Nutritional knowledge, nutritional status and associated factors among pregnant adolescents in the West Arsi Zone, central Ethiopia.

When pregnancy occur among teenagers; there is a competition for nutrients between the still-growing adolescent mother and her fetus. Pregnant adolescents' nutrition issues are not addressed well and changes are too slow in Ethiopia. This study aimed to study, nutrition knowledge, nutritional status and associated factors among pregnant adolescents in West Arsi , central Ethiopia. We conducted a cross-sectional study of 426 pregnant adolescents between January 1 and January 25, 2023. Data were collected using kobo collect and analyzed using SPSS version 25. We performed linear regression to identify independent predictors of nutritional status and multivariable logistic regression analyses to identify nutritional knowledge. Odds ratios (ORs) with 95% confidence intervals were estimated to show the strength of the association. Magnitude of good nutrition knowledge was 23.7%, 95% CI (21.4-25.3%), and the odds of having good nutrition knowledge was 7.5 times higher among participants whose education level was above college compared with illiterate participants [(AOR = 7.5, 95% CI = (5.27-9.38)],the odds of having good nutrition knowledge was 8 times higher among adolescent who had ANC visits, [(AOR = 8, 95% CI = (3.63-13.85)], and the odds of having good nutrition knowledge was 5 times higher among adolescents who received nutrition education [(AOR = 5, 95% CI = (3.67- 13.53)]. Receiving nutrition education (ß = 0.25, P = 0.002) and good nutrition knowledge (ß = 0.08, P < 0.001) were positively associated with nutritional status; however, food insecurity (ß = - 0.93, P < 0.001) was negatively associated with nutritional status. The nutrition knowledge of pregnant adolescents was suboptimal; educational status, ANC visits and nutrition education were associated with good nutrition knowledge, whereas food insecurity, low nutrition knowledge, and not receiving nutrition education were predictors of poor nutritional status. Nutritional education interventions, increasing utilization of ANC, and interventions for improving food security are strongly recommended.

Effect of nutrition counseling on nutritional status and gestational weight gain of pregnant adolescents in West Arsi, Central Ethiopia: a cluster randomized controlled trial.

When pregnancy occurs in adolescence, the growth and development of the mother and fetus may be impaired due to strong competition for nutrients between the still-growing adolescent and the fetus. Pregnant adolescents constitute an underserved population; they lack adequate nutritional knowledge. Therefore, this study investigated the effect of nutritional behavior change communication (NBCC) through alliance for development (AFD) on the nutritional status and gestational weight gain (GWG) of pregnant adolescents. A two-arm parallel cluster randomized controlled community trial was conducted in the West Arsi Zone, central Ethiopia, from August 2022 to July 2023. The nutritional status of the pregnant adolescent was assessed using mid-upper arm circumference. Weight was measured at baseline and at the end of the intervention. A total of 207 and 219 pregnant adolescents participated in the intervention and control clusters, respectively. The intervention started before 16 weeks of gestation, and the intervention group attended four NBCC sessions. The NBCC was based on the health belief model (HBM) and was given at the participants' homes with their husbands. The NBCC intervention was delivered by AFDs and community-level health actors. Pregnant adolescents in the control group received routine nutrition education from the health care system. A linear mixed-effects model and difference in difference (DID) were used to measure the intervention effect after adjusting for potential confounders. After the implementation of the trial, the mean mid-upper arm circumference (MUAC) in the intervention arm significantly increased from baseline (p ≤ 0.001), 23.19 ± 2.1 to 25.06 ± 2.9 among intervention group and 23.49 ± 2.1 to 23.56 ± 2.0 among control group and the mean difference in the MUAC (DID) was 1.89 ± 2 cm (p ≤ 0.001); the mean GWG in the intervention arm significantly increased from baseline; 51.54 ± 4.7 to 60.98 ± 4.6 among intervention group and 52.86 ± 5.27 to 58 ± 5.3 among control group; the mean GWG in the intervention group was 9.4 kg, and that in the control group was 5.14 kg, and the difference in difference was 4.23 kg and this was statically significant p ≤ 0.001). This study demonstrated that the use of the HBM for NBCC delivered through the AFD was effective at improving the nutritional status and GWG of pregnant adolescents. These results imply the need for the design of model-based nutritional counseling guidelines.Clinical trial registration: PACTR202203696996305, Pan African Clinical Trials Registry, date of first registration: 16/03/2022.

