ABSTRACT
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.
Subject(s)
Anemia , Health Surveys , Lactation , Humans , Female , Ethiopia/epidemiology , Anemia/epidemiology , Adult , Young Adult , Adolescent , Middle Aged , Risk Factors , Socioeconomic Factors , MothersABSTRACT
Background: Managing severe acute malnutrition (SAM) involves an outpatient therapeutic program (OTP), targeting more than 80% of SAM children where the quality of primary healthcare remains poor. Treatment success and recovery from SAM remain poor and could be affected by many factors, where such evidence is limited in East Hararghe. This study assessed the predictors of time to recovery from SAM in eastern Ethiopia. Methods: A retrospective cohort study was conducted on 402 records of SAM children under 5 years of age enrolled on OTP at 12 health posts retrieved from 2020 to 2021. We used the Kaplan-Meir estimate along with the p-value of the log-rank test and the survival curve to compare the time to recovery across categories. A multivariable Cox proportional hazard model was fitted to identify predictors of time to recovery from SAM. A p-value below 0.05 was used to declare statistical significance. Results: A total of 402 records were reviewed, and the cure rate from SAM was 89.6% [95% confidence interval (CI), 87-93]. Moreover, a death rate of 0.7%, a default rate of 9.5%, and a non-responder rate of 0.2% were obtained with a median length of stay of 7 weeks. The median time to recovery was significantly shorter for children from shorter distances from OTP sites with edema, amoxicillin, (p < 0.05). Edema at admission [adjusted hazard ratio (AHR) = 1.74; 95% CI: 1.33-2.29], without diarrhea (AHR = 1.51; 95% CI: 1.18-1.94), taking amoxicillin (AHR = 1.55; 95% CI: 1.19-2.02), shorter travel time to the OTP site (AHR = 1.44; 95% CI: 1.13-1.85), breastfeeding (AHR = 1.60; 95% CI: 1.27-2.02), adequacy of ready-to-use therapeutic food (RUTF) (AHR = 1.22; 95% CI: 0.90-1.65), and new admission (AHR = 1.62; 95% CI: 0.84-3.10) were important predictors of recovery from SAM. Conclusion: Recovery from SAM was found to be acceptable in comparison with the Sphere Standards and is predicted by edema, diarrhea, distance from the OTP site, amoxicillin, and RUTF adequacy. These allow for focused interventions that address the identified factors for better recovery from SAM.
ABSTRACT
Iron deficiency anemia is a public health problem among adolescents that could be addressed by weekly Iron Folic Acid Supplementation (IFAS). The Ethiopian government piloted weekly IFAS in schools, where its effectiveness depends on compliance. We assessed the determinants of compliance with the weekly IFAS in Ethiopia. A school-based survey was conducted in 506 adolescent girls on weekly IFAS. Compliance was considered when girls reported WIFAS for at least three months without discontinuation. Bivariable and multivariable logistic regression models were modeled, with odds ratios reported. Out of 506, 25.8% had limited access to educational resources, and 79.4% had no information on IFAS. Among these, 47.9% (95% CI: 45.5-49.9%) had poor compliance with weekly IFAS. Non-compliance was mainly due to school absenteeism (55.9%). Important predictors of poor compliance were adolescent girls' marital status (AOR = 5.21; 1.55-17.6), academic standing (AOR = 4.37; 2.20-8.70), family income (AOR = 1.85; 1.09-3.15), access to health education materials (AOR = 1.57; 1.02-2.40), problems with IFAS (AOR = 2.44; 1.26-4.74), a discouraging home environment for the program (AOR = 2.27; 1.54-3.34), and a lack of knowledge of the IFAS program (AOR = 1.40; 0.97-2.03). Compliance with weekly IFAS is optimal, which could be improved via strong adherence support and feasible supplementation schedules.
