Background. Malnutrition among children remains one of the most important causes of morbidity and mortality in the world. In Ethiopia, malnutrition is one of the most serious public health problem and the biggest in the world. This study aimed to assess the prevalence of malnutrition and associated factors among under-five children in pastoral communities of Afar Regional state, Northeast Ethiopia. Methods. A community-based cross-sectional study was conducted on 840 children aged 6–59 months from March 01–25, 2017. A multistage cluster sampling method was used to select the study participants. A structured questionnaire was used and anthropometric measurements were taken to collect data. EPI Data 3.1 and SPSS version 20.0 were used for data entry and analysis, respectively. Bivariate and multivariable logistic regression analysis was used to identify the factors associated with malnutrition. The statistical significance was declared at p value < 0.05 with 95% confidence intervals in the final model. Result. The study found the prevalence of wasting, stunting, and underweight was 16.2% (95% CI: 13.8–18.8%), 43.1% (95% CI: 39.8–46.5%), and 24.8% (95% CI: 21.9–27.8%), respectively. Family size (AOR = 2.72, 95% CI: 1.62–4.55), prelacteal feeding (AOR = 3.81, 95% CI: 1.79–5.42), and diarrhoea in the past two weeks (AOR = 4.57, 95% CI: 2.56–8.16) were associated with wasting. And sex of child (AOR = 1.98, 95% CI: 1.46–2.72), age of child ((12–23 months: AOR = 3.44, 95% CI: 2.24–5.29); (24–35 months: AOR = 3.58, 95% CI: 2.25–5.69); and (36–59 months: AOR = 4.42, 95% CI: 2.79–6.94)), and immunization status of child (AOR = 3.34, 95% CI: 1.31–4.81) were predictors for stunting. Moreover, mother’s education (AOR = 4.06, 95% CI: 2.01–8.19), sex of child (AOR = 1.83, 95% CI: 1.29–2.94), prelacteal feeding (AOR = 2.81, 95% CI: 1.64–3.72), and immunization status of child (AOR = 3.17, 95% CI: 2.14–4.99) were significantly associated with underweight. Conclusions. This study indicated that child malnutrition was high among under-five children. Family size of five and above, receiving prelacteal feeding, and diarrhoea in the past two weeks were positively associated with wasting. Male child, increasing age of child, and not fully immunized child were positive predictors for increasing stunting. Maternal illiteracy, male child, prelacteal feeding, and not fully immunized child were factors affecting underweight. Promoting use of family planning, preventing diarrhoeal diseases, and vaccinating children integrated with the access of nutrition education programs are vital interventions to improve nutritional status of the children.

Background. Anemia affects the lives of more than 2 billion people globally, accounting for over 30% of the world's population. Anemia is a global public health problem occurring at all stages of the life cycle but the burden of the problem is higher in pregnant women particularly in developing countries. The aim of this study was to determine the prevalence of anemia and associated factors among pregnant women attending antenatal clinics in north western zone of Tigray, northern Ethiopia. Methods. A facility based cross-sectional study was employed. A systematic random sampling procedure was employed to select 714 pregnant women who were attending antenatal clinics in health facilities found in the study area from April to May 2014. The data was entered and analyzed using Epi-info version 3.5.1 and SPSS version 20.0 statistical software, respectively. Logistic regression analysis was used to identify factors associated with anemia among the study participants. All tests were two-sided and p value < 0.05 was considered statistically significant. Results. The overall prevalence of anemia (hemoglobin < 11 g/dL) among the pregnant women was 36.1% (95% CI = 32.7%–39.7%) of which 58.5% were mildly, 35.7% moderately, and 5.8% severely anemic. In pregnant women, rural residence (AOR = 1.75, 95% CI = 1.01–3.04), no education/being illiterate (AOR = 1.56, 95% CI = 1.03–2.37), absence of iron supplementation during pregnancy (AOR = 2.76, 95% CI = 1.92–5.37), and meal frequency of less than two times per day (AOR = 2.28, 95% CI = 1.06–4.91) were the independent predictors for increased anemia among the pregnant women. Conclusions. Anemia was found to be moderate public health problem in the study area. Residence, educational status, iron supplementation during pregnancy, and meal frequency per day were statistically associated with anemia among the pregnant women. Awareness creation and nutrition education on the importance of taking iron supplementation and nutritional counseling on consumption of extra meal and iron-rich foods during pregnancy are recommended to prevent anemia in the pregnant women.

