Chronic undernutrition and adolescent school performance in central Ethiopia

Chronic undernutrition among adolescents in developing countries has been identified as a major public health issue. Previous research has found associations between chronic undernutrition and academic performance outcomes in adolescents. There isneed for localized research focusing on nutritional status and its association with educational outcomes among adolescents in different areas of Ethiopia. The purpose of this study was to examine whether chronic undernutrition (stunting) in adolescents inEthiopia was correlated with various school performance outcomes. This study was a school-based cross-sectional study conducted in North Shewa zone, Ethiopia. Data were collected through a structured questionnaire. The researchers conductedmultivariable linear regression analyses to investigate the relationship between stunting and four school performance outcomes, which included grade 8 Ministry exam score, all-subjects average score, English score, and Math score. The prevalence of stunting in this sample was 11%. After adjusting for all other variables in the model, stunting was positively associated with the grade eight Ministry exam score (β = -4.96; 95% [CI -7.68, -2.25]; p < 0.001). In the multivariate analyses, sex (being female) was significantly associated with the grade eight Ministry exam score (β = -2.08; 95% CI [-3.81, -0.35]; p = 0.019 ), the all-subjects average score (β = -3.97; 95% CI [-5.51, -2.43]; p < 0.001), English score (β = -3.72; 95% CI [-5.60, -1.84]; p < 0 .001), and Math score (β = -4.87; 95% CI [-7.02, -2.72]; p < 0.001). Residence (living in a rural area) was significantly associated with all-subjects average score (β = -3.93; 95% CI [- 5.81, -2.06]; p < 0.001), English score (β = -2.65; 95% CI [-4.94, -0.35]; p = 0.024), and Math score (β = -3.86; 95% CI [-6.50, -1.22]; p = 0.004). Maternal education (grade 1-8) was significantly associated with English score (β = 5.46; 95% CI [1.31, 9.62]; p = 0.010) and Math score (β = 4.78; 95% CI [0.03, 9.53]; p = 0.049). These findings indicate that further research focusing on adolescent chronic undernutrition and educational outcomes as well as why chronic undernutrition is associated with certain performance outcomes and not others is needed before definitive conclusions can be made. Positive changes in child growth later in a child’s life may have important implications for cognition

Chronic undernutrition and adolescent school performance in central Ethiopia

Chronic undernutrition among adolescents in developing countries has been identified as a major public health issue. Previous research has found associations between chronic undernutrition and academic performance outcomes in adolescents. There is need for localized research focusing on nutritional status and its association with educational outcomes among adolescents in different areas of Ethiopia. The purpose of this study was to examine whether chronic undernutrition (stunting) in adolescents in Ethiopia was correlated with various school performance outcomes. This study was a school-based cross-sectional study conducted in North Shewa zone, Ethiopia. Data were collected through a structured questionnaire. The researchers conducted multivariable linear regression analyses to investigate the relationship between stunting and four school performance outcomes, which included grade 8 Ministry exam score, all-subjects average score, English score, and Math score. The prevalence of stunting in this sample was 11%. After adjusting for all other variables in the model, stunting was positively associated with the grade eight Ministry exam score (β = -4.96; 95% [CI - 7.68, -2.25]; p < 0.001). In the multivariate analyses, sex (being female) was significantly associated with the grade eight Ministry exam score (β = -2.08; 95% CI [- 3.81, -0.35]; p = 0.019 ), the all-subjects average score (β = -3.97; 95% CI [-5.51, - 2.43]; p < 0.001), English score (β = -3.72; 95% CI [-5.60, -1.84]; p < 0 .001), and Math score (β = -4.87; 95% CI [-7.02, -2.72]; p < 0.001). Residence (living in a rural area) was significantly associated with all-subjects average score (β = -3.93; 95% CI [- 5.81, -2.06]; p < 0.001), English score (β = -2.65; 95% CI [-4.94, -0.35]; p = 0.024), and Math score (β = -3.86; 95% CI [-6.50, -1.22]; p = 0.004). Maternal education (grade 1-8) was significantly associated with English score (β = 5.46; 95% CI [1.31, 9.62]; p = 0.010) and Math score (β = 4.78; 95% CI [0.03, 9.53]; p = 0.049). These findings indicate that further research focusing on adolescent chronic undernutrition and educational outcomes as well as why chronic undernutrition is associated with certain performance outcomes and not others is needed before definitive conclusions can be made. Positive changes in child growth later in a child’s life may have important implications for cognition