Inadequate dietary diversity practices and associated factors among pregnant adolescents in the West Arsi Zone, Central Ethiopia: a community-based cross-sectional study.

The aftermath of dietary modifications made during pregnancy has the most substantial effects on nutritional status and birth results, despite the important influence of nutritional reserves. Numerous studies have been conducted on dietary practices and their determinants among pregnant women; however, there is a gap in evidence among pregnant adolescents. Therefore, this study sought to close this gap by examining dietary practices and associated factors among pregnant adolescents in the West Arsi Zone, Central Ethiopia. This community-based cross-sectional study was conducted among 459 pregnant adolescents between February and March 2023. Cluster sampling was used for selecting pregnant adolescents. Structured questionnaires were used for data collection. The data were entered into the Kobo toolbox and exported to SPSS version 25 software for analysis. Dietary diversity was assessed using the 24-h dietary recall method. Binary and multivariable logistic regression analyses were used to identify independent predictors of dietary practices. Odds ratios (ORs) with 95% confidence intervals (CIs) were estimated to identify the factors associated with the outcome variables. A p value ≤ 0.05 indicated statistical significance. The prevalence of inadequate dietary practices among the pregnant adolescents was 78.4% (95% CI 74.3%, 82.8%), and a level of nutritional knowledge [AOR = 2.4, 95% CI (1.82-4.74]; an unfavorable attitude toward dietary diversity [AOR = 4.3, 95% CI 2.9-5.83]; a food insecurity status [AOR = 8.7, 95% CI 2.37-10.24]; and a low perceived severity of poor dietary practices [AOR = 4.7, 95% CI 3.26-5.47]. These factors were significantly associated with inadequate dietary practices among pregnant adolescents. The most frequently consumed foods were starchy foods (81.3%) and pulses (79%), and the least consumed foods were meat (2.8%) and fruits (3.48%). The magnitude of inadequate dietary practices was high, and it was significantly associated with educational, behavioral, and economic status. Nutritional interventions focused on communicating nutritional behavioral changes and strengthening sustainable income-generating strategies are recommended to improve the dietary practices of pregnant adolescents.

Exploring dietary perception, beliefs and practices among pregnant adolescents, their husbands and healthcare providers in West Arsi, Central Ethiopia: a phenomenological study.

BACKGROUND: The two most physically active stages of life, pregnancy and adolescence, put the pregnant adolescent under a lot of stress. Adolescence is a crucial era in women's nutrition that is frequently overlooked. OBJECTIVE: This study aimed to explore dietary perceptions, beliefs and practices among pregnant Adolescents in West Arsi, Central Ethiopia. DESIGN: A qualitative method, specifically, a phenomenological research design, was carried out from February to March 2023. SETTINGS: This study was conducted in the West Arsi zone, Oromia, Ethiopia, in four randomly selected districts. PARTICIPANTS: Thirty participants, 12 pregnant adolescents, 8 husbands of pregnant adolescents and 10 healthcare providers were purposefully selected and participated. METHODS: In-depth and key informant interviews were conducted. To create relevant codes, subthemes and themes, ATLAS.ti V.7.1 software was used. An inductive qualitative data analysis approach was used. The results were presented using respondents' clear verbatim and thematic analysis. RESULTS: The findings were organised into four major themes: (1) low nutritional awareness, (2) poor dietary practice, (3) barriers to good dietary practice and (4) facilitators for good dietary practice. A low perceived severity (one's belief of the seriousness) of undernutrition and low perceived benefits (one's belief of the benefits) of balanced nutrition have been reported. A monotonous diet (one type food usually cereal based), no change in dietary practices during pregnancy, and low intake of animal food sources (meat, egg and milk) were found under dietary practices. One of the most striking findings to emerge from this study is the Alliance for Development (AFD), the former Women Development Army, which can be a great facilitator of good dietary practice. Husbands' involvement in nutrition education and specific nutrition training for healthcare providers are the other facilitators identified in this study. The lack of nutrition education, misconceptions and economic problems are barriers to dietary practices. CONCLUSION: This study found a low nutritional awareness and poor dietary practices. Further experimental studies are recommended to assess whether AFD is capable of delivering effective nutrition interventions that improve dietary practice of pregnant.

