Iodine status in pregnant women and school children of the Aira district in Ethiopia

Iodine deficiency is a public health problem in Ethiopia. This study was conducted to investigate the iodine status of pregnant women and school children of Aira district, west Ethiopia. A school-based survey of children and a clinic-based assessment that focused on pregnant women were conducted from May to June 2014. Spot urine and salt samples were collected and their iodine concentrations determined by an ammonium persulfate test and titration, respectively. Qualitative information was obtained by focus group discussions and individual interviews. The median urinary iodine excretion found in school children (n = 73) and pregnant women (n = 40) were 70.5 μg/l (95% CI, 48.1 μg/l–83.8 μg/l) and 88.6 μg/l (95% CI, 66.9 μg/l–113.5 μg/l), respectively. About 72.6% of the school children and 80% of the pregnant women had insufficient iodine intake. 67% of household salt samples (n = 46) contained iodine ˂15 ppm. In addition to its health consequences, iodine deficiency has negative social impacts. A deformed physical appearance (with clinical signs of goitre) entails psychological tensions, and is also considered to reduce chances for marriage. Iodine levels both in urine and salt samples indicated that the majority of school children and pregnant women from this study were at risk of iodine deficiency disorders. Thus, raising awareness about the nutritional importance of iodized salt and its proper packaging with sealed containers which reduce iodine loss should be promoted

Nutrition-specific and sensitive drivers of poor child nutrition in Kilte Awlaelo-Health and Demographic Surveillance Site, Tigray, Northern Ethiopia: implications for public health nutrition in resource-poor settings

Background: Child undernutrition is a prevalent health problem and poses various short and long-term consequences. Objective: This study seeks to investigate the burden of child undernutrition and its drivers in Kilte Awlaelo-Health and Demographic Surveillance Site, Tigray, northern Ethiopia. Methods: In 2015, cross-sectional data were collected from 1,525 children aged 6–23 months. Maternal and child nutritional status was assessed using the mid upper arm circumference. Child’s dietary diversity score was calculated using 24-hours dietary recall method. Log-binomial regression and partial proportional odds model were fitted to examine the drivers of poor child nutrition and child dietary diversity (CDD), respectively. Results: The burden of undernutrition and inadequate CDD was 13.7% (95% CI: 12.1–15.5%) and 81.3% (95%CI: 79.2–83.1%), respectively. Maternal undernutrition (adjusted prevalence ratio, adjPR = 1.47; 95%CI: 1.14–1.89), low CDD (adjPR = 1.90; 95%CI: 1.22–2.97), and morbidity (adjPR = 1.83; 95%CI: 1.15–2.92) were the nutrition-specific drivers of child undernutrition. The nutrition-sensitive drivers were poverty (compared to the poorest, adjPR poor = 0.65 [95%CI:0.45–0.93], adjPR medium = 0.64 [95%CI: 0.44–0.93], adjPR wealthy = 0.46 [95%CI: 0.30–0.70], and adjPR wealthiest = 0.53 [95%CI: 0.34–0.82]), larger family size (adjPR = 1.10; 95%CI: 1.02–1.18), household head’s employment insecurity (adjPR = 2.10; 95%CI: 1.43–3.09), and residing in highlands (adjPR = 1.93; 95%CI: 1.36–2.75). The data show that higher CDD was positively associated with wealth (OR wealthy = 3.06 [95%CI: 1.88–4.99], OR wealthiest = 2.57 [95%CI: 1.53–4.31]), but it was inversely associated with lack of diverse food crops production in highlands (OR = 0.23; 95%CI: 0.10–0.57]). Conclusions: Our findings suggest that the burden of poor child nutrition is very high in the study area. Multi-sectoral collaboration and cross-disciplinary interventions between agriculture, nutrition and health sectors are recommended to address child undernutrition in resource poor and food insecure rural communities of similar settings

What factors are associated with maternal undernutrition in eastern zone of Tigray, Ethiopia? Evidence for nutritional well-being of lactating mothers

Background!#!Maternal undernutrition is a pervasive health problem among Ethiopian mothers. This study aims at identifying the level of maternal undernutrition and its associated factors in Kilte Awaleo-Health and Demographic Surveillance Site (KA-HDSS), Tigray region, Ethiopia.!##!Methods!#!Nutritional status of 2260 lactating mothers was evaluated using the mid-upper-arm circumference (MUAC). Data from the vital events and verbal autopsy databases were linked to the survey and baseline recensus data to investigate the association of adult mortality from chronic causes of death (CoD) on maternal undernutrition. We employed a generalized log-binomial model to estimate the independent effects of the fitted covariates.!##!Results!#!The overall prevalence of maternal undernutrition based on MUAC < 23 cm was 38% (95% CI: 36.1, 40.1%). Recent occurrence of household morbidity (adjusted prevalence ratio (adjPR) = 1.49; 95%CI: 1.22, 1.81) was associated with increased risk of maternal undernutrition. In addition, there was a 28% higher risk (adjPR = 1.28; 95%CI: 0.98, 1.67) of maternal undernutrition for those mothers who lived in households with history of adult mortality from chronic diseases. Especially, its association with severe maternal undernutrition was strong (adjusted OR = 3.27; 95%CI: 1.48, 7.22). In contrast, good maternal health-seeking practice (adjPR = 0.86; 95%CI: 0.77, 0.96) and production of diverse food crops (adjPR = 0.72; 95%CI: 0.64, 0.81) were associated with a lower risk of maternal undernutrition. Relative to mothers with low scores of housing and environmental factors index (HAEFI), those with medium and higher scores of HAEFI had 0.81 (adjPR = 0.81; 95%CI: 0.69, 0.95) and 0.82 (adjPR = 0.82; 95%CI: 0.72, 0.95) times lower risk of maternal undernutrition, respectively.!##!Conclusions!#!Efforts to ameliorate maternal undernutrition need to consider the influence of the rising epidemiology of adult mortality from chronic diseases. Our data clearly indicate the need for channeling the integrated intervention power of nutrition-sensitive development programs with that of nutrition-specific sectoral services