Amare Tariku

Factors Associated with Anemia among Children Aged 6–23 Months Attending Growth Monitoring at Tsitsika Health Center, Wag-Himra Zone, Northeast Ethiopia

Background. Globally, about 47.4% of children under five are suffering from anemia. In Ethiopia, 60.9% of children under two years are suffering from anemia. Anemia during infancy and young childhood period is associated with poor health and impaired cognitive development, leading to reduced academic achievement and earnings potential in their adulthood life. However, there is scarcity of information showing the magnitude of iron deficiency anemia among young children in Ethiopia. Therefore, this study aimed at assessing prevalence and associated factors of iron deficiency anemia among children under two (6–23 months). Methods. Institution based cross-sectional study was carried out from March to May, 2014, at Tsitsika Health Center in Wag-Himra Zone, Northeast Ethiopia. Systematic random sampling technique was employed. Automated hemoglobin machine was used to determine the hemoglobin level. Socioeconomic and demographic data were collected by using a pretested and structured questionnaire. Binary logistic regression analysis was used to identify associated factors and odds ratio with 95% CI was computed to assess the strength of association. Results. Total of 347 children participated in this study. The overall prevalence of anemia was 66.6%. In multivariate logistic regression analysis, male sex (AOR = 3.1 (95% CI: 1.60–5.81)), 9–11 months of age (AOR = 9.6 (95% CI: 3.61–25.47)), poor dietary diversity (AOR = 3.2 (95% CI: 1.35–7.38)), stunting (AOR = 2.7 (95% CI: 1.20–6.05)), diarrhea (AOR = 4.9 (1.63–14.59)), no formal education (AOR = 2.6 (95% CI: 1.26–5.27)), early initiation of complementary food (AOR = 11.1 (95% CI: 4.08–30.31)), and lowest wealth quintile (AOR = 3.0 (95% CI: 1.01–8.88)) were significantly associated with anemia. Conclusion. The overall prevalence of anemia among children who aged 6–23 months has sever public health importance in the study area. Integrated efforts need to be prioritized to improve health as well as appropriate infant and young child feeding practice among children under.

Infant feeding counseling and knowledge are the key determinants of prelacteal feeding among HIV exposed infants attending public hospitals in Ethiopia

BackgroundDespite the fact that breastfeeding promotes optimal health and growth for infants and young children, inappropriate feeding practice, such as prelacteal feeding increases the risk of neonatal death and illness and remains a public health problem in Ethiopia. Therefore, this study assessed the prevalence of prelacteal feeding and associated factors among HIV positive mothers with children aged 7–20 months attending government hospitals in North Gondar zone, northwest Ethiopia.MethodsAn institution based cross-sectional study was conducted from February to March, 2016, at public hospitals of North Gondar Zone. Three hundred sixty-seven HIV positive mothers attending PMTCT clinics in government hospitals during the study period were included in the study. A multivariate logistic regression analysis was used to investigate factors associated with prelacteal feeding. The Adjusted Odds Ratio (AOR) with the corresponding 95% Confidence Interval (CI) was used to show the strength of association, and variables with a P-value of <0.05 were considered statistically significant.ResultsIn this study, the overall prevalence of prelacteal feeding was 19.1% (95% CI: 15–23). According to the multivariate analysis, prelacteal feeding was associated with fathers with no formal education (AOR = 5.85; 95% CI: 2.02, 16.92), lack of infant feeding counseling (AOR = 3.36; 95% CI: 1.27, 8.85), discarding the colostrum (AOR = 5.16; 95% CI: 2.32, 11.45), inadequacy of antenatal care visit (AOR = 0.07; 95% CI: 0.03, 0.15), and high IYCF knowledge (AOR = 0.10; 95% CI: 0.03, 0.30).ConclusionIn this study, the prevalence of prelacteal feeding was high. Furthermore, father’s education, colostrum feeding, infant feeding counseling, ANC visit, and IYCF knowledge were significantly associated with prelacteal feeding. As a result, strengthening maternal health care utilization, breastfeeding counseling, and IYCF knowledge are essential to address the high burden of prelacteal feeding.