Effects of nutrition education and counseling intervention on maternal weight and obstetric outcomes among pregnant women of Gedeo Zone, Southern, Ethiopia: A cluster randomized control trial.

Background: Due to the scarcity of intervention trials, especially in Ethiopia, the effect of nutrition education and counseling intervention on pregnancy outcomes is not well studied. Aim: To assess the effect of nutrition education and counseling on the outcomes of pregnancy among pregnant mothers in public health care institutions of Gedeo Zone, Southern, Ethiopia. Methods: A cluster randomized control trial study design was undertaken. Simple random sampling followed by cluster sampling was used to reach eligible study participants. A total sample of 235 (115 intervention vs.120 control group) pregnant women who followed anti-natal care service in public health facilities of Gedeo Zone was included in the study. Independent t-test was used to analyze the group difference for continuous variable and chi-square test for categorical variables. The post-intervention values between the two groups were compared using analysis of covariance by adjusting to baseline variable. Results: After nutrition education, pregnant women in the control group had less weight gain than in the intervention. The proportion of LBW neonate was 17.8% in the intervention group and 38.2% in the control group (P < 0.001). Multivariable logistic regression analysis showed that the risk of LBW in the control group was 2.43 more likely than in the intervention group (AOR = 2.43; 95% CI: (1.2, 4.92)). Conclusion: Nutrition education delivered to pregnant women during pregnancy could reduce maternal malnutrition and low birth weight. Recommendation: The intervention is easy to implement in the health facilities of Gedeo zone and would be implemented without delay to achieve the sustainable development goals.

Under-nutrition and associated factors among pregnant women in public health care hospitals of Gedeo Zone, southern Ethiopia: A cross-sectional study.

Background: Balanced and adequate nutritious food during pregnancy helps to improve maternal weight and for the healthy growth of the fetus. There has been little progress in reducing pregnant undernutrition in Ethiopia; it has been too slow. Objective: The objective of this study was to assess the prevalence of undernutrition and associated factors among pregnant women in public health care hospitals of Gedeo Zone, Southern Ethiopia. Method: A cross-sectional study design was used in public hospitals of Gedeo Zone, Southern Ethiopia from February 01 to March 01, 2019. Pretested structure questionnaire was used to collect data on the socio-economic and demographic characteristics of the study participants. Epi-data was used to code and enter the data and SPSS-25 was used to analyse and interpret the data. To assess the relationship between the dependent and the independent variables, bi-variable and multivariable logistic regression analysis was done. Results: In this study, the prevalence of undernutrition among pregnant women was 21% (95% CI: 20.8-21.2). After controlling other co-variables, the multivariable logistic regression model revealed that average monthly income, women's educational status, nutrition education and counseling, and parity were found to have a significant association with pregnant women's nutritional status. The odds of under-nutrition among pregnant women whose monthly income is <800 ETB were 2.8 times higher than those whose monthly incomes were >1500 (AOR: 2.89; 95%CI: 1.49-5.6). Conclusion: In this study the magnitude of undernutrition among pregnant women was found to be higher than the previously reported findings. Average household monthly income, family size, mother's educational status, nutrition education and counseling, current health condition of the mother, and parity were factors significantly associated with undernutrition of pregnant mothers. Therefore, Interventions should be initiated in earlier stages of pregnancy to prevent the high level of undernutrition during the second and third trimester in this study area.

