Undernutrition and associated factors among urban children aged 24-59 months in Northwest Ethiopia: a community based cross sectional study.

BACKGROUND: Globally, in every three preschool children one is affected by malnutrition. In Ethiopia, child undernutrition continues to be a serious public health problem. Data are scarce, especially in 24-59 months age children. We aimed at estimating under nutrition and its associated factors among children 24-59 months age in Aykel Town, Northwest Ethiopia. METHODS: A community based cross-sectional study was conducted among children aged 24-59 months in Aykel Town from January to February 2017. A total of 416 children were included in to the study using a systematic random sampling technique. Data were collected by interview and anthropometric measurements. Multivariable analysis was performed to identify the predictors of stunting, wasting and underweight. RESULTS: The prevalence of stunting, wasting and underweight were 28.4, 10 and 13.5%, respectively. Children from low birth order; 1st (AOR = 8.60, 95%CI: 2.40, 3.70) and 2nd -4th (AOR = 5.80, 95%CI: 1.80, 18.90), from large family size (AOR = 3.67, 95%CI: 1.92, 7.00), and had meal frequency < 3/day (AOR = 5.09, 95%CI: 2.96, 8.74) were at a higher risk of stunting. Children who had not fed on cow milk (AOR = 5.50, 95%CI: 2.30, 13.00), and from mothers who had poor hand washing practice (AOR = 11.00, 95%CI: 4.30, 27.9) were more likely to be wasted. Children who had not fed on cow milk (AOR = 2.90, 95%CI: 1.40, 6.00), breast fed for less than 24 months (AOR = 2.60, 95%CI: 1.35, 5.00), consumed foods from less than four food groups (AOR = 6.30, 95%CI: 1.70, 23.00), and were from mothers' who had poor hand washing practice (AOR = 2.50, 95%CI: 1.30, 4.70) had higher odds of being underweight. CONCLUSION: Stunting, wasting and underweight are high among children aged 24-59 months in Aykel Town. Poor child feeding and maternal hygienic practices were identified as risk factors of undernutrition. Educating mothers/care givers on the advantages of proper child feeding and maintaining hygienic practices at critical times is valuable in improving the nutritional status of children.

Incidence and Associated Factors of Chronic Pain After Caesarean Section: A Systematic Review.

The number of Caesarean section (CS) procedures has increased dramatically both in developed and developing countries in recent decades. CS has been associated with chronic pain. A vicious impediment on quality of life may occur among women who experience chronic post-CS pain (CPCSP). Therefore, this systematic review aimed to synthesize the available evidence on the incidence of chronic pain after Caesarean delivery and the possible risk factors for the development of chronic pain. The PubMed, Embase, and Google Scholar databases were searched for articles published in English between 2004 and January 2017 using appropriate terms. Studies that examined the incidence of chronic pain after CS as their primary outcome measure, and follow-up period of more than 2 months was selected. Both authors searched and reviewed the studies for eligibility and extracted the data in predefined forms. We also conducted a hand search of the reference lists of included articles. Findings from the reviewed studies are summarized using narrative and tables. Of the 4932 records, 17 studies met the review eligibility criteria. This review found that the incidence of CPCSP varies among studies and is influenced by preoperative patient factors and surgical- and anaesthetic-related factors. Of the reviewed studies, the majority were examined for chronic pain at 3 months after CS. The incidence of CPCSP after 2 to less than 6 months was found to range between 4% and 41.8%. The reported factors that influence CPCSP were inconsistent among studies. Despite this, the presence of a higher intensity of pain on postoperative day 1 was the most commonly identified factor associated with CPCSP. This systematic review found a clinically important incidence of CPCSP, ranging from 4% to 41.8% at 2 to less than 6 months after CS. Moreover, the evidence demonstrates that severe acute postoperative pain after CS is an important contributing factor for the development of CPCSP. However, no strong evidence-based conclusions and recommendations may be drawn from the evidence. Future well-designed studies with a longer follow-up period are needed to identify the most important perioperative factors associated with chronic pain following Caesarean delivery.

