Behavioral model-guided nutritional counseling could improve the dietary practice and nutritional status of elders in Ethiopia: a quasi-experimental study.

BACKGROUND: Physiological, pathological, and socioeconomic changes occurring in older people negatively influence food intake, utilization, nutritional status, and health. These problems are deeply rooted in low socio-economic settings and could partly be addressed through systematic behavioral change approaches. Hence, this study was to evaluate the effect of behavioral model-guided nutritional counseling on the dietary intake and nutritional status of elders. METHODS: A one-armed pre- and post-test quasi-experimental design was conducted on 293 community-dwelling older adults aged above 60 years from January to May 2022. A health education tool was developed and validated using health beliefs and the theory of behavioral change. The sessions were delivered by trained nurses through home-to-home visits every week lasting 45-60 min for up to two months. Data on nutritional knowledge, dietary intake, and body weight were captured using standardized questionnaires and measurements. The primary outcome was captured using the validated mini-nutritional assessment (MNA) tool and classified accordingly. The data was analyzed using Stata software, where it is presented in tables, graphs, and summary statistics. A paired t-test and the p-value were used to identify statistically significant effects of the intervention. RESULTS: A total of 263 elders were involved in the experiment, and modeled nutritional counseling significantly improved the knowledge score from 7.58 (± 1.05) to 11.6 (± 1.37) (P < 0.001) at the pre- and post-intervention periods. A significant improvement has been shown in the consumption of dairy products, fruits, and animal-source foods and, importantly, in the mean dietary diversity score (p < 0.001). As a result, the burden of malnutrition was significantly lower in the post-intervention period (9.6%: 7.9-11.3) compared to baseline (12.5%: 11.4-13.8). There is a significant increase in the mini-nutrition assessment score (MD = 0.30; p = 0.007). The mean body weight and the body mass index did not change significantly after the intervention (p > 0.05). CONCLUSION: Targeted behavioral model-guided nutritional counseling could help promote perception, diversify dietary consumption, and reduce the risk of undernutrition among elders. Particular attention to older people with the use of participant-centered nutritional behavioral change interventions coupled with livelihood support could help reduce undernutrition among older people. TRIAL REGISTRATION: Clinical Trial Registration-URL: www. CLINICALTRIALS: gov , identifier number: NCT04746664, first released 10/02/2021.

Depression and glycaemic control among adult patients with type 2 diabetes: a cross-sectional study in a comprehensive specialised hospital, Jigjiga, Ethiopia.

OBJECTIVES: The primary objective of this study was to evaluate the prevalence of depression and its sociodemographic predictors, clinical predictors and glycaemic control among adult patients with type 2 diabetes at Sheik Hassan Yabare Comprehensive Specialized Hospital (SHYCSH), Jigjiga, Ethiopia. DESIGN: A hospital-based cross-sectional study was conducted. SETTING: Patients with type 2 diabetes mellitus (T2DM) at Sheik Hassan Yabare Comprehensive Specialized Hospital, for chronic follow-up from 3 October 2022 to 13 November 2022. PARTICIPANTS: Randomly selected 278 patients with T2DM age 18 years and older, with a duration of 1 year or more since diagnosis, who had a diabetic follow-up at SHYCSH. MAIN OUTCOME MEASURES: Depression was assessed using the Patient Health Questionnaire. RESULTS: A total of 263 participants were included, with a response rate of 94.6%. Of the respondents, 134 (51%) were male, making up more than half of the total. The overall prevalence of depression was 47.1% (95% CI 41.1 to 53.2). Depression was further classified, as follows, based on its severity: the majority (66 or 25.1%) had mild depression, followed by 44 (16.7%) with moderate depression, 9 (3.4%) with moderately severe depression and 5 (1.9%) with severe depression. A multivariable logistic regression analysis indicated that poor glycaemic control (adjusted OR (AOR)=1.93; 95% CI 1.05 to 3.53), DM complications (AOR=2.02; 95% CI 1.09 to 3.74) and DM duration of 6-10 years since diagnosis (AOR=2.29; 95% CI 1.21 to 4.34) were independently associated with depression. CONCLUSIONS: Our study revealed a significant burden of depression among patients with T2DM receiving follow-up care at the hospital. Glycaemic control, the presence of complications and a longer duration of diabetes were identified as predictors of depression. Therefore, concerned stakeholders should work to improve blood sugar control and promote healthy behaviour, particularly among those with complications or who have been sick for an extended period of time.