The prevalence of non-communicable diseases in northwest Ethiopia: survey of Dabat Health and Demographic Surveillance System

Objective The main objective of this study was to investigate the magnitude and associated factors of non-communicable chronic diseases (NCDs) at the Dabat Health and Demographic Surveillance System (DHDSS) site in the northwestern part of Ethiopia. Design A population-based cross-sectional study was conducted from October to December 2014. Setting HDSS site, Ethiopia. Participants A total population of 67 397 living in 16 053 households was included in the study. Measures Structured interviewer-administered questionnaire was used to collect data. Self-reported morbidity was used to ascertain NCD. A binary logistic regression model was employed to identify the determinants of NCDs. Result One thousand one hundred sixty (1.7%) (95% CI 1.62 to 1.82) participants were found with at least one type of NCD. Heart disease and hypertension which accounted for 404 (32.2%) and 401 (31.9%), of the burden, respectively, were the most commonly reported NCDs, followed by 347 (27.7%) asthma, 62 (4.9%) diabetes mellitus and 40 (3.2%) cancer cases. Advanced age (≥65 year) (adjusted OR (AOR)=19.6; 95% CI 5.83 65.70), urban residence (AOR=2.20; 95% CI 1.83 to 2.65), household food insecurity (AOR=1.71; 95% CI 1.37 to 2.12) and high income (AOR=1.28; 95% CI 1.02 to 1.59) were significantly associated with the reported history of NCDs, whereas low (AOR=0.36; 95% CI 0.31 to 0.42) and moderate (AOR=0.33; 95% CI 0.22 to 0.48) alcohol consumption, farming occupation (AOR=0.72; 95% CI 0.57 to 0.91), and work-related physical activities (AOR=0.66; 95% CI 0.50 to 0.88) were inversely associated with NCDs. Conclusion There is a high burden of NCDs at the Dabat HDSS site. Promotion of regular physical exercise and reducing alcohol consumption are essential to mitigate the burden of NCDs. In addition, preventive interventions of NCDs should be strengthened among urban dwellers, older age people and people of higher economic status.

Improved dietary diversity of school adolescent girls in the context of urban Northwest Ethiopia: 2017

BackgroundUndiversified diet increases the vulnerability of adolescents for different nutritional problems. Therefore, this study assessed dietary and associated factors among school adolescent girls in Gondar city, northwest Ethiopia.MethodsA cross-sectional study was conducted from March to April 2017. Simple random sampling technique was used to select 778 adolescent school girls. A structured questionnaire was used to collect data. Multivariable logistic regression analysis was fitted to identify significant factors of dietary diversity. Adjusted Odds Ratio (AOR) with 95% confidence interval was used to show the strength of association, while a P-value< 0.05 of was used to declare the significance of association.ResultsThis finding indicated that adolescent girls who met minimum dietary diversity with were 75.4% (95%CI (72.3, 78.6). School type (AOR = 3.17, 95%CI: 1.90, 5.28) and residence (AOR = 2.0, 95%CI: 0.84, 3.01) were significantly associated with adequate dietary diversity.ConclusionsDietary practice of adolescent girls is good in Gondar City Administration. School type and residence of adolescents were significantly associated with minimum dietary diversity. Thus, Special attention needs to be paid on government school and rural adolescents to improve the intake of variety diet.

One in three adolescent schoolgirls in urban northwest Ethiopia is stunted

BackgroundPoor nutritional status of adolescent girls has a negative effect on the next generation as undernourished adolescents enter pregnancy with poor nutrient reserve. However, there is scarcity of evidence showing the burden of stunting among adolescent girls in Ethiopia. Therefore, the objective of this study aimed to assess prevalence of stunting and associated factors among school adolescent girls in Gondar City Administration, northwest Ethiopia.MethodsCross-sectional study was conducted from March to April, 2017. A multi-stage sampling technique was used to select812 school adolescent girls. World Health Organization Anthro-plus software was used to analyze anthropometric data into Height for Age Z-score. A multivariable logistic regression analysis was employed to identify the factors associated with stunting. Adjusted Odds Ratio (AOR) with 95% confidence interval was used to show the strength of association, while a P-value< 0.05 of was used to declare the significance of association.ResultsThe overall prevalence of stunting among adolescent girls was 33.1% (95% CI: 29.9, 36.5). Middle age of adolescence (AOR = 0.22, 95% CI: 0.15, 0.34), unsatisfactory media exposure (AOR = 1.69, 95% CI: 1.01, 2.84) and poor mother’s education (AOR = 2.84, 95% CI: 1.07, 7.94) were significantly associated with stunting.ConclusionsOne-third of adolescent girls are stunted in Gondar City which suggests the serious public health importance of the problem. Enhancing mother’s education and media exposure are critical to address the high burden of stunting.