Subject(s)
Dietary Supplements , Folic Acid , Iron , Humans , Female , Adolescent , Folic Acid/administration & dosage , Ethiopia , Cross-Sectional Studies , Iron/administration & dosage , Anemia, Iron-Deficiency/prevention & control , Anemia, Iron-Deficiency/epidemiology , Schools , Patient Compliance/statistics & numerical dataABSTRACT
BACKGROUND: In Ethiopia, malnutrition is a public health threat causing a significant burden of morbidity, mortality, and economic crisis. Simultaneously, khat consumption is alarmingly increasing among adults, yet it might contribute to the existing burden of malnutrition, where the current evidence is inconclusive. Hence, this review was to estimate the association between khat consumption and undernutrition among adults in Ethiopia. METHODS: A comprehensive search for Google, Google Scholar, and PubMed, coupled with a thorough manual search of the literature, was done up to date, October 18, 2023, using relevant search terms: "impact," "effects," "khat chewing," "khat consumption," "Ethiopia," "nutritional status," and "undernutrition." An updated PRISMA guideline was used to select relevant literature. The extracted data was summarized in narrative summaries, descriptions, and meta-analyses. The risk of bias was assessed. The results are presented in forest plots and funnel plots to assess publication bias. A pooled effect size (odds ratio) with a 95% certainty level was reported. RESULTS: While a total of 17 articles (n = 45,679) were included in the narrative review, only 15 articles were included in the quantitative meta-analysis. The majority of studies had a low and moderate risk of bias (based on risk of bias assessment tool), mainly due to unclear exposure assessment and high study heterogeneity. A total of 11 studies were cross-sectional studies (71%), three were comparative studies (17.4%), and three were case control studies (17.4%). There is a higher risk of publication bias as evidenced by the funnel plot. Overall, five studies were from the Oromia region, and three studies were conducted at the national level. Overall, chewing had been shown to significantly increase the risk of undernutrition by 53% (pooled OR = 1.53; 95% CI: 1.09-2.16) under a random effect model. Under the fixed effect model, higher weight was given to national-level studies with higher samples, where chewing contributed to a 12% increased risk of undernutrition (AOR = 1.12; 95% CI: 1.01-2.23). Hence, khat chewing could raise the odds of undernutrition by 12-53%. CONCLUSION: There is evidence of an association between khat chewing and an increased risk of undernutrition among adults in Ethiopia, which highlights the need for public health interventions to address the potential adverse effects of khat chewing on nutritional status.
Subject(s)
Catha , Malnutrition , Adult , Humans , Catha/adverse effects , Ethiopia/epidemiology , Malnutrition/epidemiology , Nutritional Status , Appetite Depressants/adverse effectsABSTRACT
Overnutrition is a recognized risk factor for hypertension, but evidence is lacking among hypertensive patients for tailored dietary interventions. This study assessed dietary factors in 331 hypertensive patients in southwest Ethiopia. The data was collected through a questionnaire and analyzed using factor analysis. Body mass index (BMI) was calculated, and a BMI above 25 kg m-2 was considered overnutrition. An ordinal logistic regression model was used to model the data and control confounders. Adjusted odds ratio and p-values were reported. Among the 331 respondents, consumption of cereals and grains (57.0%); roots and tubers (58.5); and legumes (50.0%), while 28.6% drink alcohol, was common. About 29.0% (24.1-34.2) had overnutrition (22%, 17.6-26.6%, overweight and 7.0%, 4.5-10.3%, obesity). While the predicted odds of overnutrition were higher among males (AOR = 2.85; 1.35-6.02), married (AOR = 1.47; 0.69-3.12), illiterates (AOR = 2.09; 1.18-3.72), advanced age (AOR = 1.65; 0.61-4.61), government employees (AOR = 6.83; 1.19-39.2), and urban dwellers (AOR = 4.06; 1.76-9.36), infrequent vegetable consumption (AOR = 1.47; 0.72-2.96) and lower and higher terciles of cereals and animal-source food consumption (AOR = 1.56; 0.72-3.34). Overnutrition among hypertensive patients was significantly high and associated with unhealthy dietary consumption, educational status, residence, and occupation, emphasizing the need for targeted dietary counseling.