Multidrug resistant tuberculosis in Ethiopian settings and its association with previous history of anti-tuberculosis treatment: a systematic review and meta-analysis.

BACKGROUND: Efforts to control the global burden of tuberculosis (TB) have been jeopardized by the rapid evolution of multi-drug resistant Mycobacterium tuberculosis (MTB), which is resistant to at least isoniazid and rifampicin. Previous studies have documented variable prevalences of multidrug-resistant tuberculosis (MDR-TB) and its risk factors in Ethiopia. Therefore, this meta-analysis is aimed, firstly, to determine the pooled prevalence of MDR-TB among newly diagnosed and previously treated TB cases, and secondly, to measure the association between MDR-TB and a history of previous anti-TB drugs treatment. METHODS: PubMed, Embase and Google Scholar databases were searched. Studies that reported a prevalence of MDR-TB among new and previously treated TB patients were selected. Studies or surveys conducted at national or sub-national level, with reported MDR-TB prevalence or sufficient data to calculate prevalence were considered for the analysis. Two authors searched and reviewed the studies for eligibility and extracted the data in pre-defined forms. Forest plots of all prevalence estimates were performed and summary estimates were also calculated using random effects models. Associations between previous TB treatment and MDR-MTB infection were examined through subgroup analyses stratified by new and previously treated patients. RESULTS: We identified 16 suitable studies and found an overall prevalence of MDR-TB among newly diagnosed and previously treated TB patients to be 2% (95% CI 1% - 2%) and 15% (95% CI 12% - 17%), respectively. The observed difference was statistically significant (P < 0.001) and there was an odds ratio of 8.1 (95% CI 7.5-8.7) for previously treated TB patients to develop a MDR-MTB infection compared to newly diagnosed cases. For the past 10 years (2006 to 2014) the overall MDR-TB prevalence showed a stable time trend. CONCLUSIONS: The burden of MDR-TB remains high in Ethiopian settings, especially in previously treated TB cases. Previous TB treatment was the most powerful predictor for MDR-MTB infection. Strict compliance with anti-TB regimens and improving case detection rate are the necessary steps to tackle the problem in Ethiopia.

Change in serum level of vitamin D and associated factors at early phase of bone healing among fractured adult patients at University of Gondar teaching hospital, Northwest Ethiopia: a prospective follow up study.

INTRODUCTION: Currently, Vitamin D deficiency is a major public health problem and it affects more than one billion people worldwide. Vitamin D is crucial for bone mineralization and ossification. Patients with fractures need Vitamin D for the healing of their fractured bone. The current study was carried out to determine if there is change in the serum level of Vitamin-D associated with factors at early phase of fractured bone healing (ossification) process among adult fractured patients at University of Gondar teaching hospital, Northwest Ethiopia. METHODS: This facility-based prospective follow up study was conducted from March to June 2016. Data was collected by an interviewer, and pretested and structured questionnaires were used. Biological samples were collected to determine the serum level of vitamin-D in all subjects. In addition, X-Ray findings were used to determine the early phase of bone healing process. Data was entered into EPI INFO version 3.5.3 and analyzed using the Statistical Package for Social Sciences (SPSS) version 20. Both bivariate and multivariate logistic regression analysis was done to screen for factors associated with decreased serum levels of Vitamin-D. In the Multivariate regression analysis, those variables which had a P-value of <0.05 were considered as independently associated with change in serum level of Vitamin-D. RESULTS: A total of 118 adult patients with fractures participated in this study. The prevalence of patients' with decreased serum levels of vitamin-D at post-test was 63.6% [95% CI; (0.551-0.720)]. Inadequate intake of milk and milk products in the 1st week of fracture [AOR = 95%CI: 0.20 (0.05-0.90)], Poor Dietary Diversity Score [AOR = 95% CI: 29.1 (2.27-371.65)], and ossified bone [AOR =95% CI: 4.10 (1.12-14.95)] showed statistically significant association with decreased serum level of Vitamin-D. CONCLUSION AND RECOMMENDATIONS: Decreased serum level of Vitamin-D at early phase of fractured bone healing process was found in the majority of patients (>63%) raising concern for Vitamin D deficiency to be a significant public health problem in the study population. It was statistically associated with: poor dietary diversity score, in adequate intake of milk and milk products in the 1stone week of fracture and ossified (healed) bone. Introducing hospital based Vitamin-D supplementation and integrated with health and nutritional education is a vital intervention needed to improve serum levels of Vitamin-D.

