Chronic Malnutrition Among Under Five Children of Ethiopia May Not Be Economic. A Systematic Review and Meta-Analysis

Background: Ethiopia is one of the four low income countries in achieving MDG4, however, minimizing child undernutrition became critical undertaking thus far. This review aimed at identifying the predictors of under-5 children nutrition in Ethiopia.Methods: Databases searched were Med Line, HINARY, MedNar and Embase. Furthermore, gray literatures were also sought. All papers selected for inclusion in the review were subjected to a rigorous critical appraisal using standardized critical appraisal instruments from the Joanna Briggs Institute. Quantitative papers were pooled for statistical analysis and narrative synthesis. Odds ratios and their 95% confidence intervals were calculated for analysis. Papers of optimal quality but without optimal data set for meta-analysis were subjected for narrative synthesisResults: Nonadherence towards Optimal feeding recommendations was the most reported predictor of stunting and wasting, while, maternal education and ‘Water, Sanitation and Hygiene’ factors were the second. The findings of the Meta-analysis showed no evidence of association between household income/wealth and stunting of children in Ethiopia (OR=1.14, 95% CI= 0.97, 1.34), heterogeneity test:i2 = 92%, df = 20, (P < 0.00001). On the other hand, children in low income/wealth group were 1.73 times more likely to have wasting compared to children of the higher income/wealth households (OR=1.73, 95% C I= 1.51, 1.97) heterogeneity test: i2 = 71%, df = 20, (P < 0.00001).Conclusion: An over-reliance on macroeconomic growth as a solitary factor towards undernutrition should not be the way forward. Supplementary and more focused nutrition specific and sensitive interventions are needed in Ethiopia

Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017

Background The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 comparative risk assessment (CRA) is a comprehensive approach to risk factor quantification that offers a useful tool for synthesising evidence on risks and risk–outcome associations. With each annual GBD study, we update the GBD CRA to incorporate improved methods, new risks and risk–outcome pairs, and new data on risk exposure levels and risk–outcome associations. Methods We used the CRA framework developed for previous iterations of GBD to estimate levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs), by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks or groups of risks from 1990 to 2017. This study included 476 risk–outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. We extracted relative risk and exposure estimates from 46 749 randomised controlled trials, cohort studies, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. Using the counterfactual scenario of theoretical minimum risk exposure level (TMREL), we estimated the portion of deaths and DALYs that could be attributed to a given risk. We explored the relationship between development and risk exposure by modelling the relationship between the Socio-demographic Index (SDI) and risk-weighted exposure prevalence and estimated expected levels of exposure and risk-attributable burden by SDI. Finally, we explored temporal changes in risk-attributable DALYs by decomposing those changes into six main component drivers of change as follows: (1) population growth; (2) changes in population age structures; (3) changes in exposure to environmental and occupational risks; (4) changes in exposure to behavioural risks; (5) changes in exposure to metabolic risks; and (6) changes due to all other factors, approximated as the risk-deleted death and DALY rates, where the risk-deleted rate is the rate that would be observed had we reduced the exposure levels to the TMREL for all risk factors included in GBD 2017. Findings In 2017, 34·1 million (95% uncertainty interval [UI] 33·3–35·0) deaths and 1·21 billion (1·14–1·28) DALYs were attributable to GBD risk factors. Globally, 61·0% (59·6–62·4) of deaths and 48·3% (46·3–50·2) of DALYs were attributed to the GBD 2017 risk factors. When ranked by risk-attributable DALYs, high systolic blood pressure (SBP) was the leading risk factor, accounting for 10·4 million (9·39–11·5) deaths and 218 million (198–237) DALYs, followed by smoking (7·10 million [6·83–7·37] deaths and 182 million [173–193] DALYs), high fasting plasma glucose (6·53 million [5·23–8·23] deaths and 171 million [144–201] DALYs), high body-mass index (BMI; 4·72 million [2·99–6·70] deaths and 148 million [98·6–202] DALYs), and short gestation for birthweight (1·43 million [1·36–1·51] deaths and 139 million [131–147] DALYs). In total, risk-attributable DALYs declined by 4·9% (3·3–6·5) between 2007 and 2017. In the absence of demographic changes (ie, population growth and ageing), changes in risk exposure and risk-deleted DALYs would have led to a 23·5% decline in DALYs during that period. Conversely, in the absence of changes in risk exposure and risk-deleted DALYs, demographic changes would have led to an 18·6% increase in DALYs during that period. The ratios of observed risk exposure levels to exposure levels expected based on SDI (O/E ratios) increased globally for unsafe drinking water and household air pollution between 1990 and 2017. This result suggests that development is occurring more rapidly than are changes in the underlying risk structure in a population. Conversely, nearly universal declines in O/E ratios for smoking and alcohol use indicate that, for a given SDI, exposure to these risks is declining. In 2017, the leading Level 4 risk factor for age-standardised DALY rates was high SBP in four super-regions: central Europe, eastern Europe, and central Asia; north Africa and Middle East; south Asia; and southeast Asia, east Asia, and Oceania. The leading risk factor in the high-income super-region was smoking, in Latin America and Caribbean was high BMI, and in sub-Saharan Africa was unsafe sex. O/E ratios for unsafe sex in sub-Saharan Africa were notably high, and those for alcohol use in north Africa and the Middle East were notably low. Interpretation By quantifying levels and trends in exposures to risk factors and the resulting disease burden, this assessment offers insight into where past policy and programme efforts might have been successful and highlights current priorities for public health action. Decreases in behavioural, environmental, and occupational risks have largely offset the effects of population growth and ageing, in relation to trends in absolute burden. Conversely, the combination of increasing metabolic risks and population ageing will probably continue to drive the increasing trends in non-communicable diseases at the global level, which presents both a public health challenge and opportunity. We see considerable spatiotemporal heterogeneity in levels of risk exposure and risk-attributable burden. Although levels of development underlie some of this heterogeneity, O/E ratios show risks for which countries are overperforming or underperforming relative to their level of development. As such, these ratios provide a benchmarking tool to help to focus local decision making. Our findings reinforce the importance of both risk exposure monitoring and epidemiological research to assess causal connections between risks and health outcomes, and they highlight the usefulness of the GBD study in synthesising data to draw comprehensive and robust conclusions that help to inform good policy and strategic health plannin

