Dietary practice and associated factors among elderly people in Northwest Ethiopia, 2022: Community based mixed design.

BACKGROUND: The planet's population is aging at an incredible speed. Poor dietary practices are a major problem among the elderly. However, literature is scarce on dietary practices among elders in the study area. Therefore, the results of this study may give information to decision-makers. OBJECTIVE: This study aimed to assess dietary practices and associated factors among elderly people in Northwest Ethiopia, in 2022. METHODS: A community-based mixed study design was employed among elderly people from May 20 to July 2, 2022. Systematic random sampling and purposive sampling techniques were used for selecting study participants in quantitative and qualitative studies, respectively. Data were collected using an interviewer-administered structured questionnaire for the quantitative part and an interview guide for the qualitative part. Binary logistic regression analysis was used. A P-value less than or equal to 0.05 was used to declare statistically significant variables. A crude odds ratio and an adjusted odds ratio with a 95% confidence interval were used to measure the strength of the association. Thematic analysis was used for qualitative data analysis. RESULTS: A total of 422 participants were recruited for the study. Twenty-six in-depth interviews were done. The prevalence of adequate dietary practice was only 54.5% [95% CI: (49.8, 59.2)]. It was significantly associated with being aged between 65 to 74 years (AOR: 8.32; 95 CI: 3.9, 18.1), being aged between 75 to 84 years (AOR: 2.90; 95% CI: 1.1, 7.9), eating sometimes alone (AOR: 1.86; 95% CI: 1.03, 3.4), eating always with family members (AOR: 4.96; 95% CI: 2.6, 9.4), and food security (AOR: 3.13; 95% CI: 1.8, 5.4). Thematic analysis revealed three themes that interfere with the dietary practices of elders. A majority of in-depth interviewees mentioned that there were taboos and cultural beliefs which favor inadequate dietary practices of the elderly; the study participants reported that individual, economic, societal, and physiological factors are barriers affecting the dietary practices of the elderly, and all respondents have no experiences regarding elderly dietary practices. CONCLUSION: The prevalence of adequate dietary practice was low. It was significantly associated with age, with whom feeding, and household food security status. Taboos and cultural beliefs, barriers, and experiences hampered the dietary practices of elders. Therefore, improving the dietary practices of elders focusing on advanced age, loneliness, food security, taboos, cultural beliefs, barriers, and experiences regarding dietary practices should be done.

Infant and young child feeding practice among mothers-child pair in irrigated and non-irrigated areas of Dangila district, Northwest Ethiopia, 2020: a community based comparative cross-sectional study.

BACKGROUND: The issue of Infant and Young Child Feeding practices was widespread; it was estimated that infants were not exclusively breastfed in the first six months of life. Complementary foods were frequently provided too soon or too late, and they were often nutritionally deficient. Even, there are nutrition-sensitive activities like irrigation schemes, evidence on infant and young child feeding practices between irrigated and non-irrigated areas is scarce or limited. OBJECTIVE: To assess the prevalence of infant and young child feeding practices among 0-23 months of age children in irrigated and non-irrigated areas of Dangila District, North-west Ethiopia, 2020. METHODS: A community based comparative cross-sectional study was conducted from Dec 1, 2020, to Jun 1, 2020. A stratified sampling technique was implemented to select 823 mothers with children age 0-23 months from irrigated (411) and non-irrigated (412) kebeles. Data were collected using structured questionnaires. Multivariable logistic regression was used to identify the associated factors of infant and young child feeding practice. Adjusted odds ratios with a 95% CI were used to determine the degree of association between the independent and outcome variables. A p-value < 0.05 was used as a cutoff point to declare statistically significant variables with the outcome variable. RESULTS: Among 823 households visited, 802 respondents with a response rate of 97.8% in irrigated and 96.11% in non-irrigated areas gave complete responses. The overall prevalence of good IYCF practice was 62.5% (95% CI: 34.2, 41.3), and it shows a significant difference between irrigated (72.2%) and non-irrigated areas (52.8%). Moreover, the study identified that education primary and above (AOR = 1.889, 95% CI: 1.38, 2.648) knowledge above mean (AOR = 2.347, 95% CI: 1.555, 3.542), positive attitude (AOR = 1.716, 95% CI: 1.139, 2.587), PNC follow-up (AOR = 1.606, 95% CI: 1.154, 2.360), women's decision-making power (AOR = 1.840, 95% CI: 1.226, 2.763), and multiple delivery (AOR = 0.352, 95% CI: 0.213, 0.583) were significant factors for IYCF among 0-23 month-old children. CONCLUSION AND RECOMMENDATIONS: The infant and young child feeding practice among 0-23 month-old children was better in an irrigated area than in a non-irrigated area. Promoting irrigation practices, empowering women, and strengthening postnatal care are recommended interventions to increase infant, young, and child feeding practices in the study area.

Change in stunting and its associated factors among children aged less than 5 years in Ethiopia using Ethiopia Demographic and Health Survey data from 2005 to 2019: a multivariate decomposition analysis.