Determinants of stunting and wasting in street children in Northwest Ethiopia: A community-based study.

OBJECTIVE: This study aimed to identify determinant factors of stunting and wasting in street children ages 5 to 18 y in Northwest Ethiopia. MATERIALS AND METHODS: A community-based cross-sectional study design was employed. An interviewer-administered, structured, and pretested questionnaire was used to collect the data. A convenience sampling technique was used to recruit participants. Stunting and wasting were defined as having a height-for-age and weight-for-height Z score of less than -2 SDs, respectively. Both bivariable and multivariable logistic regression analyses were fitted to identify factors associated with stunting and wasting. A 95% confidence interval (CI) and P < 0.05 were used to declare statistical significance. RESULTS: The overall prevalence of stunting and wasting was 46.4% (95% CI: 41.6-51.5%) and 15.3 % (95% CI: 11.7-19.0%), respectively. Age (adjusted odds ratio [AOR] = 0.18, 95% CI: 0.08, 0.47), substance use (AOR = 2.07, 95% CI: 1.33, 3.21), and loss of appetite (AOR = 2.00, 95% CI: 1.31, 3.04) were independently associated with stunting. Whereas age (AOR = 0.49, 95% CI: 0.27, 0.89), illness (AOR = 2.38, 95% CI: 1.27, 4.48), and open defecation (AOR = 2.27, 95% CI: 1.14, 4.51) were factors associated with wasting. CONCLUSION: Stunting and wasting were found to be critical problems in street children. Age, loss of appetite, and substance use were significantly associated with stunting, whereas child age, illness, and open defecation practice were significantly associated with wasting. Thus, tailored nutritional interventions are urgently required in this population to improve their nutritional status.

Dietary non-adherence and associated factors among individuals with diabetes who are on treatment follow up at Felege-Hiwot Referral Hospital, Northwest Ethiopia.

Difficulty in adhering to the recommended diet is a common problem in individuals with diabetes mellitus (DM). Dietary non-adherence among diabetic individuals leads to diabetes related complication and death. As far as our search established, there is a scarcity of scientific evidence of dietary non-adherence of individuals with diabetes to the recommended diet in Ethiopia, specifically in the Northwest part of the country. Hence, this study aims to assess the dietary non-adherence and associated factors among individuals with diabetes at Felege-Hiwot Referral Hospital, Bahir Dar city, Northwest Ethiopia. An institution-based cross-sectional study was conducted on 385 systematically selected individuals with diabetes following their treatment from March to April 2017. Quantitative data were collected using a pre-tested and structured questionnaire. The dependent variable association with explanatory variables was determined using logistic regression. Statistical significance was considered at p-value <0.05 with 95% CI. The overall proportion of dietary non-adherence among participants was 46.8% (95% CI: 41.1-52.0). Living rurally (AOR = 3. 75; 95% CI: 2.12-6.63), duration of diabetes less than 5 years (AOR = 2. 81; 95% CI: 1.22-6.50), did not receive nutritional education (AOR = 5. 88; 95% CI: 3.30-10.48), poor social support (AOR = 3. 84; 95% CI: 1.74-8.46) and did not make choices when eating out (AOR = 3. 49; 95% CI: 2.09-5.81) were significantly associated with dietary non-adherence. Nearly half of the individuals with diabetes involved in this study did not adhere to the recommended diet. This problem could be addressed through the provision of nutritional education and strengthening social support to adhere to diabetes dietary recommendations. Therefore, health professional and nutritional educators should take appropriate action to increase the proportion of dietary adherence of individuals with diabetes.

