Promotion of Egg and Eggshell Powder Consumption on the Nutritional Status of Young Children in Ethiopia

Abstract

Introduction: Complementary feeding presents a challenge for very young children in Ethiopia as these foods are generally thin cereals providing little protein and micronutrients. We tested whether an egg-a-day and eggshell powder (ESP) providing calcium (Ca) will improve nutritional status of young children in a 6-month randomized controlled cluster trial in Southern Ethiopia. Methods: Study sites were randomly selected kebeles (villages) and assigned to Intervention and Control groups. All eligible children 6-12 months were enrolled. Each child in Intervention kebeles received a gift of two egg laying chickens (n=122); families received education on poultry production and consumption of egg. ESP (500 mg Ca) was given to children at ≥12 mo. The Control group (n=128) had standard nutrition education. Baseline and endline outcome measures included knowledge, attitude, and practice (KAP) of caregivers on the feeding of egg and ESP, anthropometry, child dietary intake frequencies, egg sensitivities, hemoglobin, and morbidity symptoms. Results: Egg and ESP consumption in Intervention children averaged 17 days/month compared to < 1 in Controls. KAP of mothers improved only in the intervention group (p<0.001). No true egg allergy occurred, however, 7.5% of Intervention children were sensitive to eggs. Linear regression analysis showed the egg+ESP intervention increased weight-forage z-score by 0.24 (95% CI, 0.11-0.37) and reduced underweight (RR, 0.35; 95% CI, 0.16-0.74). Stunting prevalence increased in both groups, but by 28 % less in the treatment group (RR, 0.72; 95% CI, 0.53-0.98) compared with control. Mean hemoglobin increased and anemia decreased in both groups, however, much greater anemia reduction [52% (RR, 0.48; 95% CI, 0.24-0.96)] was seen in the treatment group. Conclusion: Promotion of egg and ESP consumption with poultry intervention significantly improved the nutritional status of young children, demonstrating the potential of an integrated approach to contribute to the country"s target to reduce malnutrition.

Behavior Change, Egg Consumption, and Child Nutrition: A Cluster Randomized Controlled Trial

“…These findings are different from those seen by Iannotti et al 17 in Ecuador, where egg consumption significantly reduced stunting during the period of the study, but are in line with other studies in which researchers have sought to replicate those findings. 19,21 Stunting is multifactorial and is associated with diet, disease, and gut health 44,45 and accrues over time. Repeated periods of wasting can be an important driver of chronic malnutrition.…”

“…19 A culturally tailored behavior change study in Ethiopia, targeting children 6 to 12 months of age, achieved a significant increase in child egg consumption 20 and a significant reduction in the prevalence of underweight in targeted children. 21 Women are often the decision-maker about child diet and health care 22,23 and tend to be more engaged in poultry production than in other livestock domains. 24 Despite women's role in poultry production and decision-making surrounding child diet, many barriers impede egg consumption in LMIC.…”

Efficacy of Calcium-Containing Eggshell Powder Supplementation on Urinary Fluoride and Fluorosis Symptoms in Women in the Ethiopian Rift Valley

“…Currently in Ethiopia, eggs are promoted as an excellent animal source food [ 27 , 28 , 29 ]. Our previous research had shown that the use of eggshell powder by young children in Ethiopia was acceptable [ 28 ].…”

Nutrition Interventions for Improving Nutritional Status of Toddlers in Cirebon Regency Indonesia

“…According to Mohammed et al 2019 stunting and anemia are two related things 15 . Children with low hemoglobin levels also have low HAZ 16 .The research of Omer et al 2019 shows a significant difference (p<0.05) in the average hemoglobin levels between the intervention group and the control group after the provision of eggs and eggshell powder for 6 months, this means that it takes a longer intervention time of around 6 months to see the impact of the intervention on anemia status of children under five 8 .…”

“…Giving SFP in the form of eggs to stunting toddlers for one month shows the improvement in nutritional status (height for age Z-score/HAZ) 5 . Another study with one egg a day for six to nine months had a significant effect on increasing the linear growth and reducing stunting in the Andean population in Ecuador 6 .The provision of milk for toddler showed positive relationship between milk consumption and child growth 7 .A research that was conducted in Southern Ethiopia showed that giving chicken eggs to toddlers aged 6-12 months increased their hemoglobin levels and decreased the incidence of anemia 8 . The aim of this study was to analyze the differences in the mother of children under-five's nutritional knowledge, attitudes and practicesbefore and after the nutrition education interventions as well as nutrient intakes and nutritional status of children under five before and after being given eggs and milk supplementation.…”