Burden and determinants of anemia among lactating women in Ethiopia: evidence from demographic health survey.

Globally one-third of global population are victims of anemia, significantly impacting maternal and infant health and linked to poor cognition, productivity, and mortality risks. We used randomly selected 4040 lactating mothers' record from nationally representative survey. Descriptive statistics were weighted, and the standard hemoglobin cutoff point (below 12 g/dl) was used. Bivariable and multivariable multilevel binary logistic regression model considering the individual and community-level factors associated with anemia was employed. Crude and adjusted odds ratios with a 95% confidence interval were reported. In Ethiopia, 32.3% (95% CI 30.9-33.7%) of lactating women were anemic, with 23.4% having mild, 7.3% moderate, and 1.2% severe anemia. Pastoral regions (Afar, Somalia, and Oromia region) had higher burden of anemia than the others. The advanced age of the mother above 45 years (AOR = 1.43 (1.11-1.82), unemployment (AOR = 1.19; 95% CI 1.08-1.32), household wealth index (AOR = 0.56; 95% CI 0.50-0.63), extended family size (AOR = 1.20; 95% CI 1.04-1.46), and not using family planning (AOR = 1.70; 95% CI 1.49-1.93) were significant factors associated with anemia. Anemia is a moderate public health problem and associated with location and other factors to be addressed via effective interventions.

Extent and Correlates of Self-Medication Practice among Community-Dwelling Adults in Eastern Ethiopia.

Background: The use of medications without proper medical consultations poses significant health risks, drug resistance, and undiagnosed disease conditions, becoming a major pharmaceutical challenge in the 21st century. This study assessed the magnitude and associated factors of self-medication practice among adults in parts of Ethiopia. Methods: A community-based cross-sectional study was conducted among 647 randomly selected adults residing in randomly selected households in eastern Ethiopia via a stratified sampling approach. A pretested interviewer-administered questionnaire was used to collect the data on self-medication practice. Data were presented using tables, frequencies, percentages, and graphs. A multivariable binary logistic regression was done to identify factors associated with self-medication practice and presented as an adjusted odds ratio along with its 95% CI. Associations with a p value below 5% were used to declare statistical significance. Results: A total of 647 adults with a mean age of 41.7 (11.4) years were included. Overall, 15.8% (95% CI: 12.5-18.2) of them reported to have practiced self-medication in the past month, while 67.9% (95% CI: 64.1-74.7) have practiced self-medication, mainly due to the mild nature of the symptom (11%), intention to get a rapid cure (12.2%), physical accessibility (9.1%), and less confidence in the quality of health facility services (3.7%). The majority of the drugs were in the form of oral tablets in the antibiotic, antipain, and gastrointestinal categories. Female (AOR = 1.66 and 95% CI: 0.76-3.61), larger family size (AOR = 1.34 and 95% CI: 0.73-2.46), illiteracy (AOR = 4.47 and 95% CI: 1.17-17.1), poor socioeconomic class (AOR = 4.6795 and CI: 1.71-12.7), perceived health facility visit stay as long (AOR = 1.55 and 95% CI: 0.80-3.00), khat use (AOR = 2.86 and 95% CI: 1.27-6.47), cigarette smoking (AOR = 2.86 95% CI: 1.27-6.47), and poor knowledge on proper medication use (AOR = 7.98 and 95% CI: 4.61-13.8) were associated with increased odds of self-medication. Conclusion: The practice of self-medication is a health concern and is associated with lower socioeconomic class, illiteracy, substance abuse, a perceived long stay at a health facility, and poor knowledge of medication use. Behavioral interventions targeting this segment of the population via various approaches would help.

Major dietary patterns of community dwelling adults and their associations with impaired blood glucose and central obesity in Eastern Ethiopia: Diet-disease epidemiological study.

BACKGROUNDS: Unhealthy dietary intake is an important preventable risk factor for obesity and impaired blood glucose (IBG), ultimately increasing the risk of non-communicable diseases. When compared to individual food intakes, dietary patterns are a stronger predictor of health outcomes and should be systematically evaluated where such evidence is lacking. This study evaluated dietary patterns and their association with the risk of central obesity and IBG among adults. METHODS: A community-based survey was conducted among 501 randomly-selected adults from Eastern Ethiopia. Data was collected using a semi-structured questionnaire during a face-to-face interview that included sociodemographic and lifestyle factors, as well as a validated 89-item food frequency questionnaire (collected over one month). Principal component analysis was used to derive the dietary pattern. While central obesity was assessed using waist and/or hip circumference measurements, fasting blood sugar was used for IBG. A multivariable logistic regression model was fitted with an odds ratio, 95% confidence intervals, and p-values reported. RESULTS: A total of 501 adults (95.3%) were interviewed, with a mean age of 41 years (±12). Five major dietary patterns explaining 71% of the total variance were identified: "nutrient-dense foods", "high fat and protein", "processed foods", "alcohol drinks", and "cereal diets". While 20.4% (17.0-24.2%) had IBG, 14.6% (11.8-17.9) were centrally obese, and 94.6% (92.3-96.3) had an increased waist-to-hip circumference ratio. Central obesity is associated with upper wealth status (AOR = 6.92; 2.91-16.5), physical inactivity (AOR = 21.1; 2.77-161.4), a diet high in nutrient-dense foods (AOR = 1.75; 0.75-4.06), processed foods (AOR = 1.41; 0.57-3.48), and cereal diets (AOR = 4.06; 1.87-8.82). The burden of IBG was associated with upper wealth status (AOR = 2.36; 1.36-4.10), physical inactivity (AOR = 2.17; 0.91-5.18), upper tercile of nutrient-dense foods (AOR = 1.35; 0.62-2.93), fat and protein diet (AOR = 1.31; 0.66-2.62), and cereal diet consumption (AOR = 3.87; 1.66-9.02). CONCLUSION: IBG and central obesity were prevalent and predicted by upper tercile consumption of nutrient-dense foods, high fat and protein diets, processed foods, and cereal diets, which could guide dietary interventions.