Subject(s)
Hypertension , Overnutrition , Male , Humans , Ethiopia/epidemiology , Diet , Hypertension/epidemiology , Risk Factors , Overnutrition/epidemiology , VegetablesABSTRACT
BACKGROUND: Nutrition during pregnancy is a major determinant of human health and child development, and the role of promoting essential nutrition actions (ENA) is of a paramount importance for the health of the mother and newborn. However, the practice of ENA could be hampered by many factors, which need to be understood for tailored actions. This study assessed the practice of key ENAs and associated factors among pregnant mothers in southwest Ethiopia. METHOD: A community-based cross-sectional study was employed among 373 pregnant mothers. A simple random sampling method was used to select the study participants. The data was entered into EpiData Manager and exported to SPSS version 21 for analysis. A bivariable logistic regression was conducted to explore the association between independent variables and the outcome variable. Variables with p-values less than 0.25 during bivariable analysis were entered into a multivariable logistic regression model. Level of statistical significance was declared at a p-value below 0.05. The crude and adjusted odds ratios, along with the 95% CI, were estimated to measure the strength of the association between the dependent variables and independent variables. RESULT: In this study, 373 pregnant mothers have participated, with a response rate of 97%. A total of 275 (73.7%; 95% CI: 68.9-78.0) women practiced key essential nutrition actions at optimal level. Monthly household income of 2500 ETB (AOR = 0.45, 95% CI: 0.23, 0.89), rural residence (AOR = 2.31, 95% CI: 1.25, 4.4), and poor knowledge of key ENA messages (AOR = 3.36, 95% CI: 1.81, 6.26) were factors that were significantly associated with poor practice of key ENA messages. CONCLUSIONS: The practice of key ENA messages was poor and closely linked to household income, residence, and knowledge of pregnant women's on ENA key messages. Therefore, nutritional intervention with a focus on intensified nutritional counseling is needed for better adoption of key ENA practices.
Subject(s)
Pregnancy Outcome , Pregnant Women , Female , Humans , Infant, Newborn , Pregnancy , Cross-Sectional Studies , Ethiopia , Mothers/psychology , Pregnant Women/psychology , Prenatal CareABSTRACT
Khat chewing is a deep-rooted socio-cultural tradition that affects appetite, gastric emptying, and food intake, ultimately influencing nutritional status. Moreover, there is significant variation in lifestyles and ways of living among khat chewing and non-chewing people. However, there is limited evidence on the disaggregated determinants of undernutrition among khat chewers and non-chewers in Ethiopia. A community-based comparative cross-sectional study was conducted with 253 Khat-chewing and 249 non-chewing male adults in Addis Ababa, Ethiopia. Weight and height were measured under standard procedure and used to calculate the body mass index (BMI < 18.5 kg/m2 indicates undernutrition). Variables with p-values below 0.25 in the bi-variable analysis were entered into a multivariable logistic regression model to identify factors associated with undernutrition and to control confounding respectively. An adjusted odds ratio with 95% confidence interval was used to declare the presence and the strength of association between the independent and outcome variable. Statistical significance was declared at a p value of 0.05. In this study, a total of 138 (27.5%: 23.6-31.6%) adult males were undernourished; among them, 78 (32.0%) were khat chewers and 60 (23.9%) were non chewers. Christian religion (AOR = 1.49; 1.02-2.30), vegetable consumption (AOR = 1.69; 95% CI 1.12-2.55) and khat chewing (AOR = 1.60; 1.04-2.45) were independent risk factors for undernutrition. However, none of the above factors showed a statistically significant association among non-khat chewer male adults. In conclusion, undernutrition was a public health concern in male adults in the study area. Frequent consumption of fruits, vegetables and family size of the households were the independent predictors of undernutrition. The practical implication of identifying risk factors of undernutrition among chewers and non-chewers could be helpful in depicting the relevant risk factors by exposure category and helping to further refine intervention packages. In addition, focusing on interventions which can increase the availability and accessibility of fruits and vegetables are important to improve the nutritional status of adult male populations.