Application of digital health technologies to substance use reduction among students in higher education institutions: A scoping review [version 3; peer review: 1 approved, 2 approved with reservations]

Psychoactive substances alter perception, mood, cognition, or consciousness and include a wide range of compounds such as alcohol, marijuana, nicotine, and khat. Substance use among college and university students is associated with significant health issues, academic struggles, and premature death. This scoping review examines digital health interventions, including mobile and internet platforms, targeting substance use reduction among college students in low- and middle-income countries (LMICs). A comprehensive search across databases such as PubMed, PsycINFO, Scopus, and Google Scholar identified 8 eligible studies conducted across seven countries between 2013 and 2025. These studies focused primarily on alcohol use and included digital health tools like instant messaging, Telegram applications, text messaging, and web-based interventions. The results suggest that digital health technologies can effectively motivate college students in LMICs to reduce or abstain from psychoactive substance use. However, there is a notable research gap in evaluating the effectiveness and feasibility of these tools, especially mobile text messaging, which remains one of the most widely used methods in LMICs. The review highlights the need for further research, including systematic reviews and meta-analyses, to better understand the impact of digital health interventions on substance use reduction and to develop evidence-based programs for behavior change

Global, regional, and national age-sex-specific mortality and life expectancy, 1950–2017: a systematic analysis for the Global Burden of Disease Study 2017