Health Effects of Overweight and Obesity in 195 Countries over 25 Years

BACKGROUND: Although the rising pandemic of obesity has received major attention in many countries, the effects of this attention on trends and the disease burden of obesity remain uncertain. METHODS: We analyzed data from 68.5 million persons to assess the trends in the prevalence of overweight and obesity among children and adults between 1980 and 2015. Using the Global Burden of Disease study data and methods, we also quantified the burden of disease related to high body-mass index (BMI), according to age, sex, cause, and BMI in 195 countries between 1990 and 2015. RESULTS: In 2015, a total of 107.7 million children and 603.7 million adults were obese. Since 1980, the prevalence of obesity has doubled in more than 70 countries and has continuously increased in most other countries. Although the prevalence of obesity among children has been lower than that among adults, the rate of increase in childhood obesity in many countries has been greater than the rate of increase in adult obesity. High BMI accounted for 4.0 million deaths globally, nearly 40% of which occurred in persons who were not obese. More than two thirds of deaths related to high BMI were due to cardiovascular disease. The disease burden related to high BMI has increased since 1990; however, the rate of this increase has been attenuated owing to decreases in underlying rates of death from cardiovascular disease. CONCLUSIONS: The rapid increase in the prevalence and disease burden of elevated BMI highlights the need for continued focus on surveillance of BMI and identification, implementation, and evaluation of evidence-based interventions to address this problem. (Funded by the Bill and Melinda Gates Foundation.

Anemia and undernutrition among children aged 6–23 months in two agroecological zones of rural Ethiopia

Kedir Teji Roba,1 Thomas P O’Connor,2 Tefera Belachew,3 Nora M O’Brien2 1School of Nursing and Midwifery, College of Health and Medical Science, Haramaya University, Harar, Ethiopia; 2School of Food and Nutritional Science, University College Cork, Cork, Ireland; 3Department of Population and Family Health, College of Public Health and Medical Sciences, Jimma University, Jimma, Ethiopia Background: Child malnutrition during the first 1,000 days, commencing at conception, can have lifetime consequences. This study assesses the prevalence of anemia and undernutrition among children aged 6–23 months in midland and lowland agroecological zones of rural Ethiopia.Methods: Cross-sectional data examining sociodemographic, anthropometry, hemoglobin levels, and meal frequency indicators were collected from 216 children aged 6–23 months and their mothers randomly selected from eight rural kebele (villages).Results: Of 216 children, 53.7% were anemic, and 39.8%, 26.9%, and 11.6% were stunted, underweight, and wasted, respectively. The prevalence of anemia was higher in the lowland agroecological zone (59.5%) than the midland (47.6%). Among those children who were stunted, underweight, and wasted, 63.5%, 66.7%, and 68.0% were anemic, respectively. Child anemia was significantly associated with the child not achieving minimum meal frequency, sickness during the last 2 weeks before the survey, stunting and low body mass index, and with maternal hemoglobin and handwashing behavior. The prevalence of stunting was higher in the lowland agroecological zone (42.3%) than the midland (36.2%). The predictors of stunting were age and sex of the child, not achieving MMF, maternal body mass index, and age. As maternal height increases, the length for age of the children increases (P=0.003).Conclusion: The overall prevalence of anemia and undernutrition among children aged 6–23 months in these study areas is very high. The prevalence was higher in the lowland agroecological zone. Health information strategies focusing on both maternal and children nutrition could be sensible approaches to minimize stunting and anemia. Keywords: child anemia, child stunting, lowland, midland, agroecological zone, rural Ethiopi

Iodine deficiency and its associated factors among primary school children in Anchar district, Eastern Ethiopia

