunting, and overweight/obesity among school adolescents was 4.7% (95% CI: 3%–6.4%); 5.2% (95% CI: 3.4%–7%); and 5.0% (95% CI: 3.4%–6.7%), respectively. Being male (AOR = 4.07; 95% CI: 2.35–7.02), learning at a government school (AOR = 0.37; 95% CI: 0.20–0.65), mothers with no formal education (AOR = 4.03; 95% CI: 1.82–8.92), owning no cattle (AOR = 4.92; 95% CI: 2.08–11.64), skipping meals (AOR = 1.70; 95% CI: 1.05–2.74), and illness in 2 weeks prior to survey (AOR = 2.67; 95% CI: 1.49–4.78) were significantly associated with thinness. However, males, students who had their house, and no cattle were more likely to develop overweight/obesity. Maternal education of secondary school (AOR = 0.214; 95% CI: 0.054–0.846) was significantly associated with the stunting. Conclusion. The study showed the coexistence of undernutrition and overnutrition among school adolescents in the study area. There needs to implement evidence-based school nutrition education and health policies and programs to improve nutritional status of adolescents and timely taking action to limit obesity-related health problems