Ethiopian aging policy: A review of existing frameworks in relation to the Madrid International Plan of Action on Aging.

Background: The increasing life expectancy and the growing number of older people are becoming public health challenges, warranting the need for appropriate policy tools. Existing policy frameworks should prioritize and cover the public health demands of elders. However, there is a lack of concrete evidence on the existing policy tools and programs targeting elders in Ethiopia. Objective: This study was to explore the existing policies, programs, and interventions for elderly people in Ethiopia. Study design: A descriptive qualitative study using phenomenological approach and secondary data review wa conducted. Methods: A combination of systematic desk reviews of relevant policy and program documents and key informant interviews (KIIs) was used to capture data. Four purposefully selected interviews, based on their expertise, rich experience, in-depth understanding, and direct involvement in the policy environment, were conducted. Face-to-face interviews with the Audio recorder were employed during KII. The number of KIIs was limited to four, the point of theoretical saturation where no further new and informative themes were identified. Interview audios were transcribed, translated, and analyzed in thematic descriptive analysis. The United Nations Madrid International Plan of Action on Aging was used as a guideline for the data extraction process from relevant documents. Results: A total of 221 documents were retrieved, and 75 met the inclusion criteria. We identified four interconnected main themes and 11 sub-themes of concern for the elderly. Ethiopia recognized old people as vulnerable in various national legal and policy documents, including the constitution, population policy, and development plans. Surprisingly, no government policy exists in Ethiopia to address the health and nutritional problems of the elderly in particular. Conclusion: Though Ethiopia is facing demographic transition, no specific old-age policies, programs, or interventions are being implemented. Hence, the government and relevant stakeholders should strive to design and implement an old-age policy outlining cost-effective interventions for elders.

Utilization of long-acting contraceptive methods and associated factors among female healthcare providers in South Wollo Zone hospitals, Northeast, Ethiopia. A cross-sectional multicenter study.

In Ethiopia Long-acting contraception method utilization was found low (22.7%) among female healthcare providers. However, there is no study has been conducted on the utilization long-acting contraception methods among female healthcare providers in the study area. These studies addressed important variables such as socio-demography and individual factors that might affect the use of long-acting contraceptive methods among female healthcare providers. We assessed the utilization of long-acting contraceptive methods and associated factors among healthcare providers in South Wollo Zone public hospitals, Amhara Region, Ethiopia, in 2021.An institutional-based cross-sectional study was conducted among 354 female healthcare workers in the South Wollo Zone hospitals from March to April, 2021. The participants were selected using a systematic random sampling technique. The data were collected using self-administered questionnaires entered into Epi-data version 4.1 and exported to SPSS version 25 for analysis. Bi-variable and multi-variable logistic regression analyses were performed. The adjusted odds ratio (AOR), along with a 95% confidence interval (CI), was estimated to measure the association. The significance level was set at a P- value under 0.05. The current utilization of long-acting contraceptive methods among female healthcare providers was found to be 33.6% [95%, CI 29-39)]. Discussion with a partner [AOR = 2.277,95% CI, (1.026-5.055)], method shift/switched [AOR = 4.302,95% CI, (2.285-8.102)], knowledge of the respondent [AOR = 1.887,95% CI, (1.020-3.491)], and ever birth [AOR = 15.670,95% CI, (5.065-48.49)] were significant factors toward the utilization of long-acting contraceptive methods. The current utilization of long-acting contraceptive methods was found to be low. Therefore, encouraging partner discussions through a targeted information education communication intervention strategy should be intensified to improve long-acting contraceptive methods utilization.

Prevalence of malnutrition among old age people in Africa.