Waist-to-hip circumference and waist-to-height ratio could strongly predict glycemic control than body mass index among adult patients with diabetes in Ethiopia: ROC analysis.

BACKGROUND: Poorly controlled blood glucose is prevalent and contributes to the huge burden of diabetes related morbidity, and central obesity has a great role in the pathogenesis of diabetes and its adverse complications, which could predict such risks, yet evidence is lacking. Hence, this paper is to evaluate the predictive performance of central obesity indices for glycemic control among adult patients with diabetes in eastern Ethiopia. METHODS: A survey of 432 randomly chosen patients with diabetes was conducted using a pretested questionnaire supplemented by chart review, anthropometrics, and biomarkers by trained data collectors. The poor glycemic control was assessed using a fasting blood glucose (FBS) level of above 130 and/or an HgA1c level above 7%. Weight, height, waist circumference (WC), and hip circumference (HC) were measured under standard procedures and we calculated waist-to-hip circumference ratio (WHR) and waist-to-height ratio (WHtR). The receiver operating characteristics curve was used to assess the predictive performance of obesity indices for glycemic control using area under the curve (AUC) and corresponding validity measures. RESULTS: A total of 432 (92%) patients with diabetes were enrolled with a mean age of 49.6 (±12.4) years. The mean fasting blood glucose level was 189 (±72) mg dl-1 where 330 (76.4%) (95% CI: 74.4-78.4%) and 93.3% of them had poor glycemic control based on FBS and HgA1c, respectively. WC (AUC = 0.90; 95% CI: 0.85-0.95), WHR (AUC = 0.64; 95% CI: 0.43-0.84), and WHtR (AUC = 0.87; 95% CI: 0.83-0.94) have a higher predictive performance for poor glycemic control at cut-off points above 100 cm, 0.95, and 0.62, respectively. However, obesity indices showed a lower predictive performance for poor glycemic control based on FBS. Body mass index (BMI) had a poor predictive performance for poor glycemic control (AUC = 0.26; 95% CI: 0.13-0.40). CONCLUSIONS: Poor glycemic control is a public health concern and obesity indicators, typically WC, WHR, and WHtR, have a better predictive performance for poor glycemic control than BMI.

Validity and Predictive Performance of Mini Nutritional Assessment Tool for Institutionalized Elders in Ethiopia.

Background: Despite the high burden of malnutrition in the country, there is a lack of a simple and valid tool to screen elders in Ethiopia. The Mini Nutritional Assessment (MNA) tool has been validated for comprehensive geriatric assessment to identify malnutrition in other countries. However, there is a lack of evidence on the potential validity and reliability of the tool for institutionalized elders in Ethiopia. This study was aimed at determining the validity and predictive performance of MNA tool for malnutrition among Ethiopian institutionalized elderly. Methods: A facility-based survey was conducted on randomly selected 164 elders in geriatric centers to evaluate the validity, reliability, and predictive performance of full MNA against hemoglobin (Hgb) and ideal body weight (IBW) measured under standard procedures. The data was presented in ROC graphs, and reliability was evaluated with Cronbach alpha. The receiver-operating characteristic curve (ROC) analysis was used to assess the predictive performance of the tool. The area under the curve (AUC) with its 95% CI was reported. The Youden index, at maximum sensitivity and specificity, was used to obtain optimal cutoff points. Results: The internal consistency of the tool was good (α = 0.80). The full MNA score can better predict Hgb (AUC = 0.845; 0.783-0.899) and percentage of IBW (AUC = 0.90; 0.842-0.941) at specified cutoff points. A full MNA can predict malnutrition or risk of malnutrition based on percentage IBW at a sensitivity and specificity of 97.3% and 72.2%, respectively. Conclusions: The full MNA has the potential to be a reliable and valid nutritional assessment tool for institutional elders.