Zinc deficiency among pregnant women around Lake Awasa, Hawassa City, Ethiopia: a cross-sectional analysis.

Zinc deficiency (ZD) during pregnancy has far-reaching consequences on the mother, fetus and subsequent child survival. Therefore, the present study aimed to assess the prevalence and associated factors of ZD among pregnant women around Lake Awasa, Hawassa City, Ethiopia. To this end, a facility-based cross-sectional study was conducted on 333 randomly sampled pregnant women from 08 April to 08 May 2021. The socio-economic, dietary intake, water, sanitation and hygiene, obstetric, and maternal health data were collected through face-to-face interviews. Moreover, on-spot blood and stool samples were taken. Descriptive statistics and binary and multivariable logistic regression analysis were conducted. The prevalence of ZD was 58⋅6 % (95 % CI 53⋅31, 63⋅89). The poorest (AOR = 3⋅28; 95 % CI 1⋅26, 8⋅50) and poor (AOR = 2⋅93; 95 % CI 1⋅14, 7⋅54) wealth quintiles, four of more family size (AOR = 1⋅84, 95 % CI 1⋅10, 3⋅35), poor dietary diversity (AOR = 4⋅11; 95 % CI 2⋅11, 7⋅62), not eating snacks (AOR = 3⋅40; 95 % CI 1⋅42, 8⋅15), not consuming fish (AOR = 3⋅53; 95 % CI 1⋅65, 7⋅56) and chicken (AOR = 2⋅53; 95 % CI 1⋅31, 4⋅88) at least once a month, and intestinal parasitic infection (AOR = 2⋅78; 95 % CI 1⋅52, 5⋅08) predicted zinc deficiency. In conclusion, ZD is a public health problem among pregnant women around Lake Awasa. The present study demonstrated that poor socio-economic status, large family size, poor nutritional practices and intestinal parasitic infection determine the zinc status in the present study area. The findings suggest the need for further analysis to deepen the understanding about ZD and consideration of livelihood in interventions to prevent and control ZD among pregnant women in Hawassa City, Ethiopia.

Utilization and compliance with iron supplementation and predictors among pregnant women in Southeast Ethiopia.

Anemia is predicted to affect 38% (32 million) of pregnant women worldwide. However, evidence for utilization and compliance with iron supplementation and predictors during pregnancy in low-income countries, including Ethiopia, is sparse and inconclusive. Therefore, we aimed to assess utilization and compliance with iron supplementation and predictors among pregnant women in Robe Town, Southeast Ethiopia. A community-based cross-sectional study was employed among randomly selected 445 pregnant women attending antenatal care at health facilities from May to July 2015. A systematic random sampling was used to select respondents. Data were collected using a pre-tested, interviewer-administered, structured questionnaire. Bivariable and multivariable logistic regression analyses were conducted to identify predictors of compliance with iron supplementation. An odds ratio, along with a 95% confidence interval (CI), was used to estimate the strength of the association. In this study, 54% [95% CI (49.4, 58.4%)], 45.2% [95% CI (40.9, 49.4%)], 4.3% [95% CI (2.5, 6.3%)], and 2.2% [95% CI (1.1, 3.6%)] of women received iron supplements during their first, second, third, and fourth antenatal care visits, respectively. The level of compliance with iron supplementation was 92.4% [95% CI (89.9, 94.6%)]. Having a formal education (AOR = 4.45, 95% CI 1.41, 13.99), being in the high wealth quintile (AOR = 0.18, 95% CI 0.05, 0.68), medium wealth quintile [(AOR = 0.33, 95% CI (0.11, 0.98)], receiving iron supplements for free (AOR = 3.77, 95% CI 1.33, 10.69), not experiencing discomfort related to iron supplements intake (AOR = 2.94, 95% CI 1.17, 7.39), having comprehensive knowledge about anemia (AOR = 2.62, 95% CI 1.02, 6.70), being knowledgeable about iron supplements (AOR = 3.30, 95% CI 1.12, 9.76), having information about importance of iron supplementation during pregnancy (AOR = 2.86; 95% CI 1.04, 7.87), and ever being visited by urban health extension workers (AOR = 0.31; 95% CI 0.12, 0.83) was significantly associated with compliance with iron supplementation during pregnancy. The utilization of iron supplementation during pregnancy was low, with relatively high compliance with the supplements. Thus, comprehensive nutrition education and free provision of iron supplementation are crucial tools to increase utilization and compliance with iron supplementation during pregnancy. Further research with a strong study design using golden standard methods is warranted.