Chronic energy deficiency and associated factors among older population in Ethiopia: A community based study.

INTRODUCTION: Chronic energy deficiency is an important public health problem among older (aged ≥ 65 years) population. Globally, one in seven older people has a medium to high risk of malnutrition. The situation of chronic energy deficiency among older people is quite poorly known in Ethiopia. Therefore, this study was aimed to determine the magnitude of chronic energy deficiency and associated factors among elders' aged ≥ 65 years, in Aykel town administration, Amhara Regional State, Northwest Ethiopia. METHODS: A community based cross-sectional survey was carried out from March 28th to April 20th, 2018. Study participants were recruited by a census technique. Both bivariate and multivariate logistic regression analysis used to identify factors associated with chronic energy deficiency. All variables with p-values of < 0.2 in the bivariate analysis were remarked for the multivariable analysis. Both Crude Odds Ratio (COR) and Adjusted Odds Ratio (AOR) were computed to determine the strength of association. In the multivariate analysis, all variables at p-values of < 0.05 were considered as statistically significant. RESULTS: A total of 892 participants recruited for the study. The prevalence of chronic energy deficiency was 17.6% (95%CI: 15.00, 20.20) among the study community. It was significantly associated with female sex (AOR: 1.58; 95%CI: 1.04, 2.41), age (AOR: 3.90; 95%CI: 1.85, 8.25), household food insecurity (AOR: 1.95; 95%CI: 1.16, 3.00), poor household wealth status (AOR: 1.77; 95%CI: 1.07, 2.94), loss of appetite due to illness (AOR: 2.93, 95%CI: 1.92, 4.48) and poor dietary diversity score (AOR: 5.51; 95%CI: 2.89, 10.52). CONCLUSIONS: The magnitude of chronic energy deficiency was high in the study area. It was significantly associated with female sex, age, poor dietary diversity score, loss of appetite due to illness, household food insecurity and poor wealth status. Therefore, there is a need to design and implement programs and strategies to improve nutritional status particularly focusing on female older population in improving dietary practices and food security. In addition, improving household economic and living standards is an essential measure to address the burden of CED among the older community.

Low Back Pain and Associated Factors among Primary School Teachers in Mekele City, North Ethiopia: A Cross-Sectional Study.

BACKGROUND: Low back pain (LBP) is the most prevalent musculoskeletal disorder among teachers. The pain, which is widely considered to be caused by occupational activities, has a significant impact on teachers' quality of life because it results in frequent sick leaves, functional impairment, and early retirement. It is also demanding in terms of treatment costs, individual suffering, and discontinuation of jobs. Therefore, this study assessed the magnitude of low back pain and associated factors among primary school teachers in Mekele City, north Ethiopia. METHODS: An institution-based cross-sectional study which included 611 public primary school teachers of Mekele City was conducted from March to April 2015. A multivariable logistic regression analysis was used to identify factors associated with low back pain. The adjusted odds ratio (AOR) with a 95% confidence interval (CI) was used to show the strength of the associations, and variables with a p value of less than 0.05 were considered statistically significant. RESULTS: In this study, the prevalence of low back pain was 74.8% (95% CI: 71.4-78.2). According to the multivariate analysis, the pain was associated with teachers' sleeping disturbance (AOR = 6.99; 95% CI: 2.20, 13.63), prolonged standing (AOR = 4.78; 95% CI: 3.75, 9.32), and irregular physical exercise (AOR = 1.46; 95% CI: 1.29, 5.10). CONCLUSION: The study showed that the prevalence of low back pain was high. Sleeping disturbance, prolonged standing during sessions, and irregular physical activity were significantly associated with the problem. Therefore, addressing work-related and individual factors is essential for decreasing the burden.