Factors associated with childhood underweight among orphaned preschool children: A community-based analytical cross-sectional study in Southern Ethiopia.

BACKGROUND: Childhood underweight is one of the major public health problems in Ethiopia. In Ethiopia, most of the available evidence is related to the general community children, which had different risk and severity levels than orphan children. Even though under-five orphan children have a higher risk of being underweight, they are the most neglected population. OBJECTIVE: The study aims to determine the prevalence and factors associated with childhood underweight among orphaned preschool children in Southern Ethiopia. METHODS: A community-based analytical cross-sectional study was conducted among 367 orphans. The burden of childhood underweight was assessed using World Health Organization standard cutoff points below -2 SD using z-scores. All variables with a p-value of < 0.25 during binary logistic regression analysis were entered into a multivariate logistic regression analysis to identify predictor variables independently associated with underweight at a p-value of 0.05 with 95% CI. RESULTS: In this study, the prevalence of underweight among orphan children was 27.4%. The main factors associated with underweight were female child (adjusted odds ratio (aOR) = 5.29, 95% confidence interval (CI) (2.83-9.92)), adult food as type of first complementary food (aOR = 2.47; 95% CI (1.24-4.94)), food insecurity (aOR = 1.98; 95% CI (1.23-3.21)), and child age from 24-59 months (aOR = 7.19; 95% CI (3.81-13.60)). CONCLUSION: Childhood underweight is a public health problem in the study area. The sex of a child, type of first complementary food, household food security status, and child age were the major predictors of underweight. Therefore, appropriate dietary interventions, nutrition education, and increased food security status of orphan children are highly recommended.

Magnitude of, and Factors Associated with Cardiovascular Disease Among Type Two Diabetes Mellitus Patients.

BACKGROUND: Diabetes mellitus is becoming one of the major health problems in developing countries. The number of adults living with type 2 diabetes mellitus (T2DM) worldwide is increasing over time. Cardiovascular disease (CVD) is the major cause of death in T2DM. The objective of this study was to determine the prevalence of cardiovascular disease and its associated factors among diabetic patients at the MRC clinic of Dilla University Referral Hospital (DURH). METHODS: A hospital-based cross-sectional study was conducted from April to May 2019 . A total of 216 diabetic individuals were selected with a convenient sampling technique from patients on follow-up at DURH MRC. Data were collected using a structured format. The diagnosis of CVD was made with the necessary diagnostic tests and examination. The data analysis was done in SPSS software version 20. Bivariate and multivariable logistic regression analysis was carried out to identify factors associated with cardiovascular disease. RESULTS: A total of 216 patients participated in the study and the mean age of the study participants was 30 years; 83.3% of the study participants were male. The overall prevalence of cardiovascular disease was 25% of which 57% were ischemic heart disease, 32% were hypertensive and 10% were stroke. Duration of DM for more than 10 years and diabetic drug discontinuation were factors associated with cardiovascular disease. Odds of CVD was nearly four times more in those whose duration of DM is more than 10 years (AOR=4.00, 95% CI: 2.386-6.705) and odds of CVD among those who discontinued medication were almost three times more, (AOR=2.98, 95% CI: 1.287-6.080). CONCLUSION: A quarter of the diabetic population studied developed CVD. Duration of DM for more than 10 years and drug discontinuation are independent associated factors of CVD. Hence appropriate intervention at early stages should be implemented at primary healthcare level.

Prevalence of depressive symptoms and associated factors among patients with tuberculosis attending public health institutions in Gede'o zone, South Ethiopia.