OBJECTIVE: The aim of this study is to assess change in stunting and its associated factors among children aged less than 5 years in Ethiopia using Ethiopia Demographic and Health Survey data from 2005 to 2019. DESIGN: A community-based cross-sectional study was conducted. SETTING: The study was conducted in Ethiopia. PARTICIPANTS: In 2005, 4586 individuals were examined, followed by 10 282 in 2011, 9462 in 2016 and 4937 in 2019. PRIMARY AND SECONDARY OUTCOMES: The primary outcome of the study was stunting, and the secondary outcome was factors associated with stunting and its change. A multilevel logistic regression model was fitted to identify individual and community-level factors associated with stunting among children aged less than 5 years. Multivariate decomposition analysis was also carried out to assess the role of compositional characteristics and behavioural change for decline in stunting among children aged less than 5 years in Ethiopia. RESULTS: Over the study period, the prevalence rate of stunting in children aged less than 5 years decreased from 47% to 37% in 2019. Differences in behavioural change among children under the age of 5 years account for 76.69% of the overall decline in stunting prevalence rate in the years 2005-2011, 86.53% in the years 2005-2016, 98.9% in the years 2005-2019, 70.34% in the years 2011-2016 and 73.77% in the years 2011-2019. Behavioural adjustments among breastfed children, diet diversity, place of delivery, ANC follow-up and region have all had a major effect on stunting prevalence rate. The wealth index, parenteral education, child's age in months, length of breast feeding and area were among the compositional change factors. CONCLUSION: A large percentage of children aged less than 5 years remains stunted in Ethiopia. Stunting was associated with alterations in the compositional and behavioural characteristics of children. Stimulating existing nutritional measures and improving the wealth index will make a significant difference in reducing stunting among Ethiopian children aged less than 5 years.

Nutritional status of 6-59 months of age children is not significantly varied between households with and without home gardening practices in Zege, North West Ethiopia, 2020: community based comparative study.

BACKGROUND: Malnutrition is a critical public health issue that has been related to a significant increase in mortality and morbidity rates. Despite the fact that children are expected to benefit from home gardening products, their nutritional condition in Ethiopia, particularly in the planned study region, is not thoroughly monitored. Therefore the purpose of this is to determine the nutritional status of 6-59 months of age children between households with and without home gardening practices at Zege. METHODS: A community based comparative cross-sectional study was conducted among paired mothers with 6-59 month children from February to March 2020. Data were collected using questionnaire and anthropometric measurement tools. Binary logistic regression models were used. A-p-value < 0.05 was used as cutoff point to declare statistically significant variables with the outcome variable. RESULT: Stunting and wasting among children aged 6-59 months was high and did not show significant variation between households practicing home gardening (stunting 46.1%, at 95%, CI: 40.6-51.3 and wasting 9.1%, at 95% CI: 6.2-12.7) and not practiced home gardening (stunting 50.3%, at 95% CI: 44.5-55.8 and wasting 10.1%, 95% CI: 6.8-13.8). Having low dietary diversity (AOR = 2.7; 95% CI: 1.9-3.9), Being male (AOR = 2.1; 95% CI: 1.4-3), feeding frequency < 3/day (AOR = 1.7; 95% CI: 1.1-2.4), and presence of diarrhea (AOR = 2.6; 95% CI: 1.4-4.6) were predictors of stunting. Unprotected-drinking water (AOR = 2.1; 95% CI: 1.0-4.2), not fully-immunized (AOR = 2.6; 95% CI: 1.3-5.1) and being female (AOR = 2.4; 95% CI: 1.3-4.6) were predictors for child wasting. CONCLUSION: stunting and wasting are highly prevalent in both home gardening and non- home gardening households' children of the community. Promoting diversified diet, protected water source, vaccinating children, access to a healthy environment and integrated with the access of nutrition education programs are vital interventions to improve nutrition.

Glycemic Control of Diabetes Mellitus Patients in Referral Hospitals of Amhara Region, Ethiopia: A Cross-Sectional Study.

BACKGROUND: Glycemic control is the level of glucose in diabetes patient. Evidence regarding glycemic control is scarce in resource-limited settings, and this study was conducted to generate information regarding the prevalence and predictors of glycemic control among diabetes mellitus patients attending their care from the referral hospitals of the Amhara region, Ethiopia. METHODS: A cross-sectional study design was implemented. A simple random sampling technique was used. Data were collected from March 2018 to January 2020. The data were collected using interviews, chart review, and blood samples. Hemoglobin A1c was measured using high-performance liquid chromatography. Data were entered into Epi-info software and analyzed by SPSS software. Descriptive statistics were used to estimate the prevalence of glycemic control; linear regression was used to identify the predictors of HbA1c. RESULTS: A total of 2554 diabetes patients were included giving for the response rate of 95.83%. The mean age of the study participants was 54.08 years [SD (standard deviation) ± 8.38 years]. The mean HbA1c of the study participants was 7.31% [SD ± 0.94%]. Glycemic control was poor in 55.32% [95% CI: 53.4%-57.25%] of diabetes patients. The glycemic control of diabetes patients was determined by BMI (ß 0.1; [95% CI: 0.09-0.1]), type 2 diabetes (ß -0.14; [95% CI: -0.11-0.16]), age (ß 0.22; [95% CI: 0.02-0.024]), duration of the disease (ß 0.04; [95% CI: 0.037-0.042]), the presence of hypertension (ß 0.12; [95% CI:0.09-0.16]), regular physical exercise (ß -0.06; [95% CI: -0.03-0.09]), medication adherence (ß -0.16; [95% CI: -0.14-0.18]), and male (ß 0.34; [95% CI: 0.31-.037]). CONCLUSION: The glycemic control of diabetes patients was poor, and it needs the attention of decision-makers.