Effect of maternal employment on child nutritional status in Bale Robe Town, Ethiopia: a comparative cross-sectional analysis.

Adequate nutrition is essential for early childhood to ensure healthy growth, proper organ formation, and function, a strong immune system, neurological and cognitive development. The main aim of the present study was to assess the effect of maternal employment on nutritional status among children aged 6-23 months in the town of Bale Robe, Ethiopia. A community-based comparative cross-sectional study was conducted on about 597 (293 unemployed and 304 employed) having children aged 6-23-month-old children sampled were employed with a multistage sampling technique. A face-to-face interview was conducted using a structured pretested questionnaire. Descriptive statistics, binary and multivariable logistic regression analyses were used for the statistical analysis. The magnitude of stunting (39.9 %), underweight (39⋅9 %) and wasting (22⋅2 %) was greater in 6-23-month-old children born to employed mothers than their counterparts in unemployed ones [stunted (31⋅3 %), underweight (24⋅0 %) and wasted (11⋅8 %)]. Being a girl [AOR 0⋅31; 95 % CI (0⋅17, 0⋅54)] in employed mothers and [AOR 0⋅29; 95 % CI (0⋅16, 0⋅51)] in unemployed people significantly protected stunting. This study demonstrated that the nutritional status of 6-23-month-old children is better among unemployed mothers than among employed mothers. Therefore, concerted efforts may decrease child undernutrition in a study area.

Nutritional Status and Its Association with Cognitive Function among School Aged Children at Soddo Town and Soddo Zuriya District, Southern Ethiopia: Institution Based Comparative Study.

About 1 billion stunted school-aged children are growing up with impaired mental development which can lead to low cognitive performance, reduced school achievement, and low productivity. But there is scarce evidence on cognitive function, school performance and their associated factors among school aged children. The main aim of this study was to assess cognitive function, school performance and determine their association with nutritional status among school children aged 7 to 10 years at Soddo Town and Soddo Zuriya Woreda, Wolaita Zone, Southern Ethiopia. Institutional comparative cross-sectional study was conducted on a total sample of 178 primary school children. The Raven's Color Progressive Matrices (RCPM) and selected tests from Kaufman assessment battery for children second edition were used. Mid-year average students' examination result was also used. Data were analyzed by using SPSS version 25, WHO Anthro plus, and independent sample t-test. Bivariate and multivariate linear regression analyses were also used. Mean (±SD) cognitive test scores of urban study participants was 18.7 ± 3.4 for RCPM which was higher (P < .001) as compared to rural (16.5 ± 3.3). The urban mean cognitive test scores was also higher for both pattern reasoning and visual processing with (P < .001) as compared to rural counterparts. School performance was higher (P < .001) for urban. Maternal education (P < .002) and wealth index (P < .006) were positively predicted while stunting (P < .001) negatively predicted cognitive function test scores and school performance. Cognitive function and school performance of study participants were associated with their nutritional status and rural participants had significantly lower mean scores as compared to urban counterparts. Further study should be done to community level.

Socio-economic Variables Associated with Motivational Barriers of Food Choice among Lactating Women from Central Ethiopia: A Cross-sectional Study.

Understanding the drivers of food choice is essential to guide the nutrition interventions and tailor nutrition counseling messages. There is strong evidence from a published study, which demonstrate attention for the need to consider the wide range of drivers during food choice. Due to the large variety of food products on the market, consumers make a multitude of food choice daily. The study aimed to assess major motivational drivers of food choice among randomly selected lactating women aged 15-49 years (423) from Debrebirhan Town using face to face interview. Logistic regression analysis was used to find association b/socio-economic variables and motivational drivers of food choice using SPSS version 20. Candidate variables were selected and transferred using the P- a value of less than 0.25, and AOR was reported. Variables with a P-value less than 0.05 on multiple variable logistic regressions were taken as significant variables. Influences of religion, price, preparation convenience, health value and taste during food choice were responded by above half of women. From logistic regression, 15-25 years' age and self-employed were linked to religious influence in food choice with AOR (95%CI) of 0.09(0.01-0.48) and 4.13(1.4-12.24). Age (15-25 and 26-35 years), education (no, primary and secondary) and being housewife were associated to choosing of foods for their health value with AOR (95%CI) of 0.26(0.12-0.6), 0.37(0.18-0.76), 0.14(0.04-0.42), 0.25(0.13-0.54), 0.33(0.17-0.66) and 2.5(1.23-5). Only family size (2-4 vs.>4 persons) was associated with price concern in food choice with AOR (95%CI) of 0.39(0.21-0.71). Being divorced, husband headed, 7-12 and13-18 month lactation period, 15-25 and 26-35 years' age were related to preparation convenience of foods with AOR (95%CI) of 5.94(1.13-31.33), 0.42(0.18-0.96), 3.26(1.34-7.93), 4.4(1.81-10.72), 0.16(0.05-0.47) and 0.25(0.11-0.59). Self-management approaches by nutrition education and promotion to change eating behaviors of women, increasing supply and price regulation toward healthy foods are recommended.