Background Assessments of age-specific mortality and life expectancy have been done by the UN Population Division, Department of Economics and Social Affairs (UNPOP), the United States Census Bureau, WHO, and as part of previous iterations of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD). Previous iterations of the GBD used population estimates from UNPOP, which were not derived in a way that was internally consistent with the estimates of the numbers of deaths in the GBD. The present iteration of the GBD, GBD 2017, improves on previous assessments and provides timely estimates of the mortality experience of populations globally. Methods The GBD uses all available data to produce estimates of mortality rates between 1950 and 2017 for 23 age groups, both sexes, and 918 locations, including 195 countries and territories and subnational locations for 16 countries. Data used include vital registration systems, sample registration systems, household surveys (complete birth histories, summary birth histories, sibling histories), censuses (summary birth histories, household deaths), and Demographic Surveillance Sites. In total, this analysis used 8259 data sources. Estimates of the probability of death between birth and the age of 5 years and between ages 15 and 60 years are generated and then input into a model life table system to produce complete life tables for all locations and years. Fatal discontinuities and mortality due to HIV/AIDS are analysed separately and then incorporated into the estimation. We analyse the relationship between age-specific mortality and development status using the Socio-demographic Index, a composite measure based on fertility under the age of 25 years, education, and income. There are four main methodological improvements in GBD 2017 compared with GBD 2016: 622 additional data sources have been incorporated; new estimates of population, generated by the GBD study, are used; statistical methods used in different components of the analysis have been further standardised and improved; and the analysis has been extended backwards in time by two decades to start in 1950. Findings Globally, 18·7% (95% uncertainty interval 18·4–19·0) of deaths were registered in 1950 and that proportion has been steadily increasing since, with 58·8% (58·2–59·3) of all deaths being registered in 2015. At the global level, between 1950 and 2017, life expectancy increased from 48·1 years (46·5–49·6) to 70·5 years (70·1–70·8) for men and from 52·9 years (51·7–54·0) to 75·6 years (75·3–75·9) for women. Despite this overall progress, there remains substantial variation in life expectancy at birth in 2017, which ranges from 49·1 years (46·5–51·7) for men in the Central African Republic to 87·6 years (86·9–88·1) among women in Singapore. The greatest progress across age groups was for children younger than 5 years; under-5 mortality dropped from 216·0 deaths (196·3–238·1) per 1000 livebirths in 1950 to 38·9 deaths (35·6–42·83) per 1000 livebirths in 2017, with huge reductions across countries. Nevertheless, there were still 5·4 million (5·2–5·6) deaths among children younger than 5 years in the world in 2017. Progress has been less pronounced and more variable for adults, especially for adult males, who had stagnant or increasing mortality rates in several countries. The gap between male and female life expectancy between 1950 and 2017, while relatively stable at the global level, shows distinctive patterns across super-regions and has consistently been the largest in central Europe, eastern Europe, and central Asia, and smallest in south Asia. Performance was also variable across countries and time in observed mortality rates compared with those expected on the basis of development. Interpretation This analysis of age-sex-specific mortality shows that there are remarkably complex patterns in population mortality across countries. The findings of this study highlight global successes, such as the large decline in under-5 mortality, which reflects significant local, national, and global commitment and investment over several decades. However, they also bring attention to mortality patterns that are a cause for concern, particularly among adult men and, to a lesser extent, women, whose mortality rates have stagnated in many countries over the time period of this study, and in some cases are increasin

Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980-2017: a systematic analysis for the Global Burden of Disease Study 2017

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Development of Nutrient Dense, Optimized Novel Complementary Food from Local Cereal-Legume Blends Enriched With Dabi Teff (Eragrostis Teff) Grown In Western Ethiopia

