Magnitude and factors associated with adherence to Iron-folic acid supplementation among pregnant women in Eritrean refugee camps, northern Ethiopia.

BACKGROUND: Globally, anemia is a public health problem affecting the life of more than two billion people. Pregnant women are at high risk of iron deficiency anemia due to increased nutrient requirement during pregnancy. Iron-folic acid supplementation is the main strategy for prevention and control of iron deficiency anemia and its effectiveness depends on adherence to Iron-Folic Acid tablets. In the refugee camps of Ethiopia, despite the efforts made to reduce iron deficiency anemia during pregnancy, information about adherence to iron-folic acid supplementation and its associated factors are lacking. The objective of this study was to assess magnitude and factors associated with adherence to iron-folic acid supplementation, among pregnant women, in Shire refugee camps. METHODS: Institution based cross-sectional study with mixed design (quantitative and qualitative) was carried out among pregnant women in Shire refugee camps from September to November 2015. For quantitative data, a sample of 320 pregnant women was systematically selected and data were collected via interview administered structured questionnaire. Quantitative data were coded and entered into Epi-info version 3.5.1 and exported into a statistical package for social sciences (SPSS) Version 19.0 software for analysis. Bivariable and multivariable logistic regressions were employed to identify the predictors at p-value < 0.2 and 0.05 respectively. For the qualitative part, six focus group discussions and three key informant interviews were conducted on purposely-selected individuals. Open-Code version 3.6.2.0 was used for analysis. Identified themes were arranged into coherent groupings and triangulated with quantitative findings. RESULTS: The adherence rate was found to be 64.7% [95% CI (59.7%, 70.0%)]. Women who were having lower knowledge about anemia [AOR; 0.23 95% CI (0.14, 0.38)] and not receiving information about importance of iron-folic acid supplementation [AOR; 0.43 95% CI (0.25, 0.74)] were negatively associated with adherence to iron and folic acid., Having four or more antenatal care visits [AOR; 2.83 95% CI (1.46, 5.48)] were positively significantly associated with adherence to iron-folic acid supplementation. CONCLUSIONS: Adherence rate of iron-folic acid supplementation during pregnancy in the study area is relatively low. Proper counseling and health promotion about Iron-Folic Acid tablet intake, promoting the benefits of early and frequent ANC visit, health promotion on anemia prevention and health benefits of the importance of iron-folic acid supplements are recommended to increase adherence with iron-folic acid supplementation.

Prevalence and factors associated with intestinal parasites among food handlers of food and drinking establishments in Aksum Town, Northern Ethiopia.

BACKGROUND: Various epidemiological studies indicate that the prevalence of intestinal parasites is high in developing countries and those parasites are major public health importance in Sub-Saharan Africa. Their distribution is mainly associated with poor personal hygiene, environmental sanitation and lack of access to clean water. This study was conducted to estimate the prevalence of intestinal parasitic infection and identify factors associated with intestinal parasitic infection among food handlers in the Aksum Town of Tigray Regional State, North Ethiopia. METHODS: A cross-sectional study design was used among 400 randomly selected food handlers who were selected as respondents. Data were collected by face to face interviewer administered questionnaire supplemented with observational checklist. Fresh stool samples were collected from respondents and were examined microscopically for the presence of any of intestinal parasites using standard laboratory methods. Multivariable logistic regression model using Adjusted Odds Ratio (AOR) and 95% Confidence Interval (CI) was fitted to analyze the independent predictors of intestinal parasitic infections. RESULT: The mean age of the food handlers included in this study was 26.0 years. Of the total respondents, 72.5% were females, 63% have completed at least secondary school educational level. Five species of Intestinal Parasites (IPs) were identified. The overall prevalence of being infected with at least one intestinal parasite was 14.5%, 95% CI (11.3, 18.0). The odds of being positive for at least one intestinal parasitic infection was 12.3 times higher among food handlers who practice medical checkup every 9 months compared to those who have a medical checkup every 3 months. The odds of being positive for intestinal parasitic infection was 3 times higher among food handlers with no formal education compared to those who have a level of education secondary school and above. Food handlers who received food hygiene and safety training were 66% less likely to be positive for at least one intestinal parasitic infection as compared to those who did not receive training. CONCLUSION: Prevalence of parasitic infection among food handlers observed in the current study is relatively low but is still a public health importance. Number of medical checkup, training in food hygiene and safety, feedback from customers and level of education were significantly associated with reduced odds of being infected with parasitic infection. Hence, these factors should be focused by policy makers and implementers to further bring the prevalence below the level of public health importance.