Effect of iron-folic acid supplementation on change of hemoglobin among visceral Leishmaniasis patients in northwest Ethiopia: a retrospective follow up study

BackgroundAn individual with visceral Leishmaniasis (VL) commonly present with anemia and one of the VL treatment center in northwest Ethiopia has been recommended iron-folic acid supplementation to these patients. But there is no documented evidence whether iron-folic acid supplementation improves the hematological profile of patients. Therefore, the study aimed to assess change in hemoglobin (Hb) and its determinant factors among VL patients with and without iron-folic acid supplementation in northwest Ethiopia.MethodsA retrospective cohort study was conducted from January 2015 to December 2016. Data were entered into Epi-Data version 3.1 and transferred to Statistical Package for Social Science (SPSS) version 20 for analysis. Independent sample T-test and linear regression were used to compare the change in Hb and identify factors associated with a change in Hb, respectively. A 95% confidence level and p-values less than 0.05 were used determine statistically significant.ResultsFrom a total of 602 VL patients, 299 (49.7%) were from University of Gondar hospital. The mean (±SD) change of Hb from baseline to end of treatment was 0.99(±1.64) and 1.61(±1.88) g/dl with and without iron-folate supplementation, respectively, with mean difference 0.62, 95% CI (0.34, 0.90) and a p-value of < 0.0001. In multiple linear regressions, combination therapy of sodium stibogluconate-paramomycin (SSG-PM) was positively associated with a change of Hb (β [SE, p]: 0.710/0.15, < 0.0001). Whereas age (− 0.030/0.009, 0.001), nasal bleeding (− 0.261/0.123, 0.035), baseline white blood cell (− 0.139/0.044, 0.002) and hemoglobin (− 0.513/0.031, < 0.0001), end of treatment spleen size (− 0.059/0.015, < 0.0001) and iron-folic acid supplementation (− 0.574/0.163, < 0.0001) were negatively associated with change of Hb.ConclusionIron-folic acid supplementation had a negative effect on the change of Hb. A combination therapy of SSG-PM, age, nasal bleeding, baseline white blood cells and Hb, and iron-folic acid supplementation were the determinants of change of Hb. Therefore, avoiding iron-folic acid supplementation and strengthening VL treatment with a combination of SSG-PM and, and early identification of complications is recommended for a better outcome.

Magnitude of prelacteal feeding practice and its association with place of birth in Ethiopia: a systematic review and meta-analysis, 2017

BackgroundPrelacteal feeding is one of the commonest inappropriate child feeding practice which exposes to malnutrition, infection, and neonatal mortality. However, there is no systematic review and meta-analysis that estimates the pooled prevalence of prelacteal feeding and its association with place of birth in Ethiopia. Therefore, this study aimed at investigating the magnitude of prelacteal feeding practice and its association with home delivery in the country.MethodsPrimary studies were accessed through, HINARI and PubMed databases. Additionally, electronics search engines such as Google Scholar, and Google were used. The Joana Briggs Institute quality appraisal checklist was used to appraise the quality of studies. Data were extracted using Microsoft Excel spreadsheet. Heterogeneity between the studies was examined using the I2 heterogeneity test. The DerSimonian and Liard random-effect model was used. The random effects were pooled after conducting subgroup and sensitivity analyses. Publication bias was also checked.ResultsA total of 780 primary studies were accessed. However, about 24 studies were included in the qualitative description and quantitative analysis of the prevalence of prelacteal feeding. To examine the association between home delivery and prelacteal feeding practice, only six studies were included. The prevalence of prelacteal feeding ranged from 6.1–75.8%. The pooled prevalence of prelacteal feeding among Ethiopian children was 26.95% (95% CI: 17.76%, 36.14%). The highest prevalence was observed in the Afar region. The pooled odds of prelacteal feeding among women who gave birth at home was increased by 5.16 (95% CI: 3.7, 7.2) folds as compared to those who gave birth at Health institutions.ConclusionPrelacteal feeding practice in Ethiopia was found to be high. Home delivery was strongly associated with prelacteal feeding practice. Therefore, promoting institutional delivery and strengthening of the existing child nutrition strategies are recommended.

Reducing amount and frequency of meal as a major coping strategy for food insecurity

BackgroundFood insecurity is a global problem affecting many people worldwide, including approximately 220 million people in sub-Saharan Africa. Ethiopia is among the countries severely affected by hunger. However, evidence on how populations within Ethiopia cope with hunger and food insecurity is limited. This study aimed to identify household coping mechanisms in response to food insecurity at a Dabat Health and Demographic Surveillance System site.MethodsThis study used data from a re-census collected between October 2014 and December 2014.15,159 household members in thirteen kebeles of the Dabat Health and Demographic surveillance system were included. The outcome variables of the study were food insecurity and coping strategies. Household Food Insecurity Access Scale (HFIAS) was used to assess food insecurity. If food insecurity was found, families were asked about coping mechanisms used. Binary logistic regression analysis was applied to identify socio-demographic determinants of reducing amount and frequency of meal as a coping mechanism in response to food insecurity.ResultOf the 15,159 households surveyed, 6671 (44.01%) reported the presence of a food insecurity in their household. Decreasing meal frequency and portions (3733 (55.96%)), borrowing money and food (2542 (38.11%)), and receiving food and money aid (1779 (26.67%)) were among the major coping strategies used by the households. Urban dwellers (AOR 2.07: 95% CI 1.74, 2.46), mid-altitude (weyina-dega) and high-land (dega) dwellers (AOR 2.46: 95% CI 2.08, 2.92 and AOR 1.22 95% CI 1.08, 1.38 respectively), and not married persons (AOR 1.60: 95% CI 1.07, 2.39) were more likely to consume less when faced with a food insecurity (using reducing amount and frequency of meal as a coping strategy).ConclusionHouseholds in the study area experienced a very high rate of food insecurity. Decreasing meal frequency and portions was the primary coping mechanism used by the households. Due to the severe insecurity of food in their household, many people chose to reduce the amount and frequency of their meal in order to prolong the small amount of food in their house. This finding indicates a high risk for undernourishment which can exacerbate the burden of malnutrition and related diseases in the region.