Introduction: Iron deficiency is the leading nutrient deficiency in the world affecting the lives of more than 2 billion people, accounting to over 30% of the world's population. Pregnant women are particularly at high risk of iron deficiency. Objective: To determine and compare the adherence rate and identify factors associated with iron folic acid supplementation among urban and rural pregnant women attending antenatal clinics in North Western Zone of Tigray, Ethiopia. Methods: An institution based comparative cross sectional study was employed among 358 urban and 356 rural pregnant women attending antenatal clinics in North Western Zone of Tigray from March to April 2014. Logistic regression analysis was used to identify factors associated with adherence to iron-folic acid supplementation among urban and rural pregnant women. All tests were two-sided and p value < 0.05 was considered statistically significant. Results: The rate of adherence to iron folic acid supplementation among the pregnant women in the urban and rural communities was 37.2% (95%CI, 32.26%-42.25%) and 28.9% (95%CI, 24.4%-33.81%) respectively indicating that there was no significant difference among the two groups with regard to adherence to iron-folic acid supplementation. The independent predictors for maternal adherence to iron folic acid supplementation were early registration (AOR= 1.778, 95% CI= 1.076-2.936), having four or more visits (AOR=3.784, 95%CI=2.073-6.909), previous anemia (AOR=1.913, 95%CI=1.135-3.223), and current anemia (AOR= 0.408, 95%CI=0.224-0.744) for urban pregnant women. Similarly, elderly age (AOR=0.527, 95%CI=0.315-0.881), early registration (AOR=1.918, 95%CI=1.116-3.296), previous anemia (AOR= 2.472, 95%CI=1.352-4.517) and current anemia (AOR=0.400, 95%CI=0.214-0.749) were the independent predictors for maternal adherence to iron folic acid supplementation for the rural pregnant women. Conclusion: Adherence rate to iron-folic acid supplementation in both urban and rural communities were very low. Comprehensive nutrition education should focus on the importance of adherence to iron folic acid tablets both for urban and rural pregnant women.

Background: Stunting is defined as a child with a height for-age Z-score less than minus two standard deviations. Globally, 162 million less than 5 years were stunted. In Ethiopia, Nationally the prevalence of stunting among under five children was 38.4% and in Afar it is above the national average (41.1%). This study was aimed to identify determinants of stunting among children aged 6 to 59 months in rural Dubti district, Afar region, North East Ethiopia, 2017. Methods: Community based unmatched case-control study design was conducted among 322 (161 cases and 161 controls) children aged 6 to 59 months from March 2-30/ 2017. Simple random method was used to select 5 kebelles from 13 kebelles. Training was given for data collectors and supervisors. Data were entered to EPI data version 3.02 and exported to SPSS version 20 for analysis. Binary logistic regression analysis was used and variables with p-value < 0.25 on univariable binary logistic regression analysis were further analyzed on multivariable binary logistic regression analysis and statistical significance was declared at 95% CI. Results: Being from a mother with no education (AOR = 4.92, 95%CI (1.94, 12.4), preceding birth interval less than 24 months (AOR = 4.94, 95% (2.17, 11.2), no ANC follow-up (AOR = 2.81, 95% (1.1.46, 5.38), no access to latrine (AOR =3.26, 95% CI (1.54-6.94), children born from short mother < 150 cm (AOR = 3.75, 95%CI (1.54, 9.18), not fed colostrum (AOR = 4.45, 95% CI (1.68, 11.8), breast fed for less than 24 months (AOR = 3.14, 95% CI (1.7, 5.79) and non-exclusive breast feeding (AOR = 6.68, 95% (3.1, 14.52) were determinants of stunting at 95% CI. Conclusion: No maternal education, preceding birth interval less than 24 months, no ANC follow-up, no access to latrine, short maternal height, not feeding colostrum, duration of breast feed less than 24 months and nonexclusive breast feeding were determinants of stunting at 95% CI.

IntroductionAbout 20 million children suffer from severe acute malnutrition each year. The World Health Organization recommends the outpatient therapeutic program as a standard treatment protocol for the management of uncomplicated severe acute malnutrition and for children who are transferred from inpatient cares after recovery. This study aimed to assess the treatment outcome of severe acute malnutrition and determinants of survival in children admitted to outpatient therapeutic program at public health institutions, Afar Regional State.MethodsInstitution-based prospective cohort study was conducted on 286 children aged 6–59 months admitted to the outpatient therapeutic program, from April to September 2017, at selected public health institutions in Afar Regional State. For the comparison of time to recovery among the different groups of children on the outpatient therapeutic program, Kaplan-Meir curve was used and significance test for these differences was assessed by the log-rank test. Then, a proportional hazard in the Cox model was used to identify independent predictors of survival. p value < 0.05 was considered significant.ResultsOf 286 children, 238 (83.2%; 95% CI (79, 88)), 18 (6.3%), 14 (4.9%), 8 (2.8%), and 8 (2.8%) cases were cured, defaulters, non-responder, died, and transfer to inpatient care, respectively. The overall mean rate of weight gain was 10.5(± 3.45) g/kg/day, and mean length of stay was 44.15(± 8.77) days. The recovery rate of children whose mothers travel less than 2 h to the health institution was about three times (AHR, 2.91; 95% CI (2.18, 3.88)) higher than children whose mothers travel 2 h and above. Compared with children who received vitamin A supplementation, children who lack supplementation were less likely (AHR, 0.39; 95% CI (0.25, 0.59)) to be cured. Moreover, the rate of recovery from outpatient therapeutic program among children who received antibiotics was about 1.4 times (AHR, 1.38; 95% CI (1.01, 1.89)) higher compared with children who did not receive of antibiotics.ConclusionThis study showed that nearly eight children in every ten had recovered from severe acute malnutrition. Therefore, considering the distance of health facility from children’s residence, improving vitamin A supplementation and antibiotics are vital in improving the rate of recovery. Further research is also required to identify and address barriers to the provision of antibiotics and vitamin A supplementation.