BACKGROUND: Depression is a common mental disorder among patients with tuberculosis and it is associated with a greater risk of suicide, multidrug-resistant tuberculosis, and poor quality of life. Evidence suggests the early identification of depression among patients with tuberculosis is important to decrease adverse outcomes. However, there are limited studies that examined the prevalence and determinants of depressive symptoms among patients with tuberculosis. This study aimed to assess the prevalence and associated factors of depressive symptoms among patients with tuberculosis attending public health institutions in Gede'o zone, South Ethiopia. METHODS: An institution-based a cross-sectional study was conducted from November 1 to December 30, 2018, among a randomly selected sample of 415 patients with tuberculosis attending public health institutions in Gede'o zone, South Ethiopia. Patient Health Questionnaire (PHQ-9) was used to assess depressive symptoms. Logistic regression was used to identify the potential risk factors of depressive symptoms. The strength of the association was presented by crude odds and adjusted odds ratio with their corresponding 95% CI. Finally, the statistical significance was set at p < 0.05. RESULTS: The prevalence of depressive symptoms was found to be 45.5% (95% CI; 41.1-50.1%) among patients with tuberculosis; 33.3% had moderate, 9.8% had moderately severe, and 2.4% had severe depression. After adjusting for the possible confounders, being on re-treatment for tuberculosis (AOR = 2.47, 95% CI: 1.17-5.22), aged ≥45 years (AOR = 2.41, 95% CI: 1.09-5.32), having poor social support (AOR = 4.21, 95% CI: 2.10-8.47), and Tuberculosis/Human Immunodeficiency Virus (TB/HIV) co-infection) (AOR = 3.96, 95% CI 2.0, 7.84) were significantly associated with depressive symptoms among patients with TB. CONCLUSIONS: This study suggests that a substantial percentage of patients with TB had depressive symptoms (45.5%). TB/HIV coinfection, being on re-treatment for tuberculosis, those having poor social support, patients aged 45 and above were factors associated with depressive symptoms. Routine screening of depression among patients with TB is warranted. Moreover, patients with TB falling into the risk categories should be more carefully monitored for depression and when possible referred to mental health professionals.

Effectiveness of Leg Elevation to Prevent Spinal Anesthesia-Induced Hypotension during Cesarean Delivery in the Resource-Limited Area: Open Randomized Controlled Trial.

BACKGROUND: Postspinal hypotension is the most common complication after spinal anesthesia for cesarean section (CS). Hypotension mainly occurs due to the reductions of vascular tone leading to decreased systemic vascular resistance and decreased venous return. The aim of this study was to assess the effectiveness of leg elevation (LE) as a method of prevention of postspinal hypotension in patients who undergo cesarean section under spinal anesthesia. METHODS: This is a single-center parallel-randomized controlled trial study, and 52 full-term parturients scheduled for elective cesarean section who meets inclusion criteria were included in the study. The randomization sequence was created by a researcher not participating in patient management using a computer random generator. The participant was randomly assigned to the leg elevation group (n = 26) or to the control group (n = 26) of usual perioperative care. RESULTS: The proportions of patients who develop hypotension are lower (8 (33.3%)) in the leg elevation group than the control group (15 (62.5%)) with an X 2 (1, N = 48) = 4.09, P=0.043. The relative risk of developing postspinal hypotension in the leg elevation group compared to the control group was 0.47 (95% CI, 0.28-1.00). The proportion of severe hypotension was significantly decreased in the leg elevation group at a P value of 0.02. CONCLUSION: Performing leg elevation immediately after spinal anesthesia reduced the incidence of hypotension. The trial is registered with PACTR201908713181850.

Food insecurity and its predictors among lactating mothers in North Shoa Zone, Central Ethiopia: a community based cross-sectional study.