Complementary feeding determines children’s growth and survival with implications on health, education, work capacity and productivity in later life and on national economic development. Consequently, the provision of nutritionally adequate, safe and acceptable complementary food to ensure the nutritional well-being of children in early life is more emphasized. There is urgency and opportunity to explore the possibility of developing nutritionally adequate complementary foods based on locally available cereals and legume blends by inclusion of nutritious underutilized plant foods. Poor quality complementary foods due to high dietary bulk, lower energy, protein and iron densities, lower intake of bioavailable iron and inadequate intake of daily required nutrients by children coupled with inappropriate feeding practices are leading to a great risk of nutritional deficiencies. These are among the prime causes of persistent and unacceptably high protein energy and micronutrient malnutrition in infants and young children. Proper food selection, combination and preparation practices that affect the nutrient density, bioavailability and acceptability compounded by age-specific feeding, caregiver’s nutrition knowledge and socio economic statutes of the family are among the known integral components of caregiving to infants and young children feeding (IYCF). The food-based approach is a sustainable way of providing a nutritionally adequate complementary diet through diversification of locally available foods either through own production or purchase from the local market, proper selection, preparation and adequate feeding. The approach also employs the enrichment of traditional foods using nutritious local foods, where if the enriched food is consumed on a regular and frequent basis, it will maintain body stores of nutrients more efficiently and effectively than intermittent supplements. This is an important advantage to growing children who need a sustained supply of macro- and micronutrients for growth and development particularly in rural and semi-urban poor who don’t have purchasing power of commercial fortified foods. The use of indigenous locally available food ingredients to develop complementary products could provide an opportunity to utilize the use of unreached/untouched golden crops to prepare good quality home-made complementary foods for IYCF. xii The main aim of this PhD dissertation work was to develop a nutrient dense optimized novel complementary food from locally available cereal-legume blends through the incorporation of dabi teff, the underutilized crop to be used for IYCF in Ethiopia. Before diving into the detail dissertation works, a scoping review, ethnographic qualitative study and preliminary test on the key micronutrient contents of the principal ingredient (dabi teff) were conducted (Annex V). Proper controlled processing techniques were applied to the selected cereals, legume and oilseed crops. The energy, protein and iron densities of the developed complementary product were compared with the traditional complementary food and the Cerifam® faffa flour (the popular commercial complementary flour in Ethiopia) and checked against the Food and Agriculture Organization and World Health Organization (FAO/WHO) recommended standards. The effects of blending ratio variation on the macro- and selected micro-nutrient compositions of the formulations were investigated. Finally, the likely contribution of the optimized novel complementary product to daily energy and nutrient damans by 6-23 months children was checked/modeled against the recommended dietary allowance (RDA) set by the Pan American Health Organization and World Health Organization (PAHO/WHO) child feeding guidelines. This was to verify whether the new product could demonstrate the energy and nutrients adequacy to expect positive nutritional outcomes following feeding of infants and young children. To realize these, the dissertation work was organized into seven interrelated studies in Nedjo district, Ghimbi Zone, Western Ethiopia. The summary of the major findings from each chapter of the study was presented as follows: Chapter 3 presents a scoping review of studies conducted in sub-Saharan Africa (SSA) on the possibility of enriching traditional staple foods using nutritious underutilized plant foods including the effects of common processing techniques on the nutritional value of the resultant complementary products. The review showed that underutilized plant foods such as amaranth seeds, moringa olifera leaf, baobab fruit pulp, Bambara ground nut, chickpea, red teff, soya bean, spinach, peanut and orange-fleshed sweet potato were used to enrich traditional complementary diets. All the studies have proven that enrichment of the staple diets with underutilized nutritious plant foods has resulted in the development of nutritionally dense complementary foods, meeting standards, specifically, with improved micronutrient contents such as iron, calcium, zinc magnesium, phosphorous, and potassium. The most common processing techniques applied were xiii found to be fermentation, germination, malting, extrusion cooking, dehulling and roasting resulting in the improvement of the nutritional values and bioavailability of micronutrients in the complementary foods developed. Chapter 4 presents an exploratory ethnographic qualitative study on traditional usage, social beliefs and cultivation trends of dabi teff (Eragrostis teff), a typical farmer variety teff grown in Nedjo district, Western Ethiopia: including its usage as complementary food. The result showed that there is a profound tradition in the usage of dabi teff, where the participants had shown to have life-long practices of preparing and enjoying a number of food forms from dabi teff which are highly praised in their community. Yet, the practice of using dabi teff as a complementary food is not common and the crop is usually reserved for the nutritional treatment of sick, delivered women and bone-fractured persons. The findings showed that there is a deep-rooted social belief linked to dabi teff among the communities in the area and it was claimed that the crop has strong nutritional potential and is prized as a medicinal food. All the participants argued that eating the different food forms, particularly the “mooqa manyee” (gruel type made from bull hooves and dabi teff flour) and “cafaqoo” (a blouse-like food made from dabi teff), it increases blood volume “dhiiga dabalaa”, boosts energy/strength “humna dabalaa”, and repairs/strengthens the backbone and fractured bones “dugda jabeessa”. It was further claimed that if “mooqa manyee” is served to a recently delivered mother, she would recover from her backbone pain shortly and fast weight gain (postnatal nutrition), and if served to a bone-fractured person he/she would be healed fast and the participants praised the crop using a quote, ‘if we have dabi teff crop in our home, we feel like we have a medicine at home’. Yet, it was told that the cultivation of the crop is declining than the past

Global, regional, and national disability-adjusted life-years (DALYs) for 359 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017

