Background Nutrition transition in many low- and middle-income countries (LMICs) has led to shift in childhood nutritional outcomes from a predominance of undernutrition to a double burden of under- and overnutrition. Yet, policies that address undernutrition often times do not include overnutrition nor do policies on overweight, obesity reflect the challenges of undernutrition. It is therefore crucial to assess the prevalence and determinants of concurrence stunting and overweight/obesity to better inform nutrition programs in Ethiopia and beyond. Methods We analyzed anthropometric, sociodemographic and dietary data of children under five years of age from 2016 Ethiopian Demographic and Health Survey (EDHS). A total of 8,714 children were included in the current study. Concurrence of stunting and overweight/obesity (CSO) prevalence was estimated by basic, underlying and immediate factors. To identify factors associated with CSO, we conducted hierarchical logistic regression analyses. Results The overall prevalence of CSO was 1.99% (95% CI, 1.57–2.53). The odds of CSO was significantly higher in children in agrarian region compared to their counter parts in the pastoralist region (AOR = 1.51). Other significant factors included; not having improved toilet facility (AOR = 1.94), being younger than 12 months (AOR = 4.22), not having history of infection (AOR = 1.83) and not having taken deworming tablet within the previous six months (AOR = 1.49). Conclusion Our study provided evidence on the co-existence of stunting and overweight/obesity among infants and young children in Ethiopia. Therefore, identifying children at risk of growth flattering and excess weight gain provides nutrition policies and programs in Ethiopia and beyond with an opportunity of earlier interventions through improving sanitation, dietary quality by targeting children under five years of age and those living in Agrarian regions of Ethiopia.
Background Immunization is one of modern medicine’s greatest achievements in the last three decades. Annually it can prevent nearly 2 to 3 million deaths. Understanding the determinants of effective immunization coverage is a critical undertaking. Accordingly, we set out to check the best available evidence of outstanding predictors of immunization coverage among children aged 12–23 months in Ethiopia. Method Electronic databases including PubMed, Google Scholar, HINARI, and SCOPUS, Web of Science, African Journals Online, Ethiopian Medical Journals were searched. The search process, study selection, critical appraisal, and data extraction were done independently by two reviewers using Joanna Briggs Institute Meta-analysis for Review Instrument (JBI-MAStARI). The difference between reviewers was resolved with a third person. The risk of bias was assessed by the Newcastle Ottawa Tool for observational studies. Data were extracted using the Microsoft Excel checklist and exported to STATA 13. Heterogeneity was assessed using I2, Funnel plot and Egger’s test was used to check for publication bias. Results We identified 26 studies with 15,042 children with mothers/caretakers to assess factors associated with immunization coverage and significant factors were: maternal formal education, (OR = 2.45; 95% CI: 1.62–3.72), paternal formal education, (OR = 1.01; 95% CI: 0.27–3.77), residence, (OR = 2.11; 95% CI: 1.00–4.45), birth at health facility (OR = 1.86; 95% CI: 0.99–3.49), family size less than four, (OR = 1.81; 95% CI: 1.16–2.84), knowledge on age of immunization to be completed (OR = 6.18;95% CI: 3.07–12.43), knowledge on immunization schedule (OR = 2.49; 95% CI: 1.35–4.59), time to travel to health faculties, (OR = 1.74; 95% CI: 0.62–4.89), antennal care, (OR = 3.11; 95% CI: 1.64–5.88), and tetanus toxoid vaccination, (OR = 4.82; 95% CI: 2.99–7.75). Conclusion Our findings showed that literacy, residence, awareness, family size, maternal health services use, and proximity of the health facilities were factors associated with full immunization. This implies that there is a need for primary health service expansion and health education to “hard to reach areas” to improve immunization coverage for children aged 12–23 months.