Recovery rate and associated factors of children age 6 to 59 months admitted with severe acute malnutrition at inpatient unit of Bahir Dar Felege Hiwot Referral hospital therapeutic feeding unite, northwest Ethiopia.

BACKGROUND: Despite numerous advances made in improving child health and the clinical management protocols for treating severe acute malnutrition at treatment centers, evidences concerning the treatment outcomes are scarce. Therefore, this study was conducted to assess the recovery rate and associated factors of severely acute malnourished children of age 6 to 59 months admitted to inpatient therapeutic feeding unit at Felege Hiwot Referral Hospital. METHODS: We conducted a hospital-based cross-sectional study including 401 severely malnourished children who were admitted from September 2012 to January 2016. Bivariable and a Multivariable logistic regression model were fitted to identify factors associated with recovery rate. Adjusted Odds ratio with its 95% CI was reported and P-value less than 0.05 was considered as significant. RESULTS: Fifty eight percent (58.4%) (95%CI: 53.1-64.1) of admitted children were recovered with a mean recovery time of 18 (±6.3) days. Being female, children who were fully and partially vaccinated, who had better MUAC measurement, who stayed longer in the hospital, and children who took routine vitamin-A supplementation had better recovery rate. However, children who had co-morbidity at admission, had human immune virus (HIV) and Tuberculosis (TB) infection, and who had edema were less likely to recover. INTERPRETATION: Recovery rate was low as compared to international SPHERE cutoff points (> 75% recovery rate). Interventions that could address the outlined factors would be helpful to improve treatment recovery rate of admitted children.

Complementary feeding practices among children in Benishangul Gumuz Region, Ethiopia.

BACKGROUND: Appropriate complementary feeding helps to reduces child's risk of undernutrition, infectious disease and related mortality. However, complementary feeding practices are sub-optimal in Ethiopia. There is, however, also limited evidence in the country, particularly of Pawie District. Therefore, this study aimed to assess timely initiation of complementary feeding and associated factors among mothers who had children aged 6-23 months in Pawie District, Benishangul Gumuz Regional State. METHODS: A community based cross-sectional study was conducted in Pawie District from February 01 to March 29, 2015. A multi-stage sampling technique was employed to select 806 mother-child pairs. Multivariable logistic regression analysis was used to investigate factors associated with timely initiation of complementary feeding. Adjusted odds ratio (AOR) with corresponding 95% Confidence Interval was calculated to show the strength of association. A p value of <0.05 was used to declare significance of association. RESULTS: The overall prevalence of timely initiation of complementary feeding was 61.8%. One quarter (23.7%) of children had good dietary diversity and 32.7% of children aged 12-23 months were fed with appropriate meal frequency. Mother's place of residence: urban settlement [AOR = 2.11, 95% CI 1.47, 3.02] and postnatal checkup [AOR = 1.68, 95% CI 1.15, 2.45] were significantly associated with timely initiation of complementary feeding. CONCLUSIONS: The prevalence of timely initiation of complementary feeding was low in Pawie District. Therefore, further strengthening maternal postnatal care utilization is a key to improve timely initiation of complementary feeding. Moreover, attention needs to be given to the rural mothers.

Anemia among adult HIV patients in Ethiopia: a hospital-based cross-sectional study.

