Iron Deficiency Anaemia among Women of Reproductive Age in Nine Administrative Regions of Ethiopia

Background: Iron deficiency anaemia (IDA) is one of the most common causes of nutritional problem; and is of great public health significance affecting children; adolescents and women of reproductive age world wide. The magnitude of IDA in the general population of Ethiopia has not yet been well documented. Objective: To estimate the magnitude of IDA among women of reproductive age in nine administrative regions. Methods: A cross-sectional study of analytical nature was conducted in 270 clustered villages drawn from 9 administrative regions of the country between June and July 2005. A total of 22;861 women of reproductive age (15-49 years) were examined clinically for pallor and 5of these subjects were systematically selected and assessed further for their haemoglobin (Hgb) and serum ferritin (SF) status. Results: The prevalence rate of clinical anaemia; anaemia; ID (iron deficiency) and IDA were 11.3; 30.4; 49.7and 17.0respectively. The majority of anaemic women were in the category of mild (19.3) to moderate (10.3) and severe anaemia was 0.9. A significantly higher proportion of clinical anaemia [26.7(95CI: 24 to 28)]; anaemia (Hgb) [79.4(95CI: 72 to 86)]; ID [65.1(95CI: 72 to 86)] and IDA [58.0(95CI: 55 to 76)] was observed in Afar signifying distinct regional variation. The most affected age groups were those between 36-49 years and the difference noted was statistically significant. Conclusion: This study substantiates the existence of mild to moderate form of IDA among women of reproductive age and underlines the need for iron supplementation to all reproductive women during the antenatal period with more attention to the most affected regions

Malnutrition and xerophthalmia in rural communities of Ethiopia.

OBJECTIVE: To determine the level of malnutrition and xerophthalmia in pre-school children. DESIGNS: Non-randomised community based study. SETTINGS: Four different administrative regions: Harari, Tigray, Southern Nation Nationalities and people region (SNNPR) and Oromiya, with different eco-zones, were studied from May to June 1996. SUBJECTS: Fifteen thousand and eighty seven children, aged between six and 71 months, examined for clinical symptoms and signs of xerophthalmia. Anthropometry and blood samples were taken from every 20 children (n = 634) of same age, for serum retinol and nutritional determination. INTERVENTION MEASURES: Disease targeted approach of vitamin A supplementation was employed in the regions. RESULTS: The overall prevalence rates of night blindness and Bitot's spots exceeded WHO cut-off point for xerophthalmia as a public health problem, with higher prevalence rates in males (53%) than females (26%). The proportion of children with deficient serum retinol concentrations (SRC), and Bitot's spot were observed to be higher in Oromiya and Harari regions followed by Tigray, than SNNPR administrative regions. Most of the affected children were aged between 36 and 72 months. The greatest low SRC was also observed in the same age group of children in all regions. There was higher prevalence rate of stunting (60.1%) than wasting (12.2%) with an additional (8.8%) of children both stunted and wasted. The proportion of stunted children was high in Tigray followed by Oromiya, SNNPR and Harari regions. CONCLUSION: The high level of stunting and Bitot's spot, together with the low level of serum retinol concentrations found in these regions, indicates the need to strengthen this intervention strategy further with universal vitamin A capsule distribution, nutrition education and promotion of horticulture activities.

The nutritional impact of seasonality in children and adults of rural Ethiopia.

A survey of the nutritional status of subsistence farmers was conducted over 13 months in a rural area of Ethiopia characterized by moderate climatic seasonality and intensive land exploitation. Bi-monthly questionnaires on food consumption, time allocation, agricultural production and cash flow were administered to 203 households and anthropometry performed on 1407 individuals. Comparison of post-harvest and pre-harvest anthropometry was made on 672 individuals (48% of the sample). In children, seasonal changes in the Z-score of weight-for-height were small and not significant. Height growth velocity showed instead a marked seasonal pattern, with values close to normal (-0.2 SD units) in July to December, a period characterized by better food availability, and lower values (-3.0 SD units) in January to June, a period characterized by intensive farm labour and heavy rains. Among the adults, body weight was highest in the post-harvest season (December) and decreased by 1.5 +/- 2.3 kg in men and 1.3 +/- 2.6 kg in women to the yearly minimum in the pre-harvest season (June). The paper shows that in this area children and adults both suffer from exposure to seasonal energy stress. The change in weight-for-height Z-score observed in children and the body weight loss observed in adults was greater in individuals of low socio-economic status and, within the same socio-economic level, in individuals with better nutritional status.

Seasonal energy stress in an Ethiopian rural community: an analysis of the impact at the household level.

The household integrated response to seasonal fluctuations in food availability and work load was assessed in a longitudinal study in two villages of southern Ethiopia. The household response to energy stress was estimated by pooling weight changes of all members of the family, accounting for the diverse biological and functional meaning of weight losses of different age and sex groups, and levels of nutritional status. On average, seasonal energy stress experienced by the households was modest (3.3%, P < 0.05 by Tukey test). The cumulative weight change of poor households was twice as large as that of rich ones, and evidence was obtained of their further deterioration over the following agricultural year. Household food availability fluctuated seasonally, with evident socio-economic gradient: in the early pre-harvest season food stocks of poor households were 6.5 times smaller than those of better-off families (P < 0.001 by ANOVA). Unlike rich households, poor families markedly decreased the time devoted to agriculture in the pre-harvest season. Crop selection, quality of land management and time employed in agricultural work might have synergistically concurred to cause the stress situation.

Intensity of intestinal parasite infestation in a small farming village; near Lake Tana; Ethiopia

Of the 806 people in Gebaba Village; 192 were examined for intestinal parasites. The overall prevalence was 61 per cent. The mean intensity of infestation for A. lumbricoides generally fell with age. Of the total nematode egg counts; 41 per cent was harboured by children below 10 years of age. The cure rate with a single dose of levamisole (Ketrax) for A. lumbricoides was 94 per cent and for T. trichiura and Hookworm 100 per cent. The study has an important implication in understanding the epidemiology of intestinal parasites and in the design of community based control programmes