Background. Adolescence is an essential stage in the human life cycle, a transition period between childhood and adulthood that is characterized by rapid growth spurt in which nutritional requirement is high. Adolescents are risk groups for malnutrition, but they are not part of a target in many intervention strategies. Hence, this study was aimed at assessing nutritional status of adolescent girls and its associated factors. Methods. Institutional based cross-sectional study design was employed among randomly selected 348 school going adolescent girls. Data were entered into Epi Info and transported to SPSS version 20 for further analysis. Binary logistic regression analysis was used to identify predicators of nutritional status of adolescent girls at p value <0.05 and 95% confidence level. Results. is study revealed that 22.9% and 8.82% of school adolescent girls were stunted and thin, respectively. Being at early adolescent age (14-15 years) [AOR � 1.4, 95% CI (1.04-4.28)], ownership of phone [AOR � 3.3, 95% CI (1.55-7.02)], and dietary diversity score of <4 food groups [AOR � 2.2, 95% CI (1.4-4.54)] were some of the potential predictors of stunting. Similarly, dietary diversity score of <4 food groups [AOR � 1.8, 95% CI (1.14-4.38)] and low food consumption [AOR � 3, 95% CI (1.15-7.90)] were some of the potential predictors of thinness. Conclusion and Recommendation. e prevalence of both stunting and thinness is a public health problem in the study area. Early adolescent age (10-14 years), ownership of phone, and dietary diversity score of <4 food groups were independent predictors of stunting. Dietary diversity score of <4 food groups and eating less than usual were independent predictors of thinness. An integrated nutritional intervention and health related services that meet the needs of adolescent girls in the school community have to be established and strengthened. Since adolescent age is period of growth and development in which growth spurt and nutritional requirement are high, adolescents should be provided with enough meals and diversified foods.

BackgroundMalaria is a major public health problem in Sub-Saharan Africa including Ethiopia and it affects children under five and pregnant mothers. Theprevalence of malaria is not well studied though the burden is expected to be high in low lands of Afar region.Therefore, this study attempts to assess the prevalence and associated factors of malaria among under five children in the pastoral community.MethodsCross-sectional study design was employed from April 15th to 15th May 2018 on a sample of 484 under-five children who visited the randomly selected health facilities of Dubti district, Afar region.The study participants were recruited randomly with the basic assumption that their arrival at health facilities is random. The main outcome variable was parasitological confirmed malaria among under five children and it was measured using either microscopy blood film examination. Binary logistic regression model was done to measure the association between confirmed malaria infection and its predictors. Independent variables with p-value less than 0.25 in the bivariate analysis were entered into multivariable logistic regression analysis model. Statistical significance level was declared at p-value less than 0.05.ResultsThe prevalence of malaria among febrile under-five children was 64% (95% CI 59.5%–68.4%). Of these, more than half (66.5%) and one-fifth (22. 2%) of the cases were caused by p.falciparum and p.vivax respectively. The multivariable logistic regression analysis showed thatliving in rural residence [AOR=1.77: 95% CI 1.10–2.85], having educated mother [AOR=0.406: 95% CI 0.26–0.63], age of child ([AOR=2.98: 95% CI 1.41–6.32], sex of child [AOR=1.99: 95% CI 1.29–3.08], not sleep under ITN [AOR=9.10: 95% CI 1.01- 82.58], ITN availability [AOR=2.23: 95% CI 1.01- 4.89] and history of malaria infection among family members [AOR=9.10: 95% CI 1.01–82.58] were the independent predictors of malaria infection among under five children.ConclusionThe overall prevalence of malaria among under-five children was high compared to the national prevalence of malaria among the general population. Health care providers (HCPs) should educate parents/guardians regarding proper utilization of ITN at night. In addiotion, they should provide early treatment for febrile family members to halt the transmission of malaria. The regional government should give due attention to supply of ITN and enhance the awareness of the community. Additional longitudinal studies are recommended.

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