Spatial distribution of iron rich foods consumption and its associated factors among children aged 6-23 months in Ethiopia: spatial and multilevel analysis of 2016 Ethiopian demographic and health survey.

BACKGROUND: Micronutrient deficiencies are the most prevalent nutritional deficiencies that cause serious developmental problems in the globe. The aim of this study was to assess the spatial distribution of iron rich foods consumption and its associated factors among children aged 6-23 months in Ethiopia. METHODS: The data retrieved from the standard Ethiopian Demographic and Health Survey 2016 dataset with a total sample size of 3055 children aged 6-23 months. Spatial scan statistics done using Kuldorff's SaTScan version 9.6 software. ArcGIS version 10.7 software used to visualize spatial distribution for poor consumption of iron rich foods. Multilevel mixed-effects logistic regression analysis employed to identify the associated factors for good consumption of iron-rich foods. Level of statistical significance was declared at a two-sided P-value < 0.05. RESULTS: Overall, 21.41% (95% CI: 19.9-22.9) of children aged 6-23 months had good consumption of iron rich foods in Ethiopia. Poor consumption of iron rich foods highly clustered at Southern Afar, Southeastern Amhara and Tigray, and the Northern part of Somali Regional States of Ethiopia. In spatial scan statistics, children aged 6-23 months living in the most likely cluster were 21% more likely vulnerable to poor consumption of iron rich foods than those living outside the window (RR = 1.21, P-value < 0.001). Child aged 12-17 months (AOR = 1.90, 95% CI: 1.45-2.49) and 18-23 months (AOR = 2.05, 95% CI: 1.55-2.73), primary (AOR = 1.42, 95% CI:1.06-1.87) and secondary and above (AOR = 2.26, 95% CI: 1.47-3.46) mother's education level, rich (AOR = 1.49, 95% CI: 1.04-2.13) and middle (AOR = 1.83, 95% CI: 1.31-2.57) household wealth status, Amhara (AOR = 0.24, 95% CI: 0.09-0.60), Afar (AOR = 0.38, 95% CI: 0.17-0.84), and Harari (AOR = 2.11, 95% CI: 1.02-4.39) regional states of Ethiopia were statistically significant factors for good consumption of iron rich foods. CONCLUSION: Overall, the consumption of iron rich foods was low and spatially non-random in Ethiopia. Federal Ministry of Health and other stakeholders should give prior attention to the identified hot spot areas to enhance the consumption of iron rich foods among children aged 6-23 months.

Nitric oxide production in the exhaled air of patients with pulmonary tuberculosis in relation to HIV co-infection.

BACKGROUND: Nitric oxide (NO) is essential for host defense in rodents, but the role of NO during tuberculosis (TB) in man remains controversial. However, earlier observations that arginine supplementation facilitates anti-TB treatment, supports the hypothesis that NO is important in the host defense against TB. Local production of NO measured in fractional exhaled air (FeNO) in TB patients with and without HIV co-infection has not been reported previously. Thus, our aim was to investigate levels of FeNO in relation to clinical symptoms and urinary NO metabolites (uNO). METHODS: In a cross sectional study, FeNO and uNO were measured and clinical symptoms, chest x-ray, together with serum levels of arginine, tumor necrosis factor alpha (TNF-alpha) and interleukin 12 (IL-12) were evaluated in sputum smear positive TB patients (HIV+/TB, n = 36, HIV-/TB, n = 59), their household contacts (n = 17) and blood donors (n = 46) from Gondar University Hospital, Ethiopia. RESULTS: The proportion of HIV-/TB patients with an increased FeNO level (> 25 ppb) was significantly higher as compared to HIV+/TB patients, but HIV+/TB patients had significantly higher uNO than HIV-/TB patients. HIV+ and HIV-/TB patients both had lower levels of FeNO compared to blood donors and household contacts. The highest levels of both uNO and FeNO were found in household contacts. Less advanced findings on chest x-ray, as well as higher sedimentation rate were observed in HIV+/TB patients as compared to HIV-/TB patients. However, no significant correlation was found between FeNO and uNO, chest x-ray grading, clinical symptoms, TNF-alpha, IL-12, arginine levels or sedimentation rate. CONCLUSION: In both HIV negative and HIV co infected TB patients, low levels of exhaled NO compared to blood donors and household were observed. Future studies are needed to confirm whether low levels of exhaled NO could be a risk factor in acquiring TB and the relative importance of NO in human TB.