Dietary practices and nutritional status of young children in the former ensete monoculture dominated Sidama region, southern Ethiopia: A community based cross-sectional study.

BACKGROUND: Child undernutrition is a challenge in Ethiopia, where morbidity and mortality among children are attributed to it. This study aimed to describe the dietary practices, household food insecurity, and nutritional status of young children in Dale district, Sidama region, southern Ethiopia. We discuss our findings in light of research from the same area 3 to 5 decades ago, and we analyze factors associated with linear growth of young children. METHOD: A community-based cross-sectional study design was employed. Children less than two years old and their primary caretakers (n = 903) were included in this study. Among whom 791 children were aged above six months and 742 children out of 791 provided a 24-hour dietary recall. Interviews capturing other dietary practices, food insecurity, socio-demographic characteristics, anthropometric measurements, and haemoglobin assessments were performed for all. The WHO Child Growth Standards were used to calculate anthropometric indices and to describe stunting (length-for-age z-score <-2). Haemoglobin measures below 11g/dl were defined as low haemoglobin levels (anaemia). Multilevel linear regression was used to identify factors associated with length-for-age z-scores. RESULT: The prevalence of stunting, wasting, and anaemia was 39.5%, 3.9%, and 61.7%, respectively. The majority of children (97%) ate cereals (maize) during the past 24 hours, and 79.6% of households use maize as the main food. Three fourth (75%) of the total households were food insecure ranging from mild to severe food insecurity. Boys were at higher risk of having lower length-for-age z-score than girls (ß -0.53; 95% Confidence Interval (CI): -0.78, -0.27). For each month the children grew older, length-for-age z-score decreased slightly (ß -0.06; -0.07, -0.04). Household food insecurity scores (ß -0.05; -0.08, -0.01) and children haemoglobin levels, (ß 0.21; 0.06, 0.35) were also associated with length-for-age z-score among young children. CONCLUSION: Linear growth failure (stunting) was prevalent among young children in the rural Sidama region and the majority of them were also anaemic. Older age, male sex, a lower haemoglobin level in children, and household food insecurity were risk factors of linear growth failure in young children. Maize seems to be the dominant food in this previously ensete dominated area; however, there have been minimal improvements in length-for-age z-score over decades. Strategies to ensure household's food access and improve the quality of child diets need to be implemented.

Child alcohol use disorder in Eastern Uganda: screening, diagnostics, risk factors and management of children drinking alcohol in Uganda (TREAT C-AUD): a mixed-methods research protocol.

Background: Following a finding of alcohol use among children aged 5-8 years old in Mbale, Uganda, this project investigates the magnitude of alcohol and substance use among children ged 6-13 years old and related household, community, school, health system and clinical factors. Methods: The project includes four larger work packages (WPs). WP1 comprises management, WP2 and 3 include the scientific components and WP4 includes integration of results, dissemination, policy and implementation advice. This protocol presents the planned research work in WP 2 and 3. WP2 comprises the adaptation and validation of the alcohol use screening tool Car-Relax-Alone-Forget-Family and Friends-Trouble (CRAFFT) to the age group and setting. WP3 comprises four substudies (SS). SS1 is a cross-sectional community household survey with an estimated sample size of 3500 children aged 6-13 years and their caregivers. We apply cluster sampling and systematic sampling within the clusters. Data collection includes a structured questionnaire for caregiver and child, measuring social and demographic factors, mental health status, alcohol and substance use, nutrition history and anthropometry. Urine samples from children will be collected to measure ethyl glucuronide (EtG), a biological marker of alcohol intake. Further, facilitators, barriers and response mechanisms in the health system (SS2) and the school system (SS3) is explored with surveys and qualitative assessments. SS4 includes qualitative interviews with children. Analysis will apply descriptive statistics for the primary outcome of establishing the magnitude of alcohol drinking and substance use, and associated factors will be assessed using appropriate regression models. The substudies will be analysed independently, as well as inform each other through mixed methods strategies at the stages of design, analysis, and dissemination. Ethics and dissemination: Data protection and ethical approvals have been obtained in Uganda and Norway, and referral procedures developed. Dissemination comprises peer-reviewed, open access research papers, policy recommendations and intersectoral dialogues.Trial registration numberClinicaltrials.gov 29.10.2020 (NCT04743024).