Background: Immunization is a cost-effective public health strategy. Immunization averts nearly three million deaths annually but immunization coverage is low in some countries and some regions within countries. The aim of this systematic review and meta-analysis is to assess pooled immunization coverage in Ethiopia. Method: A systematic search was done from PubMed, Google Scholar, EMBASE, HINARI, and SCOPUS, WHO's Institutional Repository for Information Sharing (IRIS), African Journals Online databases, grey literature and reviewing reference lists of already identified articles. A checklist from the Joanna Briggs Institute was used for appraisal. The I 2 was used to assess heterogeneity among studies. Funnel plot were used to assess publication bias. A random effect model was used to estimate the pooled prevalence of immunization among 12-23 month old children using STATA 13 software. Result: Twenty eight articles were included in the meta-analysis with a total sample size of 20,048 children (12-23 months old). The pooled prevalence of immunization among 12-23 month old children in Ethiopia was found to be 47% (95%, CI: 46.0, 47.0). A subgroup analysis by region indicated the lowest proportion of immunized children in the Afar region, 21% (95%, CI: 18.0, 24.0) and the highest in the Amhara region, 89% (95%, CI: 85.0, 92.0). Conclusion: Nearly 50% of 12-23 month old children in Ethiopia were fully vaccinated according to this systematic review and meta-analysis this indicates that the coverage, is still low with a clear disparity among regions. Our finding suggests the need for mobile and outreach immunization services for hard to reach areas, especially pastoral and semi-pastoral regions. In addition, more research may be needed to get more representative data for all regions.
Background: Anemia is a significant public health concern in many developing countries, particularly during pregnancy, and it has adverse effects on mother and fetus/baby. Objective: To determine the factors associated with anemia among pregnant women attending antenatal care in Jigjiga public health facilities, Somali Region, East Ethiopia. Methods: An institution-based unmatched case-control study was conducted. The sample size was 228 pregnant women; comprising 114 presenting with anemia and 114 controls. Hemoglobin levels were measured using a portable heme analyzer. Socio-demographic, dietary, medical history, and nutrition-related data were collected using a structured questionnaire. Data were entered into Epidata 3.1 and exported to Statistical Package for the Social Sciences (SPSS) version 23.0 for cleaning and analyses. Bivariate and multivariate logistic regression was performed and statistical significance was considered at a level of p<0.05. Results: Three predictors of anemia among pregnant women were identified in this study. An inadequate intake of red meat (i.e. those who consumed red meat 1-2 times a month [AOR=7.245; 95% CI=(2.007-26.151)] or not at all [AOR=8.690; 95% CI=(1.795-42.072)]), and insufficient consumption of green vegetables (i.e. 1-2 times a week [AOR=2.970; 95% CI= (1.012-8.716)] or 1-2 times a month [AOR=8.057; 95% CI=(2.358-27.526)]) were associated with anemia. Also, having a mid-upper arm circumference (MUAC) of less than 23 cm was strongly associated [AOR=16.432; 95% CI= (5.240-51.526)] with anemia. Conclusion: This study revealed three key factors to be associated with anemia among pregnant women in Jigjiga Town, namely reduced intake of red meat and green vegetables, and low MUAC. Interventions including nutrition counselling and enrolling pregnant women with low nutritional status in nutritional programs should be the core components of anemia control strategies, needed to address the high prevalence of anemia during pregnancy in developing countries.
Background Coronavirus disease (COVID-19) is a contagious disease caused by the severe acute new coronavirus called SARS-CoV-2. Devastating social, economic, and health service utilisation-related activities. Increased burden and lifestyle changes due to confinement. Objective This study aimed to investigate and determine the determinants of obesity during the coronavirus disease (COVID-19) pandemic from 2019 to 2023. Methods Observational studies published between December 2019 and January 2023 were thoroughly searched using a PRISMA flow chart. PubMed, Google Scholar, Web of Science, HINARI, Scopus, and Embase databases were used. Two reviewers independently identified and critically evaluated the relevant literature. Studies that reported weight gain or involved BMI measurements of 25 kg/m2 or BMI z-scores for children during the COVID-19 lockdown were selected for inclusion. The Newcastle–Ottawa Scale (NOS) was used as a quality assessment instrument in nonrandomised studies to evaluate study quality. All the contributing determinants of weight increase were identified, gathered, and synthesised. Results This systematic review identified 40 studies with a total population of 5,681,813 from 22 countries, of which 74.6% were male. The sample size from included articles ranged from 37 to 5,315,435. Of the 40 selected articles, 24 focused on adults, five on adolescents, three on children, and eight on children and adolescents. Physical inactivity, sedentary behaviour, bad eating habits, behavioural lifestyle, excessive stress, depression, anxiety, behavioural risk factors, sex, and ethnic minorities were associated with obesity during the COVID-19 pandemic lockdown. Conclusion During the COVID-19 pandemic, physical inactivity, sedentary lifestyle, and poor eating patterns were the most common risk factors for obesity. Additionally, unhealthy eating habits, excessive behavioural stress, depression, anxiety, low mood, age, gender, and ethnic minorities have been identified as risk factors for obesity during the COVID-19 pandemic.
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