Validation of the CIMI-Ethiopia Program and Seasonal Variation in Maternal Nutrient Intake in Enset (False Banana) Growing Areas of Southern Ethiopia.

BACKGROUND: Tools for the rapid and accurate analysis of nutrient intakes from diets of individuals in Southern Ethiopia are lacking. The Calculator of Inadequate Micronutrient Intake program for Ethiopia (CIMI-Ethiopia) has been developed to overcome this problem. CIMI-Ethiopia also computes protein and energy intakes from the diet. The objectives of the current study were to validate CIMI-Ethiopia for the dietary pattern of Southern Ethiopia, and assess the nutrient intakes in postharvest dry and lean wet seasons. METHODS: 24-h dietary recall (24HR) data was collected from 578 women of a reproductive age in postharvest dry and lean wet seasons in 2017. For analysis, 24HR data was entered into NutriSurvey (NS), which was the reference nutrition software, and then into CIMI-Ethiopia. For validation, the mean and standard deviation (SD) of the difference between CIMI-Ethiopia and NS were computed. The percentage of participants with an inadequate intake was calculated. The correlation between CIMI-Ethiopia and NS results was determined. The nutrient intakes in postharvest dry and lean seasons were compared. RESULTS: Among the nutrients, pantothenic acid, vitamin B1, and protein showed a very high accuracy in CIMI-Ethiopia calculation (|difference (D)| < 5.0% of the NS result). Nutrients with a good accuracy (|D| = 5%-15%) were iron, zinc, magnesium, vitamin B12, vitamin B6, and energy. The accuracy for calcium, niacin, and vitamin A was moderate (|D| = 15%-30%). The intakes calculated by CIMI-Ethiopia and NS of iron, zinc, magnesium, calcium, B-complex vitamins, vitamin A, protein, and energy were highly correlated (r = 0.85-0.97, p < 0.001). NS analysis identified a significant reduction in the mean intake of iron; zinc; magnesium; pantothenic acid; vitamin B1, B12, and D; protein; and energy in the lean wet season; however, calcium and vitamin A intake increased. CONCLUSIONS: It has been found that CIMI-Ethiopia is a valid tool for estimating nutrient intakes at an individual level in Southern Ethiopia. The study demonstrated a decline in intakes of iron; zinc; magnesium; pantothenic acid; vitamin B1, B12, and D; protein; and energy in the lean wet season. This result provides some hint for fortification and supplementation programs that aim to combat maternal malnutrition in rural Southern Ethiopia.

Dietary Diversity and Anthropometric Status of Mother-Child Pairs from Enset (False Banana) Staple Areas: A Panel Evidence from Southern Ethiopia.