Four in every ten infants in Northwest Ethiopia exposed to sub-optimal breastfeeding practice.

BACKGROUND: Improper breastfeeding practices significantly impair the health, development, and survival of infants, children, and mothers. A Breastfeeding Performance Index (BPI) is a composite index to describe overall maternal breastfeeding practice with infants under six months of age. To date, there is insufficient evidence on breastfeeding performance index and its associated factors in Ethiopia. OBJECTIVE: To assess the breastfeeding performance index and its associated factors in Sekela District, Northwest Ethiopia, 2019. METHODS: A community-based cross-sectional study was conducted on 605 randomly selected mothers having infants aged 6 to 12 months from April 02, 2019 to May 13, 2019. Data was collected using a structured interviewer-administered questionnaire. Multivariable logistic regressions were used to identify independent predictors of BPI. RESULTS: Two hundred forty-six (40.7%) of mothers had low BPI scores. Mothers who lived alone (AOR = 3.18; 95%CI: 1.15, 8.82), mothers who were merchants (AOR = 2.75; 95%CI:1.05, 7.15), attended three antenatal care (ANC) visits (AOR = 0.42; 95% CI: 0.20, 0.82), attended four antenatal care visits (AOR = 0.35; 95%CI: 0.12, 0.82), received postnatal care (PNC) (AOR = 0.35; 95%CI: 0.19, 0.64), had poor knowledge on breastfeeding (AOR = 3.19;95%CI: 1.14, 8.89) or negative attitudes towards breastfeeding (AOR = 2.70;95%CI: 1.13, 6.45), were independent predictors of low BPI scores. CONCLUSIONS: The prevalence of sub-optimal breastfeeding practice in northwest Ethiopia was very high. A mother living alone, maternal occupation, ANC visits, PNC, maternal breastfeeding knowledge, and attitude towards breastfeeding were independent predictors of low BPI scores. Nutrition promotion should be implemented by considering the above significant factors to decrease inappropriate breastfeeding practice in Northwest Ethiopia.

The recovery rate from severe acute malnutrition among under-five years of children remains low in sub-Saharan Africa. A systematic review and meta-analysis of observational studies.

BACKGROUND: Globally, Severe Acute Malnutrition (SAM) has been reduced by only 11% over the past 20 years and continues to be a significant cause of morbidity and mortality. So far, in Sub-Saharan Africa, several primary studies have been conducted on recovery rate and determinants of recovery from SAM in under-five children. However, comprehensive reviews that would have a shred of strong evidence for designing interventions are lacking. So, this review and meta-analysis was conducted to bridge this gap. METHODS: A systematic review of observational studies published in the years between 1/1/2000 to 12/31/2018 was conducted following the Meta-analysis of Observational Studies in Epidemiology (MOOSE) statement. Two reviewers have been searched and extracted data from CINAHL (EBSCO), MEDLINE (via Ovid), Emcare, PubMed databases, and Google scholar. Articles' quality was assessed using the Newcastle-Ottawa Scale by two independent reviewers, and only studies with fair to good quality were included in the final analysis. The review presented the pooled recovery rate from SAM and an odds ratio of risk factors affecting recovery rate after checking for heterogeneity and publication bias. The review has been registered in PROSPERO with protocol number CRD42019122085. RESULT: Children with SAM from 54 primary studies (n = 140,148) were included. A pooled rate of recovery was 71.2% (95% CI: 68.5-73.8; I2 = 98.9%). Children who received routine medication (Pooled Odds ratio (POR):1.85;95% CI: 1.49-2.29; I2 = 0.0%), older age (POR: 1.99;95% CI: 1.29-3.08; I2 = 80.6%), and absence of co-morbidity (POR:3.2;95% CI: 2.15-4.76; I2 = 78.7%) had better odds of recovery. This systematic review and meta-analysis suggestes HIV infected children had lower recovery rate from SAM (POR; 0.19; 95% CI: 0.09-0.39; I2 = 42.9%) compared to those non-infected. CONCLUSION: The meta-analysis deciphers that the pooled recovery rate was below the SPHERE standard, and further works would be needed to improve the recovery rate. So, factors that were identified might help to revise the plan set by the countries, and further research might be required to explore health fascilities fidelity to the WHO SAM management protocol.