Anemia among Women Attending Antenatal Care at the University of Gondar Comprehensive Specialized Referral Hospital, Northwest Ethiopia, 2017

Background In Ethiopia, prenatal anemia is a major public health concern affecting both the health of the woman and babies. The World Health Organization recommends to conduct repeated prevalence studies concerning prenatal anemia . However, there is no recent evidence on the magnitude of the prenatal anemia. Therefore, the aim of this study was to determine the prevalence and the associated factors of prenatal anemia among women attending the Antenatal Care Clinic at the University of Gondar Referral Hospital. Methods A facility-based cross-sectional quantitative study was conducted among 362 participants from June 03-July 08, 2017, at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia. The systematic random sampling technique was employed. Structured interviewer administered questionnaire was used. Human Immunodeficiency Virus (HIV) screening was conducted. Nutritional status of the participants was assessed. Blood sample was collected by capillary tube . Intestinal parasite was examined by stool wet mount test. HIV serostatus was detected. Anemia was defined as hemoglobin concentration below 11 g/dl. The multivariable logistic regression model was employed to identify associated factors and to control the possible effects of confounders. Result The prevalence of anemia was 22.2% (95% CI: 18.11, 27.1%). The highest odds of anemia were observed among pregnant women with family size of >five [AOR = 3 (95% CI: 1.03, 8.65)], unprotected water source users, [AOR = 4.09 (95% CI: 1.75, 9.55)], HIV infected [AOR = 2.94(95% CI: 1.37, 6.35)], and multigravida women [AOR = 3.5 (95% CI: 1.35, 9.17)]. Conclusion and Recommendations The prevalence of anemia among pregnant women attending the University of Gondar Referral Hospital was a moderate public health problem. Unprotected water source, large family size, Human Immunodeficiency Virus infection, and repeated pregnancies were factors that predicted anemia. Thus, prevention of Human Immunodeficiency Virus infection, family planning utilization, and accessing pure water are recommended.

Determinants of virological failure among patients on highly active antiretroviral therapy in University of Gondar Referral Hospital, Northwest Ethiopia: a case–control study

Background Viral load monitoring is used as an important biomarker for diagnosing treatment failure in patients with HIV infection/AIDS. Ethiopia has started targeted viral load monitoring. However, factors leading to virological failure are not well understood and studied. Thus, the aim of this study was to identify the determinants of virological failure among HIV-infected patients on highly active antiretroviral therapy at the University of Gondar Referral Hospital, Northwest Ethiopia. Methods A case–control study was conducted from May to June 2015. Cases were subjects who had already experienced virological failure; controls were those without virological failure. Data were extracted from 153 cases and 153 controls through chart review. A multivariate logistic regression analysis was carried out to identify factors associated with virological failure, and variables with a p-value <0.05 were considered statistically significant. Results In this study, higher odds of virological failure was observed among patients aged <35 years (adjusted odds ratio [AOR] =2.52, 95% CI: 1.33, 4.77), who had had CD4+ count <200 cells/mm3 (AOR=9.03, 95% CI: 4.40, 18.50), showed poor adherence to antiretroviral therapy (ART) (AOR=15.80, 95% CI: 6.90, 36.50), and had taken ART for longer durations of 25–47 months (AOR=3.00, 95% CI: 1.10, 8.40) and ≥48 months (AOR=6.70, 95% CI: 2.70, 16.60). Conclusion This study showed that patients aged <35 years and with recent low CD4 count, poor adherence to treatment, and longer exposure to ART were positively and significantly associated with virological treatment failure. Therefore, evidence-based intervention should be implemented to improve adherence to ART, which in turn helps to boost immunity (CD4) and suppresses viral replication and load. Moreover, attention should be given to younger patients who have had ART for longer periods.