Muzemil Muktar,1 Kedir Teji Roba,2 Bezatu Mengistie,3 Berhe Gebremichael4 1West Hararghe Zone Health Department, Chiro, Ethiopia; 2School of Nursing and Midwifery, Haramaya University, Harar, Ethiopia; 3Department of Environmental Health Science, Haramaya University, Harar, Ethiopia; 4School of Public Health, Haramaya University, Harar, Ethiopia Background: Iodine deficiency is a major public health problem in Ethiopia. Most of the studies in Ethiopia were done on clinical goiter without assessing the subclinical iodine deficiency. Therefore, there was a need to study the magnitude and associated factors of iodine deficiency among school-age children in Eastern Ethiopia. Subjects and methods: A school-based cross-sectional study design was used to assess the iodine level of 200 primary school children aged 6–12 years who were selected by using the multistage sampling technique. The study used an interview-administered questionnaire and checklists to collect data from the respondents. Data were entered to EpiData version 3.1 and exported to SPSS version 22.0 for analysis. Bivariable and multivariable analyses were conducted, and statistical significance was declared at p value ≤0.05. Results: The median urinary iodine concentration of the children was 146 µg/L, and 31% had median urinary iodine concentration below the acceptable level (<100 µg/L). Female sex (adjusted odds ratio [AOR]=3.12, 95% CI: 1.52, 6.39), family size ≥5 (AOR=2.24, 95% CI: 1.06, 4.75), having no awareness of a balanced diet (AOR=3.25, 95% CI: 1.37, 7.71), and cabbage ­consumption ≥2 times per week (AOR=3.01, 95% CI: 1.31, 6.93) were the significant associated factors. Conclusion and recommendation: Ethiopia is implementing the universal iodization of salt. However, urinary iodine deficiency and utilization of inadequately iodized salt were high in the study area. Therefore, the health sectors of the study site should disseminate messages to increase the awareness on iodized salt, iodine-rich foods, and goiterogens. Keywords: iodine deficiency, primary school, children, Anchar distric

Global, regional, and national burden of migraine and tension-type headache, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016

Background Through the Global Burden of Diseases, Injuries, and Risk Factors (GBD) studies, headache has emerged as a major global public health concern. We aimed to use data from the GBD 2016 study to provide new estimates for prevalence and years of life lived with disability (YLDs) for migraine and tension-type headache and to present the methods and results in an accessible way for clinicians and researchers of headache disorders. Methods Data were derived from population-based cross-sectional surveys on migraine and tension-type headache. Prevalence for each sex and 5-year age group interval (ie, age 5 years to ≥95 years) at different time points from 1990 and 2016 in all countries and GBD regions were estimated using a Bayesian meta-regression model. Disease burden measured in YLDs was calculated from prevalence and average time spent with headache multiplied by disability weights (a measure of the relative severity of the disabling consequence of a disease). The burden stemming from medication overuse headache, which was included in earlier iterations of GBD as a separate cause, was subsumed as a sequela of either migraine or tension-type headache. Because no deaths were assigned to headaches as the underlying cause, YLDs equate to disability-adjusted life-years (DALYs). We also analysed results on the basis of the Socio-demographic Index (SDI), a compound measure of income per capita, education, and fertility. Findings Almost three billion individuals were estimated to have a migraine or tension-type headache in 2016: 1·89 billion (95% uncertainty interval [UI] 1·71–2·10) with tension-type headache and 1·04 billion (95% UI 1·00–1·09) with migraine. However, because migraine had a much higher disability weight than tension-type headache, migraine caused 45·1 million (95% UI 29·0–62·8) and tension-type headache only 7·2 million (95% UI 4·6–10·5) YLDs globally in 2016. The headaches were most burdensome in women between ages 15 and 49 years, with migraine causing 20·3 million (95% UI 12·9–28·5) and tension-type headache 2·9 million (95% UI 1·8–4·2) YLDs in 2016, which was 11·2% of all YLDs in this age group and sex. Age-standardised DALYs for each headache type showed a small increase as SDI increased. Interpretation Although current estimates are based on limited data, our study shows that headache disorders, and migraine in particular, are important causes of disability worldwide, and deserve greater attention in health policy debates and research resource allocation. Future iterations of this study, based on sources from additional countries and with less methodological heterogeneity, should help to provide stronger evidence of the need for action. Funding Bill & Melinda Gates Foundation