Subject(s)
Catha , Malnutrition , Adult , Humans , Male , Catha/adverse effects , Cross-Sectional Studies , Ethiopia/epidemiology , Mastication , Malnutrition/epidemiologyABSTRACT
OBJECTIVES: Adolescents go through rapid development and increased nutritional requirements that can put them at higher risk of undernutrition--a problem that can be highest among orphaned or street children. Evidence on nutritional risk and its contributing factors among this segment is lacking in the city of Dire Dawa, where many children are on the streets with limited access to proper care. The aim of this study was to identify determinants of undernutrition among street adolescents in Ethiopia. METHODS: A community-based cross-sectional study was conducted with 358 street adolescents 12 to 19 y of age in Dire Dawa from January to February 2022. After conducting a preliminary survey and registering all available street children, a complete enumeration was made. For data collection, an interviewer-administered questionnaire was used along with anthropometric measurements using standard procedures. Height-for-age (HAZ) and body mass index (BMI) for age z scores were computed using World Health Organization (WHO) Anthroplus and statistical analysis was done using SPSS software version 26. Independent variables with P < 0.25 in bivariable analysis were included in multivariable logistic regression, and variables with P < 0.05 were considered statistically significant. A crude and adjusted odds ratio (AOR) with a 95% confidence interval (CI) was reported. RESULTS: Among 358 street adolescents, 44% (38.9-49.5) and 56% (50.8-61.4) were thin and stunted, respectively. Thinness among street children could be associated with a longer stay on the street (AOR, 1.65; 95% CI, 1.40-1.90), infrequent meal frequency (AOR, 1.32; 95% CI, 1.19-1.45), unprotected drinking water sources (AOR, 1.55; 95% CI, 1.40-1.71), alcohol drinking (AOR, 2.92; 95% CI, 1.51-4.32), inadequately diversified diet (AOR, 1.21; 95% CI, 1.06-1.36), and illness history (AOR, 1.34; 95% CI, 1.21-1.47). Moreover, odds of stunting were significantly associated with staying on the street (AOR, 1.32; 1.10-1.54), unsafe drinking water (AOR, 1.63; 95% CI, 1.13-2.66), smoking cigarettes (AOR, 1.54; 95% CI, 1.21-2.52), dietary diversity (AOR, 2.34; 95% CI, 1.43-3.82), and acute illness (AOR, 2.12; 95% CI, 1.31-5.23). CONCLUSION: Thinness and stunting were prevalent among street children and are associated with infrequent meals, poor dietary diversity, substance abuse, unsafe water sources, and illness histories that could be targeted for multisectoral interventions.
Subject(s)
Drinking Water , Homeless Youth , Malnutrition , Child , Humans , Adolescent , Ethiopia/epidemiology , Cross-Sectional Studies , Thinness/epidemiology , Thinness/etiology , Malnutrition/epidemiology , Growth Disorders , PrevalenceABSTRACT
In Somalia, where a poorly diversified diet is leading to adverse pregnancy and neonatal outcomes, there is a significant dearth of evidence that needs to be studied. Hence, this study was to identify factors associated with minimum dietary diversity among pregnant women in Somalia. A facility-based survey was conducted among 361 pregnant women attending antenatal care (ANC) using a structured questionnaire. Dietary diversity was measured using consumption of 10-food groups. Bivariable and multivariable binary logistic regression analyses were used, along with odds ratios and 95% confidence intervals. About 48.2% (42.9-53.5) of women had an inadequately diversified diet. The risk of having an inadequately diversified diet was higher among rural residents (AOR = 1.20; 0.30-4.75), multigravida (AOR = 2.85; 1.43-5.68), young women (AOR = 2.15; 0.82-5.61), extended families (AOR = 1.19; 0.68-2.10), with infrequent ANC visits (AOR = 4.12; 2.06-8.27), fewer frequent meals (AOR = 1.84; 1.09-3.10) and from food-insecure households (AOR = 3.84; 2.28-6.49) as compared to their counterparts. Consumption of poorly diversified diet was prevalent and associated with dietary diversity was prevalent among women which could be strongly predicted by parity, ante-natal care and food security, which needs to be targeted for interventions.
Subject(s)
Pregnant Women , Prenatal Care , Infant, Newborn , Female , Pregnancy , Humans , Somalia , Follow-Up Studies , Diet , Meals , Gravidity , Health FacilitiesABSTRACT
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.