Background How long one lives, how many years of life are spent in good and poor health, and how the population's state of health and leading causes of disability change over time all have implications for policy, planning, and provision of services. We comparatively assessed the patterns and trends of healthy life expectancy (HALE), which quantifies the number of years of life expected to be lived in good health, and the complementary measure of disability-adjusted life-years (DALYs), a composite measure of disease burden capturing both premature mortality and prevalence and severity of ill health, for 359 diseases and injuries for 195 countries and territories over the past 28 years. Methods We used data for age-specific mortality rates, years of life lost (YLLs) due to premature mortality, and years lived with disability (YLDs) from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 to calculate HALE and DALYs from 1990 to 2017. We calculated HALE using age-specific mortality rates and YLDs per capita for each location, age, sex, and year. We calculated DALYs for 359 causes as the sum of YLLs and YLDs. We assessed how observed HALE and DALYs differed by country and sex from expected trends based on Socio-demographic Index (SDI). We also analysed HALE by decomposing years of life gained into years spent in good health and in poor health, between 1990 and 2017, and extra years lived by females compared with males. Findings Globally, from 1990 to 2017, life expectancy at birth increased by 7·4 years (95% uncertainty interval 7·1–7·8), from 65·6 years (65·3–65·8) in 1990 to 73·0 years (72·7–73·3) in 2017. The increase in years of life varied from 5·1 years (5·0–5·3) in high SDI countries to 12·0 years (11·3–12·8) in low SDI countries. Of the additional years of life expected at birth, 26·3% (20·1–33·1) were expected to be spent in poor health in high SDI countries compared with 11·7% (8·8–15·1) in low-middle SDI countries. HALE at birth increased by 6·3 years (5·9–6·7), from 57·0 years (54·6–59·1) in 1990 to 63·3 years (60·5–65·7) in 2017. The increase varied from 3·8 years (3·4–4·1) in high SDI countries to 10·5 years (9·8–11·2) in low SDI countries. Even larger variations in HALE than these were observed between countries, ranging from 1·0 year (0·4–1·7) in Saint Vincent and the Grenadines (62·4 years [59·9–64·7] in 1990 to 63·5 years [60·9–65·8] in 2017) to 23·7 years (21·9–25·6) in Eritrea (30·7 years [28·9–32·2] in 1990 to 54·4 years [51·5–57·1] in 2017). In most countries, the increase in HALE was smaller than the increase in overall life expectancy, indicating more years lived in poor health. In 180 of 195 countries and territories, females were expected to live longer than males in 2017, with extra years lived varying from 1·4 years (0·6–2·3) in Algeria to 11·9 years (10·9–12·9) in Ukraine. Of the extra years gained, the proportion spent in poor health varied largely across countries, with less than 20% of additional years spent in poor health in Bosnia and Herzegovina, Burundi, and Slovakia, whereas in Bahrain all the extra years were spent in poor health. In 2017, the highest estimate of HALE at birth was in Singapore for both females (75·8 years [72·4–78·7]) and males (72·6 years [69·8–75·0]) and the lowest estimates were in Central African Republic (47·0 years [43·7–50·2] for females and 42·8 years [40·1–45·6] for males). Globally, in 2017, the five leading causes of DALYs were neonatal disorders, ischaemic heart disease, stroke, lower respiratory infections, and chronic obstructive pulmonary disease. Between 1990 and 2017, age-standardised DALY rates decreased by 41·3% (38·8–43·5) for communicable diseases and by 49·8% (47·9–51·6) for neonatal disorders. For non-communicable diseases, global DALYs increased by 40·1% (36·8–43·0), although age-standardised DALY rates decreased by 18·1% (16·0–20·2). Interpretation With increasing life expectancy in most countries, the question of whether the additional years of life gained are spent in good health or poor health has been increasingly relevant because of the potential policy implications, such as health-care provisions and extending retirement ages. In some locations, a large proportion of those additional years are spent in poor health. Large inequalities in HALE and disease burden exist across countries in different SDI quintiles and between sexes. The burden of disabling conditions has serious implications for health system planning and health-related expenditures. Despite the progress made in reducing the burden of communicable diseases and neonatal disorders in low SDI countries, the speed of this progress could be increased by scaling up proven interventions. The global trends among non-communicable diseases indicate that more effort is needed to maximise HALE, such as risk prevention and attention to upstream determinants of healt

Corrigendum: Effect of school feeding program on body mass index of primary school adolescents in Addis Ababa, Ethiopia: a prospective cohort study

