Children with Moderate Acute Malnutrition with No Access to Supplementary Feeding Programmes Experience High Rates of Deterioration and No Improvement: Results from a Prospective Cohort Study in Rural Ethiopia

Background: Children with moderate acute malnutrition (MAM) have an increased risk of mortality, infections and impaired physical and cognitive development compared to well-nourished children. In parts of Ethiopia not considered chronically food insecure there are no supplementary feeding programmes (SFPs) for treating MAM. The short-term outcomes of children who have MAM in such areas are not currently described, and there remains an urgent need for evidence-based policy recommendations. Methods: We defined MAM as mid-upper arm circumference (MUAC) of ≥11.0cm and <12.5cm with no bilateral pitting oedema to include Ethiopian government and World Health Organisation cut-offs. We prospectively surveyed 884 children aged 6–59 months living with MAM in a rural area of Ethiopia not eligible for a supplementary feeding programme. Weekly home visits were made for seven months (28 weeks), covering the end of peak malnutrition through to the post-harvest period (the most food secure window), collecting anthropometric, socio-demographic and food security data. Results: By the end of the study follow up, 32.5% (287/884) remained with MAM, 9.3% (82/884) experienced at least one episode of SAM (MUAC <11cm and/or bilateral pitting oedema), and 0.9% (8/884) died. Only 54.2% of the children recovered with no episode of SAM by the end of the study. Of those who developed SAM half still had MAM at the end of the follow up period. The median (interquartile range) time to recovery was 9 (4–15) weeks. Children with the lowest MUAC at enrolment had a significantly higher risk of remaining with MAM and a lower chance of recovering. Conclusions: Children with MAM during the post-harvest season in an area not eligible for SFP experience an extremely high incidence of SAM and a low recovery rate. Not having a targeted nutrition-specific intervention to address MAM in this context places children with MAM at excessive risk of adverse outcomes. Further preventive and curative approaches should urgently be considered

Prevalence of premarital sexual practice and associated factors among undergraduate health science students of Madawalabu University, Bale Goba, South East Ethiopia: institution based cross sectional study

Abstract Introduction: Several studies in Sub-Saharan Africa have documented high and increasing premarital sexual activities among adolescents

Dietary Diversity Practice and Associated Factors among Children Aged 6–23 Months in Robe Town, Bale Zone, Ethiopia

Background. Diet diversification is essential to prepare adequate food that is useful for children’s physical and cognitive development. Despite the limited studies performed in different parts of Ethiopia, the information about the feeding practice of children in the current study area is not documented. Thus, this study intended to assess the dietary diversity practices and associated factors among children aged 6–23 months. Methods. Community-based cross-sectional study was conducted on 517 children aged 6–23 months paired with their mothers in Robe town. Systematic sampling technique was applied to select a child-mother pair. Data were collected using a pretested and structured questionnaire. Multivariate logistic regression analyses were used to identify the factors associated with the dependent variable. Adjusted odds ratios with 95% confidence interval were used to assess the strength of association and level of significance. Results. From a total of 508 children included, making a 98% response rate, 77% of them did not meet the minimum dietary diversity. Children aged 12–23 months were more likely fed diversified food when compared with those aged 6–11 months (AOR = 2.99). Mothers whose educational level was secondary and above (AOR = 3.21), had media exposure (AOR = 3.99), and were knowledgeable about diet diversification (AOR = 8.5) were more likely to feed their child diversified food than their counterpart. Children whose father was a merchant were more likely to receive a diversified diet compared to those whose fathers were daily laborers. Conclusions. Inadequate practices of minimum dietary diversity observed in the current study area were mainly associated with the child’s age, maternal education, mothers’ knowledge on diet diversification, and media exposure. Improving knowledge of mothers, increasing their education, and promoting appropriate infant and child feeding practices through media are an important intervention to improve dietary diversity practices

Contagious Bovine Pleuropneumonia: Seroprevalence and Risk Factors in Gimbo District, Southwest Ethiopia

Contagious bovine pleuropneumonia (CBPP) is a highly contagious disease of cattle which is one of the great plagues which continues to devastate the cattle herds on which so many people are dependent in Africa. Cross-sectional study was conducted from October 2015 to August 2016 to determine the seroprevalence of CBPP in cattle and associated risk factors in Gimbo district, Southwest Ethiopia. A total of 384 serum samples were collected and tested for the presence of specific antibodies against Mycoplasma mycoides subspecies mycoides small colony (MmmSC), using a competitive enzyme-linked immunosorbent assay (cELISA). Univariable and multivariable logistic regression analysis were performed to determine the association between risk factors and seroprevalence of CBPP. An overall seroprevalence of CBPP was 8.1% (31/384) and it was ranging from 0% to 20% across different Peasant associations (PAs). The seroprevalence of CBPP among adult animals was 8.5% (25) and in young 6.6% (6), in good body condition animals 6.6% (18) and in poor 11.5% (13), in dry season 11.9% (20) and in rainy 5.1% (11), and in highland altitude 2.5% (3), midland 3.8% (5), and lowland 17.4% (23). Among the potential predisposing factors assessed, altitude was found significantly (p = 0.02, OR = 7.3) associated with the seroprevalence of contagious bovine pleuropneumonia and other risk factors had no significant (P > 0.05) influence. The present study showed that the overall seroprevalence of CBPP in Gimbo district was high and this indicates a need for intervening and implementing control measures to prevent further spread of the disease in the district through the use of better and coordinated vaccination program

Subject flow diagram.

<p>Subject flow diagram.</p

Agricultural calendar of Jimma zone and study implementation period.

<p>Agricultural calendar of Jimma zone and study implementation period.</p

Baseline household and child characteristics.

<p>Baseline household and child characteristics.</p

Predictors of occurrence of severe acute malnutrition based on parameters at enrolment: bivariate and Cox proportional hazards analyses^†.

<p>Predictors of occurrence of severe acute malnutrition based on parameters at enrolment: bivariate and Cox proportional hazards analyses<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0153530#t004fn001" target="_blank">^†</a>.</p

Distribution of outcomes based on the WHO (2009) MUAC based operational definitions.

<p>Distribution of outcomes based on the WHO (2009) MUAC based operational definitions.</p

Survival curve for developing Severe Acute Malnutrition as per Ethiopian operational criteria (MUAC <11cm or bilateral pitting oedema), stratified by MUAC category at enrolment.

<p>Survival curve for developing Severe Acute Malnutrition as per Ethiopian operational criteria (MUAC <11cm or bilateral pitting oedema), stratified by MUAC category at enrolment.</p