BACKGROUND: Anemia is a major public health problem in HIV patients around the world. It has a negative effect on the quality of life of HIV patients and progression of the HIV disease. In the sub-Saharan African setting, including Ethiopia where both HIV infection and under-nutrition are expected to be high, there is a paucity of data on the matter. This study was aimed to reveal the magnitude and factors associated with anemia among adult HIV patients in Debre-Tabor Hospital, northwest Ethiopia. METHODS: A hospital-based cross-sectional study was used among adult HIV patients in Debre-Tabor Hospital from April 1 to May 30, 2015. The diagnosis of anemia was made following the 2011 World Health Organization recommendation on hemoglobin cut-off points. Univariable and multivariable logistic regression was carried out to assess factors associated with anemia. RESULTS: A total of 377 patients' charts were reviewed. Most of the participants (n=237, 62.9%) were taking antiretroviral treatment (ART). The overall prevalence of anemia was 23% (95% CI: 19.1, 27.6). Being ART-naïve (adjusted odds ratio [AOR]: 3.37; 95% CI: 1.59, 7.14), having treatment history with anti-tuberculosis (TB) drug (AOR: 3.2; 95% CI: 1.19, 8.67), taking zidovudine (ZDV)-containing ART regimen (AOR: 2.14; 95% CI: 1.03, 4.57), and having recent CD4+ T-lymphocytes count of <200 cells/µL (AOR: 2.13; 95% CI: 1.04, 4.36) were associated with occurrence of anemia among adult HIV patients. CONCLUSION AND RECOMMENDATION: Anemia continues to be a major co-morbidity among adult HIV patients in Ethiopia. Adult HIV patients who are taking ZDV-containing ART, with a history of TB treatment, have a low CD4+T-lymphocytes count and are ART-naïve should be carefully screened and treated for anemia.

Factors associated with minimal meal frequency and dietary diversity practices among infants and young children in the predominantly agrarian society of Bale zone, Southeast Ethiopia: a community based cross sectional study.

BACKGROUND: Poor infant and young child feeding (IYCF) practices in the first 2 years of age are among major causes of childhood malnutrition, in developing countries including Ethiopia. It results in irreversible outcomes of stunting, poor cognitive development, and significantly increases risks of many chronic and infectious diseases. This study was intended to assess factors associated with minimum meal frequency and minimum dietary diversity practice among children aged 6-23 months in the predominantly agrarian society of Bale zone, Southeast Ethiopia. METHODS: A community based cross sectional study was employed from January to June 2016. An interviewer administered, pretested and structured questionnaire was used to collect data. Multi-stage sampling followed by a systematic random sampling technique was used to include study subjects. Data was entered using Epi info version 3.5.3 and analyzed by SPSS version 20. In the logistic regression, both bivariate and multivariate analyses were carried out to identify factors associated with minimum meal frequency and minimum dietary diversity scores. All variables with P-values of <0.2 in the bivariate were earmarked for the multivariate analysis. Both Crude Odds Ratio (COR) and Adjusted Odds Ratio (AOR) were computed at 95% Confidence Interval (CI) to determine the strength of associations. In the multivariate analysis, variables at P-Values of <0.05 were considered as statistically significant with minimum meal frequency and dietary diversity practice. RESULT: A total of 801 infants and young children aged 6-23 months and their mothers participated in the study. The overall prevalence of minimum meal frequency and minimum dietary diversity practice was 68.4% [95% CI: 0.652, 0.716] and 28.5% [95% CI: 0.254, 0.316], respectively. Child age (AOR = 0.29; 95% CI: 0.28, 0.94) and parity of mother (AOR = 2.8; 95% CI: 1.11, 7.50) were independently associated with minimal meal frequency. On the other hand, mothers educational level (AOR = 0.52; 95% CI: 0.28, 0.94), child illness in the past 1 week (AOR = 0.44; 95% CI: 0.26, 0.73) and maternal counselling on IYCF practice during postnatal care (PNC) visits (AOR = 2.6; 95% CI: 1.59, 4.45) were factors statistically associated with dietary diversity practice in the study area. CONCLUSION AND RECOMMENDATIONS: Compliance to recommended minimum meal frequency and diversified diets was low in this study community. Minimum meal frequency was associated with the age of child and parity of mother. But, mothers' education, child illness in the past 1 week, and maternal counseling on IYCF during PNC visits were factors associated with minimum dietary diversity practice. Improving the level of maternal and child health care utilization, increasing the educational level of mothers and providing health and nutrition counseling on IYCF during maternal PNC service visits are vital interventions to improve IYCF practices in the predominantly agrarian society of Bale zone, Southeast Ethiopia.