Subject(s)
Health Facilities , Independent Living , Adult , Humans , Female , Ethiopia/epidemiology , Cross-Sectional Studies , Surveys and QuestionnairesABSTRACT
Background: Overnutrition among adolescents is becoming a major public health concern, with all the adverse consequences associated with unhealthy eating behaviors. Hence, clear evidence linking dietary consumption with the risk of overnutrition is crucial for targeted dietary recommendations using a robust statistical approach. This study assessed the link between dietary consumption patterns and the risks of overnutrition among adolescents in Ethiopia. Method: A community-based survey was conducted on a random sample of 510 adolescents selected using a stratified random sampling via proportional allocation. Dietary consumption was captured using a validated and contextualized 80-item food frequency questionnaire over the past month through a face-to-face interview. Weight and height were measured under a standard procedure. Body Mass Index for Age Z-score (BAZ) was calculated, and BAZ above +1 was considered overnutrition. The frequency measures were standardized into daily equivalents, and dietary patterns were derived using exploratory factor analysis after checking for assumptions. A bivariable and multivariable binary logistic regression model was fitted with an odds ratio and 95% confidence intervals. Results: A total of 510 participants were enrolled. Four major dietary patterns ("cereals, energy, and discretionary calory," "fat, oil, and milk groups," "proteins and vegetables," and "fruits"), explaining 66.6% of the total variation, were identified. The overall prevalence of overnutrition was 29.0% (27-31%), where 22.5 and 6.5% were overweight and obese, respectively. Physical inactivity (AOR = 6.27; 95% CI: 2.75-14.3), maternal literacy (AOR = 111.3; 95% CI: 50.0-247.8), habit of snacking (AOR = 1.80; 95% CI: 0.69-4.67), skipping meals (AOR = 2.05; 955 CI: 0.84-5.04), cereals and discretionary food dietary pattern (AOR = 2.28; 95 CI: 0.94-5.55), and protein-rich and vegetable dietary pattern (AOR = 2.30; 95% CI: 0.97-5.46) were important factors associated with odds of overnutrition. Conclusion: Overnutrition is a public health concern affecting one-third of adolescents, and it is closely linked with dietary consumption patterns, eating behaviors, wealth status, literacy, and level of physical activity. Therefore, public health interventions targeting unhealthy eating and lifestyles are urgently needed to curb the increasing burden of overnutrition among adolescents and its future complications.
ABSTRACT
BACKGROUND: Iodine deficiency is a global public health threat, affecting an estimated two billion people. The median urinary iodine concentration is more reliable in determining recent iodine intakes and the risks of iodine deficiency. Therefore, this study was aimed to identify the factors associated with recent iodine intake level using median urinary iodine concentration as an indicator among household food handlers in southwest Ethiopia. METHODS: A community-based survey was conducted with selected households using a pretested interviewer-administered questionnaire in southwest Ethiopia. A 20-gram sample of table salt and a 5 ml causal urine samples were also collected and analyzed using rapid test kit and a Sandell-Kolthoff reaction, respectively. A salt iodine concentration above 15 ppm was classified as adequately iodized and a median urinary iodine concentration between 100 and 200µgl- 1 was considered as adequate iodine intake. A bivariable and multivariable logistic regression model was fitted. Crude and adjusted odds ratios with their 95% confidence levels were reported. Associations with a p-value ≤ 0.05 were used to declare statistical significance. RESULTS: A total of 478 women were included, with a mean age of 33.2 (± 8.4 years). Only 268 (56.1%) of the households had adequately iodized salt (> 15 ppm). The median urinary iodine concentration (interquartile range) was 87.5 µg l- 1 (45.6-107.6). In a fitted multivariable logistic regression model (p-value = 0.911), illiterate women (AOR = 4.61; 95% CI: 2.17, 9.81), poorly iodized salt in the household (AOR = 25.0; 95% CI: 13-48), salt purchased from open market (AOR = 1.93; 95% CI: 1.0, 3.73) and women who do not read the label during purchasing the salt (AOR = 3.07; 95% CI: 1.31, 7.17) were important predictors of the risk of Iodine deficiency. CONCLUSION: Despite public health efforts to improve iodine intake, its deficiency is still a major public health problem among southwest Ethiopian women.