BACKGROUND: Governments and developmental organizations are encouraged to devote adequate resources to the establishment of free school meals to low-income children in developing countries. In Ethiopia, the school feeding program (SFP) is implemented in a few regions including the capital, Addis Ababa. However, the nutritional benefit of the program was not monitored and reported thus far. In this study, we evaluated the effect of the SFP on the body mass index (BMI) of primary school adolescents in Addis Ababa, Central Ethiopia. METHOD: A prospective cohort study was employed to collect data from 644 SFP-beneficiary adolescents (n = 322) and non-SFP (n = 322). Nutritional outcomes were measured following 6 months of follow-up. WHO Anthroplus were used to convert anthropometric data into body-mass-index-for-age Z scores. The independent effect of school feeding is analyzed through a multivariable linear regression model. RESULT: In linear regression, unadjusted model (Model 1), compared with the non-school-fed adolescents, the mean difference in difference of BAZ-score of school-fed adolescent was higher by 0.36 (β 0.36, 95% CI 0.17, 0.55). The beta coefficient remained positive after adjusted for age and sex (Model 2: β 0.35, 95% CI 0.16, 0.54) and sociodemographic variable (Model 3: β 0.35, 95% CI 0.16, 0.54). In the final model, adjusted for model four, lifestyle and health status there was a significant difference in favor of school-fed adolescents on BAZ-score indices (Model 4: β 0.4, 95% CI 0.18–0.62). On the contrary, for a unit increase in family size, the BAZ score will decrease by 0.06 (β 0.06, 95% CI −0.12–−0.01). Similarly, adolescents with a middle tertile wealth index decreased their BAZ score by 0.30 (β 0.30, 95% CI −0.55–−0.05) as compared to the higher tertile wealth index. CONCLUSION: School feeding was positively associated with a change in BAZ score whereas family size and middle tertile wealth index were negatively associated. This implies that school feeding can serve as an optimal strategy for addressing the nutrition needs of adolescents

Global, regional, and national disability-adjusted life-years (DALYs) for 359 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017

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Impact of weekly iron-folic acid supplementation on nutritional status and parasitic reinfection among school-age children and adolescents in Sub-Saharan Africa: a systematic review and meta-analysis

BackgroundTwo significant etiological factors contributing to iron deficiency anemia, and undernutrition posing substantial public health challenges in Sub-Saharan Africa, are soil-transmitted helminths and malaria. This study carried out the effect of weekly iron-folic acid supplementation (WIFAS) on the nutrition and general health of school-age children and adolescents in Sub-Saharan Africa, a systematic review and meta-analysis have been conducted.MethodsTo find pertinent publications for this study, a thorough search was carried out on May 20, 2023, across five databases: Pubmed (MEDLINE), Web of Science, Scopus, Cochrane Library, and Google Scholar. In addition, a search was conducted on August 23, 2023, to capture any new records. The inclusion criteria for the studies were based on school-age children and adolescent populations, randomized controlled trials, and investigations into the effects of WIFAS. The outcomes of interest were measured through anthropometric changes, malaria, and helminthic reinfection.ResultsA systematic review of 11 articles revealed that WIFAS significantly decreased the risk of schistosomiasis reinfection by 21% among adolescents (risk ratio = 0.79, 95%CI: 0.66, 0.97; heterogeneity I2 = 0.00%, P = 0.02). However, no significant impact was observed on the risk of malaria reinfection (risk ratio = 1.02, 95%CI: 0.92, 1.13; heterogeneity I2 = 0.00%, P = 0.67) or A. Lumbricoides reinfection (risk ratio = 0.95, 95%CI: 0.75, 1.19; heterogeneity I2 = 0.00%, P = 0.65). Moreover, the analysis demonstrated that there is no significant effect of iron-folic acid supplementation in measured height and height for age Z-score (HAZ) of the school-age children (Hedge's g −0.05, 95%CI: −0.3, 0.2; test for heterogeneity I2 = 0.00%, P = 0.7) and (Hedge's g 0.12, 95%CI: −0.13, 0.37; test for heterogeneity I2 = 0.00%, P = 0.36) respectively.ConclusionThe effectiveness of WIFAS in reducing the risk of schistosomiasis reinfection in adolescents has been demonstrated to be greater than that of a placebo or no intervention. Additionally, the narrative synthesis of iron-folic acid supplementation has emerged as a potential public health intervention for promoting weight change. However, there was no significant association between WIFAS and Ascariasis, trichuriasis, and hookworm. Moreover, the certainty of the evidence for the effects of WIFAS on height and malaria is low and therefore inconclusive. Whereas, the certainty of the evidence for the effectiveness of WIFAS on Schistosomiasis is moderate. Even though the mechanisms need further research WIFAS may be implemented as part of a comprehensive public health strategy to address schistosomiasis in adolescents.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023397898, PROSPERO (CRD42023397898)