Background: Improved health care and rising life expectancy are creating a growing pool of old age people all over the world, including Africa. Malnutrition in the old age people is associated with both short- and long-term negative health outcomes. However, the reported burdens of malnutrition are fragmented and inconsistent, where more compiled evidence is warranted to aid decision-makers. Hence, this paper is aimed to estimate the pooled prevalence of malnutrition among old age people in Africa. Methods: A systematic search for research reporting the prevalence of malnutrition among old age people (aged above 60 years) was conducted from HINARI/PubMed and Google Scholar databases using combination keywords. Published articles in English language starting from January 2000 to October 2021 were screened. We presented the results based on the standard for reporting systematic review and meta-analysis of observational studies. A random-effect meta-analysis was done to estimate the prevalence of malnutrition along with the 95% confidence intervals. The publication bias was assessed using the funnel plot. Results: A total of 1,442 studies were retrieved based on the search strategy, where only 36 studies (n = 15,266 participants) reported from 11 African countries were included for meta-analysis. The reported prevalence of malnutrition ranges from 2.2 to 77.3% across Africa. Overall, the pooled prevalence of malnutrition was 18% (95% CI: 15-22; I2 = 98.1; p < 0.001). The prevalence is higher in the Central Africa (3.8%; 95% CI: 3.2-4.4), in the community (3.1%; 95% CI: 2.7-3.7), and among advanced age (3.5%; 95% CI: 2.3-5.4). Conclusion: The prevalence of malnutrition in African old age people is high and differs by setting, assessment tool, and country of residence. Hence, due attention to geriatric nutrition is mandatory, and the need for a valid, reliable, and simple screening tool should be thought of.

Prevalence of malnutrition among old people in Africa: systematic review and meta-analysis.

OBJECTIVE: To summarise available evidence and estimate the pooled prevalence of malnutrition among old people in Africa. DESIGN: Systematic review and meta-analysis. SETTING: Any healthcare or community research reporting the prevalence or incidence of malnutrition in Africa from January 2000 to October 2021. PARTICIPANTS: Old people, aged above 60 years. OUTCOME MEASURES: Malnutrition, either undernutrition or overnutrition. RESULTS: A total of 1442 studies were retrieved based on the search strategy, where only 36 studies (n=15 266 participants) reported from 11 African countries were included for meta-analysis. The reported prevalence of malnutrition ranges from 2.2% to 77.3% across the continent. Overall, the pooled prevalence rates of undernutrition and overnutrition were 18% (95% CI: 15% to 22%; I2=98.1; p<0.001) and 33% (95% CI: 22% to 44%; p<0. 001), respectively. CONCLUSION: The prevalence of malnutrition in old African people is high and differs by setting, assessment tool and country of residence. Hence, due attention to geriatric nutrition is mandatory, and the need for a valid, reliable and simple screening tool should be thought of.

Adherence to pre-operative fasting guidelines and associated factors among pediatric surgical patients in selected public referral hospitals, Addis Ababa, Ethiopia: Cross sectional study.

Background: Fasting before anesthesia is mandatory in children to reduce the complications of regurgitation, vomiting, and aspiration during anesthesia and surgery. Prolonged fasting times have several negative implications in children, because high fluid turnover quickly leads to dehydration, hypotension, metabolic disturbances, and hypoglycemia, resulting in poor anesthetic outcomes. Aims: This study aimed to assess adherence to preoperative fasting guidelines and associated factors among pediatric patients undergoing elective surgery in Addis Ababa public hospitals in Ethiopia in 2020. Methods: A cross-sectional survey was conducted in Addis Ababa, which selected public hospitals in Ethiopia, in 2020. A total of 279 pediatric patients aged <17 years scheduled for elective surgery were included in the study. Data analysis was performed using SPSS V.21, and the values of the variables and factors were checked for associations using logistic regression. Statistical significance was determined at P -value of <0.05. The results are presented in text, tables, charts, and graphs. Results: A total of 279 pediatric patients responded to the analysis, with a 98.6% response rate. The majority of the participants (n = 251, 89.96%) did not follow the guidelines for preoperative fasting. The mean fasting time for clear liquids was 10 ± 4.03 (2-18 h) for breast milk 7.18 ± 2.26 (3.5-12 h), and for solid foods 13.5 ± 2.76 (8-19 h). The reasons for which the preoperative fasting delay was due to incorrect order were 35.1%, prior case procedures took longer times 34.1%, and changing sequence of schedule was 20.8%. Conclusion: Most children had prolonged fasting. The staff's instructions and schedules were challenged to follow international fasting guidelines.