Subject(s)
Iodine , Malnutrition , Humans , Female , Adult , Cross-Sectional Studies , Ethiopia/epidemiology , Surveys and QuestionnairesABSTRACT
Despite the fact that health facilities in Ethiopia are being built closer to communities in all regions, the proportion of home deliveries remains high, and there are no studies being conducted to identify low birth weight (LBW) and premature newborn babies using simple, best, alternative, and appropriate anthropometric measurement in the study area. The objective of the present study was to find the simple, best, and alternative anthropometric measurement and identified its cut-off points for detecting LBW and premature newborn babies. A health facility-based cross-sectional study was conducted in the Dire Dawa city administration, Eastern Ethiopia. The study included 385 women who gave birth in health facility. To evaluate the overall accuracy of the anthropometric measurements, a non-parametric receiver operating characteristic curve was used. Chest circumference (AUC = 0â 95) with 29â 4 cm and mean upper arm circumference (AUC = 0â 93) with 7â 9 cm proved to be the best anthropometric diagnostic measure for LBW and gestational age, respectively. Also, both anthropometric measuring tools are achieved the highest correlation (r = 0â 62) for LBW and gestational age. Foot length had a higher sensitivity (94â 8 %) in detecting LBW than other measurements, with a higher negative predictive value (NPV) (98â 4 %) and a higher positive predictive value (PPV) (54â 8 %). Chest circumference and mid-upper arm circumference were found to be better surrogate measurements for identifying LBW and premature babies in need of special care. More research is needed to identify better diagnostic interventions in situations like the study area, which has limited resources and a high proportion of home deliveries.
Subject(s)
Infant, Low Birth Weight , Infant, Newborn , Infant , Humans , Female , ROC Curve , Cross-Sectional Studies , Anthropometry , Predictive Value of TestsABSTRACT
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.
Subject(s)
Blood Glucose , Obesity, Abdominal , Adult , Humans , Obesity, Abdominal/epidemiology , Obesity, Abdominal/etiology , Ethiopia/epidemiology , Independent Living , Feeding Behavior , Cross-Sectional Studies , Obesity/epidemiology , Obesity/etiology , Diet , Epidemiologic StudiesABSTRACT
BACKGROUND: Metabolic syndrome (Mets) is a cluster of cardiovascular risk factors secondary to an inflammatory and insulin resistance state that increases the risk of cardiovascular disease and type 2 diabetes mellitus. However, there is limited evidence on it despite an increasing metabolic syndrome (Mets) related morbidity and mortality. OBJECTIVE: This study was to identify the magnitude and factors associated with Mets among adults seeking care in Southern Ethiopia. METHOD: An institution-based cross-sectional study design was conducted on randomly selected 361 adults through face-to-face interviews and biomarker assessments. Mets were defined according to the NECP/ATP III criteria which are based on biochemical and lifestyle indicators. Bivariable and multivariable logistic regression analyses were used to identify factors associated with Mets. Crude and adjusted odds ratio with their 95% confidence interval was reported. Model fitness was checked using the Hosmer and Lemeshow tests. Multicollinearity diagnostic was checked using inflated standard error and variance inflation factor. Statistical significance was affirmed at a p-value <0.05. RESULTS: A total of 351 respondents were studied, with a response rate of 97.2%. Overall, the magnitude of Mets among adults was 18.5% (95% CI: 14.4-22.6%). Individuals with BMI ≥25 kg/m2 (AOR = 4.1; 95% CI = 3.13-11.51), having a sedentary behavior ≥8 h per day (AOR = 3.76; 95% CI = 1.38-10.25), adequate fruit or vegetable consumption (AOR = 0.48; 95% CI = 0.27-0.92), being involved in physical activity (AOR = 0.41; 95% CI: 0.20-0.80) and consuming alcohol 5-6 days per week (AOR = 2.9; 95% CI: 1.11-7.55) were significantly associated with Mets. CONCLUSION: the burden of Mets is a major public health concern among adults which is closely linked to physical activity, optimum body weight, fruit and vegetable consumption, and sedentary lifestyles.