Child wasting is a severe public health problem in the predominantly rural population of Ethiopia: A community based cross-sectional study.

BACKGROUND: In Ethiopia, child wasting has remained a public health problem for a decade's, suggesting the need to further monitoring of the problem. Hence, this study aimed at assessing the prevalence of wasting and associated factors among children aged 6-59 months at Dabat District, northwest Ethiopia. METHODS: A Community based cross-sectional study was undertaken from May to June, 2015, in Dabat District, northwest Ethiopia. A total of 1184 children aged under five years and their mothers/caretakers were included in the study. An interviewer-administered, pre-tested, and structured questionnaire was used to collect data. Standardized anthropometric body measurements were employed to assess the height and weight of the participants. Anthropometric body measurements were analyzed by the WHO Anthro Plus software version 1.0.4. Wasting was defined as having a weight-for-height of Z-score lower than two standard deviations (WHZ < -2 SD) compared to the WHO reference population of the same age and sex group. In the binary logistic regression, both bivariate and multivariate analyses were done to list out factors associated with wasting. All variables with P-values of < 0.2 in the bivariate analysis were earmarked for the multivariate analysis. Both Crude Odds Ratio (COR) and Adjusted Odds Ratio (AOR) at 95% Confidence Interval (CI) were computed to determine the strength of association. In the multivariate analysis, variables at P-values of < 0.05 were identified as determinants of wasting. RESULTS: The overall prevalence of wasting was 18.2%; 10.3% and 7.9% of the children were moderately and severely wasted, respectively. Poor dietary diversity [AOR = 2.08, 95% CI: 1.53, 4.46], late initiation of breastfeeding [AOR = 1.43, 95% CI: 1.04, 1.95], no postnatal vitamin-A supplementation [AOR = 1.55, 95% CI: 1.04, 2.30], and maternal occupational status [AOR = 2.31, 95% CI: 1.56, 3.42] were independently associated with wasting in the study area. CONCLUSION: Wasting is a severe public health problem in Dabat District. Therefore, there is a need to strengthen the implementation of optimal breastfeeding practice and dietary diversity. In addition, improving the coverage of mothers' postnatal vitamin-A supplementation is essential to address the burden of child wasting.

Iodine deficiency and associated factors among school children: a cross-sectional study in Ethiopia.

BACKGROUND: Iodine deficiency remains a public health problem in the world. It is the leading cause of preventable mental retardation and brain damage worldwide. Though 12 million school age children are at risk of developing iodine deficiency, there is a scarcity of literature showing the magnitude of iodine deficiency in Ethiopia. Therefore, this study aimed to determine the prevalence and associated factors of iodine deficiency among school children in Robe District, southeast Ethiopia. METHODS: A school based cross-sectional study was conducted from February to June, 2015. A structured interviewer-administered questionnaire was used to collect data. A systematic random sampling technique was employed to select 422 children. A multivariate logistic regression analysis was carried out to identify factors associated with iodine deficiency. In the multivariate analysis, variables with a P-value of <0.05 were considered statistically significant. RESULTS: A total of 393 school children participated in the study. The median urinary iodine level was 78 µg/l. About 57 and 43.5 % of the children were found with low urinary iodine level and goiter, respectively. Only 29 % of the households utilized adequately iodized salt. The result of the multivariate analysis revealed that the odds of iodine deficiency were higher among female [AOR = 2.23; 95 % CI: 1.54, 3.55] and older (10-12 years) [AOR = 2.21; 95 % CI: 1.44, 3.42] children. CONCLUSION: In this community, the prevalence of goiter and low urine iodine level is high. Thus, iodine deficiency exists as severe public health problem. In addition, there is a low utilization of iodized salt in the setting. Therefore, it is crucial to intensify efforts in the implementation of iodized salt. Moreover, attention should be given to school children to address ID.

Nearly half of preschool children are stunted in Dembia district, Northwest Ethiopia: a community based cross-sectional study.