BACKGROUND: A sizable cross-sectional studies demonstrated a low dietary diversity in Southern Ethiopia. However, its seasonal trend has not been well studied in areas where nutrient-poor enset (false banana (Ensete ventricosum)) foods are major staple. Moreover, there is scarcity of information on seasonal nature of anthropometric status of mother-child pairs (MCP) from the same areas in Southern Ethiopia. Therefore, the present study aimed to investigate the dietary diversity and anthropometric status of MCP in postharvest dry and lean wet seasons and identify factors associated with anthropometric status. METHODS: The dietary intake and anthropometric data were collected from 578 households (578 mothers and 578 children) January-June 2017. The study compared data of the two seasons using McNemar's test for dichotomous, Wilcoxon signed-rank test for non-normally distributed, and paired samples t-test for normally distributed continuous data. Logistic regression was conducted to identify risk factors for malnutrition. In addition, Spearman's Rho test was used to determine correlations between maternal and child variables. RESULTS: Over 94% of the mothers did not fulfil the minimum diet diversity score in both seasons. The meal frequency and pulses/legumes intake significantly declined in lean wet season; however, dark green leaves consumption increased. Meat, poultry, and fish consumption dropped to almost zero in the lean wet season. The dietary diversity and anthropometric status of the MCP were correlated. Weight-for-age (WAZ) and weight-for-height (WHZ) of children significantly declined in the lean wet season. In the same way, maternal mid upper arm circumference (MUAC), body weight, and body mass index (BMI) dropped (p < 0.001) in this season. Being pregnant and a lactating mother, poverty, and the ability to make decisions independently predicted maternal undernutrition (low MUAC). On the other hand, maternal undernutrition and education were associated with child underweight. CONCLUSIONS: The results demonstrated that the dietary diversity of MCP is low in both postharvest dry and lean wet seasons. This suggests the need for continuous nutrition intervention to improve the dietary diversity. In addition, the anthropometric status of MCP declines in lean wet season. This may provide some clue for policy targeting on improving nutritional status of mothers and children in rural Southern Ethiopia.

Time-to-recovery from severe acute malnutrition in children 6-59 months of age enrolled in the outpatient treatment program in Shebedino, Southern Ethiopia: a prospective cohort study.

BACKGROUND: In Ethiopia uncomplicated severe acute malnutrition (SAM) is managed at health posts level through the outpatient therapeutic program (OTP). Yet, evidence on the treatment success rate of the program is scarce. This study determines the treatment outcomes and predictors of time-to-recovery among children 6-59 months of age with SAM managed at the health posts level in Shebedino district, Southern Ethiopia. METHODS: This was a prospective cohort study that enrolled 216 children with SAM identified through a campaign conducted in May 2015 and treated over eight weeks at 25 health posts of the district. The average time-to-recovery was estimated using Kaplan-Meier survival curve and the independent predictors of the recovery were determined using multivariable Cox-proportional hazard model. The outputs of the analyses are presented via adjusted hazard ratio with 95% confidence intervals (AHR, CI). RESULTS: At the end of the eight weeks of treatment 79.6% (95% CI: 74.2-85.0%) of cases recovered from SAM with a weight gain rate of 5.4 g/kg/day. The median time-to-recover was 36 days. The analysis indicated, maternal illiteracy (0.54, 0.38-0.78), severe household food insecurity (0.47, 0.28-0.79), walking for more than 1 h to receive the treatment (0.69, 0.50-0.96), diarrhoea co-morbidity (0.63, 0.42-0.91) and practicing sharing of ready to use therapeutic food (RUTF) (0.53, 0.32-0.88) were associated with slower propensity of recovery from SAM. Children who were enrolled with marasmus diagnosis showed lower recovery than children with kwashiorkor (0.30, 0.18-0.51). CONCLUSION: The median time-to-recover was 36 days. Discouraging sharing of RUTF, appropriate management of diarrhoea in SAM cases and improving access to OTP sites can help to improve the treatment outcome for SAM.

Women's and children's acceptance of biofortified quality protein maize for complementary feeding in rural Ethiopia.

BACKGROUND: For impact of nutritionally improved biofortified crops, consumer acceptance specifically by women and children is necessary when the target beneficiaries are young children. The objective was to assess women's and children's acceptance of a biofortified crop, quality protein maize (QPM), for complementary feeding in rural Ethiopia. RESULTS: Randomly sampled mothers (n = 61) of young children (6-24 months) evaluated flours from a QPM and a conventional maize variety for five sensory characteristics and overall acceptance by mother and child in a home use test with a double-blind, randomized controlled cross-over design. Women distinguished the varieties when used to prepare porridge, and QPM scored more favorably for texture in hand and mouth (both P < 0.05). The varieties did not differ in overall acceptance, which was, however, affected by order of presentation, mothers' number of children, and enumerators who collected data (all P < 0.05). Aroma and taste were key in mothers' acceptance, and appearance was further important for children. Women were more than twice as likely to prefer QPM over conventional maize. CONCLUSION: Consumer acceptance is unlikely to impede uptake and impact of QPM on young children's nutritional status. Home use testing proved feasible for assessing acceptance in rural areas with food insecurity and limited education. © 2015 Society of Chemical Industry.