Subject(s)
Diabetes Mellitus, Type 2 , Metabolic Syndrome , Humans , Adult , Metabolic Syndrome/complications , Diabetes Mellitus, Type 2/epidemiology , Diabetes Mellitus, Type 2/complications , Risk Factors , Cross-Sectional Studies , Public HealthABSTRACT
Introduction: Widal agglutination test is a serologic investigation that is used to diagnose typhoidfever. This is an easy, fairly inexpensive, and readily available test it'ith questionable reliability. The test performance differs from setting to setting depending on the technique used and otherfactors. The accuracy ofthis test in Ethiopia is poorly understood. So, the aim of this scientific work was to analyze the accuracy of Widal agglutination in diagnosing typhoidfever in Ethiopia. Methods: We performed a systematic review and meta-analysis. Two electronic databases (PubMed/Medline and Google scholar) were searched using preset search strategv to find relevant studies. The methodological quality of the studies included was evaluated "'ith a QUADAS-2. We extracted important variables from the eligible articles. Statistical analysis was conducted using STATA version 14. The protocol of our systematic review and metaanalysis is registered in the International Prospective Register of Systematic Reviews (PROSPERO) with the record number CRD42020194252. Results: The electronic quests yielded 42 papers of which 8 "'ere eligible for analysis. The quality of these studies was rated to be moderate based on the QUADAS-2. The pooled sensitivity, specificity, and negative, andpositive predicthe values ofthe Widal test were 80.8%, 53.0%, 98.5%, and 2.1% respecth'ely. Conclusion: The "'idal agglutination test has average specificity, ven good negative predicth'e value, and ven poor positive predictive value for the diagnosis of typhoidfever. Depending on Widal to diagnose typhoid fever may lead to over-diagnosis of typhoid fever and related complications including inappropriate use of antibiotics. There is an urgent needfor quick and dependable tests for diagnosing typhoidfever, particularly in settings like Ethiopia M'here doing timely culture is notfeasible.
Subject(s)
Serologic Tests , Dimensional Measurement Accuracy , Typhoid Fever , Meta-Analysis , Network PharmacologyABSTRACT
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.
Subject(s)
Diabetes Mellitus , Hyperglycemia , Adult , Humans , Middle Aged , Waist Circumference , Body Mass Index , ROC Curve , Obesity, Abdominal , Glycemic Control , Blood Glucose , Ethiopia/epidemiology , Waist-Height Ratio , Waist-Hip Ratio , Obesity/complications , Diabetes Mellitus/epidemiology , Risk FactorsABSTRACT
As the world's aging population grows, nutrition and health issues are becoming a major concern. The aim of the present study was to identify the factors associated with nutritional status among old age population. A community-based cross-sectional study was employed among randomly selected 739 elders over the age of 60 in Dire Dawa City administration, eastern Ethiopia. The validated full mini nutritional assessment tool and appetite test (SNAQ) was used to assess the nutritional status of the study population. Considering the ranked nature of the data, a bivariate and multivariable ordinal logistic regression model (under the generalised linear model) was conducted, with crude and adjusted odds ratios reported along with 95 % confidence intervals. Statistically significant associations are declared at P-value less than 0â 05. In this study, 22 % (95 % CI: 19 %, 25 %) of elders were malnourished. Participants with >75 years old (AOR 4â 95; 95 % CI 1â 54, 8â 4), being female (AOR 1â 6; 95 % CI 1â 1, 2â 2), illiterate (AOR 1â 5; 95 % CI 1â 01, 2â 2), severe depression (AOR 13â 9; 95 % CI 8â 2, 23â 7) and with poor appetite (AOR 3â 3; 95 % CI 2â 3, 4â 8) were important predictors of malnutrition among older age group. We found that the prevalence of malnutrition and the risk of malnutrition is a public health concern that warrants intervention in the area. Advanced age, illiteracy, depression and poor appetite were important risk factors for malnutrition among older age group. The identified risk factors will guide public health professionals and programmes in the design, implementation of interventions to improve the nutritional status of older age group.