BACKGROUND: Stunting has been the most pressing public health problem throughout the developing countries. It is the major causes of child mortality and global disease burden, where 80 % of this burden is found in developing countries. In the future, stunting alone would result in 22 % of loss in adult income. About 40 % of children under five-years were stunted in Ethiopia. In the country, about 28 % of child mortality is related to undernutrition. Thus, the aim of this study was to determine the prevalence and determinants of stunting among preschool children in Dembia district, Northwest Ethiopia. METHODS: A community based cross-sectional study was carried out in Dembia district, Northwest Ethiopia from January 01 to February 29, 2015. A multi-stage sampling followed by a systematic sampling technique was employed to reach 681 mother-child pairs. A pretested and structured questionnaire was used to collect data. After exporting anthropometric data to ENA/SMART software version 2012, nutritional status (stunting) of a child was determined using the WHO Multicenter Growth Reference Standard. In binary logistic regression, a multivariable analysis was carried out to identify determinants of stunting. The Adjusted Odds Ratio (AOR) with a 95 % confidence interval was computed to assess the strength of the association, and variables with a P-value of <0.05 in multivariable analysis were considered as statistically significant. RESULTS: A total 681 of mother-child pairs were included in the study. The overall prevalence of stunting was 46 % [95 % CI: 38.7, 53.3 %]. In multivariable analysis, the odds of stunting was higher among children whose families had no latrine [AOR = 1.6, 95 % CI: 1.1, 2.2)]. Likewise, children living in household with more than four family size [AOR =1.4, 95 % CI: 1.1, 1.9)] were more likely to be stunted. CONCLUSIONS: This study confirms that stunting is a very high public health problem in Dembia district. The family size and latrine availability were significantly associated with stunting. Hence, emphasis should be given to improve the latrine coverage and utilization of family planning in the district.

Factors Associated with Anemia among Children Aged 6-23 Months Attending Growth Monitoring at Tsitsika Health Center, Wag-Himra Zone, Northeast Ethiopia.

Background. Globally, about 47.4% of children under five are suffering from anemia. In Ethiopia, 60.9% of children under two years are suffering from anemia. Anemia during infancy and young childhood period is associated with poor health and impaired cognitive development, leading to reduced academic achievement and earnings potential in their adulthood life. However, there is scarcity of information showing the magnitude of iron deficiency anemia among young children in Ethiopia. Therefore, this study aimed at assessing prevalence and associated factors of iron deficiency anemia among children under two (6-23 months). Methods. Institution based cross-sectional study was carried out from March to May, 2014, at Tsitsika Health Center in Wag-Himra Zone, Northeast Ethiopia. Systematic random sampling technique was employed. Automated hemoglobin machine was used to determine the hemoglobin level. Socioeconomic and demographic data were collected by using a pretested and structured questionnaire. Binary logistic regression analysis was used to identify associated factors and odds ratio with 95% CI was computed to assess the strength of association. Results. Total of 347 children participated in this study. The overall prevalence of anemia was 66.6%. In multivariate logistic regression analysis, male sex (AOR = 3.1 (95% CI: 1.60-5.81)), 9-11 months of age (AOR = 9.6 (95% CI: 3.61-25.47)), poor dietary diversity (AOR = 3.2 (95% CI: 1.35-7.38)), stunting (AOR = 2.7 (95% CI: 1.20-6.05)), diarrhea (AOR = 4.9 (1.63-14.59)), no formal education (AOR = 2.6 (95% CI: 1.26-5.27)), early initiation of complementary food (AOR = 11.1 (95% CI: 4.08-30.31)), and lowest wealth quintile (AOR = 3.0 (95% CI: 1.01-8.88)) were significantly associated with anemia. Conclusion. The overall prevalence of anemia among children who aged 6-23 months has sever public health importance in the study area. Integrated efforts need to be prioritized to improve health as well as appropriate infant and young child feeding practice among children under.