OBJECTIVE: To assess the prevalence of food insecurity (FI) and its predictors among lactating mothers in Ataye District, North Shoa Zone, Central Ethiopia. DESIGN: A community-based cross-sectional study design was used. SETTING: Two urban and four rural randomly selected kebeles of the Ataye District in Ethiopia. PARTICIPANTS: Out of 635 participants, 612 lactating mothers aged 15-49 years participated from February to April 2018. Mothers who lived for at least 6 months and above in the district were included, and mothers who were not able to respond to an interview were excluded. A single lactating mother per household was included. Lactating mothers in the households were selected using a cluster sampling technique. The number of lactating mothers found in each kebele was taken from family folder documentation. PRIMARY OUTCOME: The prevalence and predictors of food insecurity. RESULTS: The prevalence of FI among lactating mothers was 36.8%. No formal education (adjusted OR (AOR) =1.82, 95% CI 1.13 to 2.92), no income-generating activities (AOR=3.39, 95% CI 2.05 to 5.64), no home gardening practice (AOR=5.65, 95% CI 3.51 to 9.08), alcohol use by husbands (AOR=2.02, 95% CI 1.25 to 3.24), low minimum dietary diversity score (AOR=2.94, 95% CI 1.88 to 4.57), less than three frequencies of meals (AOR=3.97, 95% CI 1.65 to 9.54) and three meals only per day (AOR=1.86, 95% CI 1.08 to 3.17) were significant predictors of FI of mothers. CONCLUSION: The prevalence of FI was high in the study area. No formal education, no income-generating activities, no home gardening practice, alcohol use by husbands, low minimum dietary diversity score, fewer than three frequencies of meals and three meals only per day were independent predictors of FI. Therefore, increasing home gardening, decreasing alcohol intake, increasing dietary diversity and performing income-generating activities are highly recommended to reduce FI.

Prevalence of Goiter and Associated Factors among Women of Reproductive Age Group in Demba Gofa Woreda, Gamo Gofa Zone, Southwest Ethiopia: A Community-Based Cross-Sectional Study.

BACKGROUND: Iodine deficiency disorder is a major public health problem in Ethiopia that is more common in women of reproductive age. However, it is not well addressed and there is a lack of information on its prevalence and associated factors in women of reproductive age group. Therefore, the objective of this study was to assess goiter prevalence and associated factors among women of reproductive age in the Demba Gofa woreda, Gamo Gofa Zone, Southwest Ethiopia. METHODS: A community-based cross-sectional study was used among 584 randomly selected women in the reproductive age group from February 05 to April 20, 2016. A simple random sampling technique was used to select the study kebeles, and a systematic random sampling technique was used to select the study samples. Data were collected through a pretested questionnaire, and the goiter examination was done clinically for each participant. The collected data were coded and entered into a computer for statistical analysis using EpiData version 3.2 and analyzed using SPSS version 20. Variables with a P value ≤0.25 in bivariate logistic regression analysis were entered into multivariate logistic regression analysis, and finally, variables with a P value <0.05 in multivariate logistic regression were considered significantly associated with the dependent variable. RESULTS: The total goiter rate was 43%, 95% CI = 39.2-46.9. Cassava consumption (AOR: 2.02, 95% CI: 1.03-4), salt wash before use (AOR: 3.14, 95% CI: 1.1-11.3), salt use after >2 months of purchase (AOR: 11, 95% CI: 5-26), family history of goiter (AOR: 4.6, 95% CI: 1.4-15.8), and poor knowledge of iodized salt (AOR: 2.7, 95% CI: 1.4-5.5) were significant factors associated with goiter. CONCLUSION: Iodine deficiency was found to be severe in women of reproductive age in the study area. This showed that women of reproductive age, especially during pregnancy, are exposed to iodine deficiency and its adverse effects at delivery. Thus, they need urgent supplementation with iodine, improved access to foods rich in iodine, and intake of iodized salt. Additionally, health education should focus on the importance of iodized salt, the proper method of use, and the prevention of iodine deficiency, which are highly recommended to minimize the problem.