Subject(s)
Malnutrition , Nutritional Status , Aged , Cross-Sectional Studies , Ethiopia/epidemiology , Female , Humans , Linear Models , Male , Malnutrition/epidemiologyABSTRACT
INTRODUCTION: Exclusive breastfeeding (EBF) means providing only breast milk for infants for up to six months without the addition of solid or liquid matter. Even though EBF had great benefits for infants and mothers, the rate of EBF is so limited below the global target. In Ethiopia, the overall EBF practice is 59%. This low EBF practice had a great unexplained variation among employed and unemployed mothers. Therefore, this study aimed to compare EBF practice and associated factors among employed and unemployed mothers of infants aged 6-12 months in Wolkite town, Southern Ethiopia, 2020. METHODS: A community-based comparative cross-sectional study was conducted in March 2020. A total sample of 485 (241 employed and 244 unemployed) study subjects was involved in the study. A simple random sampling technique was used to recruit study subjects. A pre-tested structured interviewer-administered questionnaire was used. Multivariable logistic regression was used to identify associated factors of EBF practice for the whole study participants and then for employed and unemployed mothers independently. RESULTS: The pooled prevalence of exclusive breastfeeding practice was 63.9% [95% CI (59.8-68.2%)]. Exclusive breastfeeding practice was 54.8% [95% CI (48.5-61.4%)] and 73% [95% CI (66.8-78.7%)] among employed and unemployed mothers respectively. Three or more years of a birth interval [AOR = 4.03; 95% CI (1.80-8.99)], three or more ANC visits [AOR = 5.39; 95% CI (1.49-19.45)], and having PNC service [AOR = 4.56; 95% CI (2.0-9.4)] significantly associated to exclusive breastfeeding practice among employed mothers. No history of breastfeeding counseling during ANC visits [AOR = 0.15; 95% CI (0.06-0.41)], had history of breast disease [AOR = 0.28; 95% CI (0.08-0.99)], three or more ANC visits [AOR = 5.11; 95% CI (1.66-15.8)], and having social support [AOR = 3.05; 95% CI (1.23-7.6)] significantly associated to EBF practice among unemployed mothers. CONCLUSION: Employment among mothers was found to discourage EBF practice. The predictors of exclusive breastfeeding practice are different for employed and unemployed. Therefore Policymakers and program planners are called to come together and create a conducive environment for lactating employees, and appropriate intervention at respective predictor variables is needed to enhance EBF practice.
Subject(s)
Breast Feeding , Mothers , Cross-Sectional Studies , Employment , Ethiopia/epidemiology , Female , Humans , Infant , LactationABSTRACT
Background: Dietary pattern analysis is a robust statistical procedure that efficiently characterize the dietary intakes of individuals. However, there is a lack of robust dietary intake evidence beyond nutrient intake in Ethiopia. This study was to answer, what are the major dietary consumption patterns and its predictors among pregnant women in Ethiopia. Methods: A facility-based survey among 380 randomly selected pregnant women using a contextualized food frequency questionnaire (FFQ) over 1 month recall was used. The frequency of food consumption was standardized to daily frequency equivalents, and a sequential exploratory factor analysis was used to derive major dietary patterns. A multivariable ordinary logistic regression model was fitted with all its assumptions. Results: Three major dietary patterns ("fruits and animal-source foods," "cereals, tubers, and sweet foods," "legumes and vegetables"), explaining 65% of the total variation were identified. Women snacks (AOR = 1.93; 1.23-2.75), without food aversion (AOR = 1.59; 1.08-2.35), non-fasting (AOR = 0.75; 1.12-2.12), and receiving nutritional counseling (AOR = 1.96; 1.25-3.07) were significantly positively associated with a higher tercile of fruits and animal-source food consumption. Non-working mothers (AOR = 1.8;1.23-2.76), chronic disease (AOR = 1.88; 1.14-3.09), or received nutritional counseling (AOR = 1.33; 0.88-2.01), were fasting (AOR = 1.33;0.88-2.01), and no food cravings (AOR = 4.27;2.67-6.84), and aversion (AOR = 1.60;1.04-2.44) had significantly higher odds of consuming cereals, tubers, and sweet foods. Literacy (AOR = 1.87; 1.14-3.09), urban residence (AOR = 2.10; 1.10-3.93), low socioeconomic class (AOR = 2.68; 1.30-5.23), and skipping meals (AOR = 1.73; 1.15-2.62) were associated with higher odds of legume and vegetable consumption. Conclusion: Socioeconomic class, literacy, occupation, getting nutritional counseling, habits of food craving, food aversion, and fasting can predict a woman's dietary pattern.