| 1. |
- Bogale, Tesfahun Yonas, et al.
(författare)
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Prevalence and associated factors for stunting among 6-12 years old school age children from rural community of Humbo district, Southern Ethiopia
- 2018
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 18
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Tidskriftsartikel (refereegranskat)abstract
- Background: Stunting is one of the most serious and challenging public health problems in Ethiopia, which constitute a significant obstacle to achieving better child health outcomes. This study aimed to assess the prevalence and factors associated with stunting among 6-12 years old children in Humbo district, Southern Ethiopia. Methods: This was a cross-sectional study conducted among 633 children 6-12 years old living in Humbo district, Southern Ethiopia, from March to April, 2015. A multistage cluster sampling technique was used to select participants from households in eight Villages in the study area. Height was measured using standard methods and height for age Z-score was computed to assess stunting. EPI info version 3.5.4 was used for data entry, whereas Anthroplus software and SPSS version 20.0 were used for computation of height for age Z-scores and statistical analyses respectively. Simple and multiple logistic regression analyses were used to examine factors associated with stunting in the study sample, using 95% confidence limits (statistical significance set at p < 0.050). Results: Prevalence of stunting was 57%, about, 3.5% were severely stunted, 27.3% moderately stunted and 26.4% mildly stunted, and the mean (SD) was -1.1 (+/- 1.2). About 7 (1.1%) boys and 15 (2.4%) girls were severely stunted. Age groups 10-12 years had significantly higher rate of stunting than others. Age (AOR = 1.7, 95% CI = 1.1-2.6), big family size (AOR = 4.6, 95% CI = 2.2-9.5) and field disposal of wastes (AOR = 2.7, 95% CI = 1.2-5.8) were factors significantly associated with stunting. Conclusion: This study exposed high rate of stunting among school age children. Stunting remains a noticeable attribute of rural school age children. Findings suggest the need to implement evidence-based school-aged rural children nutrition policy and strategies as well as need for intervention to improve domestic waste management system in the rural community.
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| 2. |
- Tadesse, Amare Worku, et al.
(författare)
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Comparison of Mid-Upper Arm Circumference and Weight-for-Height to Diagnose Severe Acute Malnutrition : A Study in Southern Ethiopia
- 2017
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Ingår i: Nutrients. - : MDPI AG. - 2072-6643. ; 9:3
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Tidskriftsartikel (refereegranskat)abstract
- Weight-for-height Z-score (WHZ) and mid-upper arm circumference (MUAC) are two independent anthropometric indicators for diagnosing and admitting children with severe acute malnutrition (SAM) for treatment. While severely wasted children are at high risk of mortality, MUAC and WHZ do not always identify the same population of children as having SAM. Understanding how this discrepancy relates to age and sex may provide valuable information for care programmes for children with SAM. Age and sex distribution for differences between children identified as SAM by MUAC and WHZ were examined and the degree of agreement calculated. Children (n = 4297) aged 6-59 months with validated anthropometric measures were recruited from a population-based survey conducted in rural southern Ethiopia. MUAC < 115 mm and WHZ < 3 were used to define severe wasting as per the World Health Organization (WHO) classification. The kappa coefficient (kappa) was calculated. There was fair agreement between the MUAC and WHZ definitions of severe wasting in boys (kappa = 0.37) and children younger than 24 months (kappa = 0.32) but poor agreement in girls (kappa = 0.15) and children aged 24 months and above (kappa = 0.13). More research is needed on response to treatment and prediction of mortality using different anthropometric measurements in relation to ages and sex of children.
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| 3. |
- Tadesse, Amare Worku, et al.
(författare)
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Does caregivers’ autonomy influence recovery from Severe Acute Malnutrition in an integrated community-based outpatient Therapeutic Feeding Program?
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Caregivers’ autonomy is important for child nutritional status as it improves the availability of food and access to health resources necessary for children’s growth and recovery from illnesses. However, evidence on the extent of influence of caregivers’ autonomy during recovery from severe acute malnutrition (SAM) is limited. A cohort of children (n=788) aged 6-59 months admitted to community-based outpatient therapeutic programme (OTP) for SAM in rural southern Ethiopia were studied. Recovery from SAM was defined by MUAC ≥ 125 mm and absence of edema after treatment in OTP. A Kaplan Meier (KM) survival analysis was employed to estimate the recovery rates of the children treated for SAM for different level of caregivers’ autonomy and multivariable Cox proportional hazard regression analysis was used to control for confounding. Results from adjusted cox proportional hazard regression analysis indicated that children of caregivers with higher decision-making autonomy recovered more rapidly from SAM than children of caregivers with lower autonomy. Promotion of caregivers’ autonomy could augment effectiveness of a scaled up and integrated outpatient therapeutic feeding programme.
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| 4. |
- Worku Tadesse, Amare, et al.
(författare)
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Choosing Anthropometric Indicators to Monitor the Response to Treatment for Severe Acute Malnutrition in Rural Southern Ethiopia : Empirical Evidence
- 2017
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Ingår i: Nutrients. - : MDPI AG. - 2072-6643. ; 9:12
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Tidskriftsartikel (refereegranskat)abstract
- The World Health Organization (WHO) recommends the assessment of nutritional recovery using the same anthropometric indicator that was used to diagnose severe acute malnutrition (SAM) in children. However, related empirical evidence from low-income countries is lacking. Non-oedematous children (n = 661) aged 6–59 months admitted to a community-based outpatient therapeutic program for SAM in rural southern Ethiopia were studied. The response to treatment in children admitted to the program based on the mid-upper arm circumference (MUAC) measurement was defined by calculating the gains in average MUAC and weight during the first four weeks of treatment. The children showed significant anthropometric changes only when assessed with the same anthropometric indicator used to define SAM at admission. Children with the lowest MUAC at admission showed a significant gain in MUAC but not weight, and children with the lowest weight-for-height/length (WHZ) showed a significant gain in weight but not MUAC. The response to treatment was largest for children with the lowest anthropometric status at admission in either measurement. MUAC and weight gain are two independent anthropometric measures that can be used to monitor sufficient recovery in children treated for SAM. This study provides empirical evidence from a low-income country to support the recent World Health Organization recommendation.
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| 5. |
- Abu Hatab, Assem, et al.
(författare)
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An extended integrative model of behavioural prediction for examining households’ food waste behaviour in Addis Ababa, Ethiopia
- 2022
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Ingår i: Resources, Conservation and Recycling. - : Elsevier. - 0921-3449 .- 1879-0658. ; 179
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Tidskriftsartikel (refereegranskat)abstract
- In developing countries, urbanization and demographic changes are increasing food waste generation at household levels. However, it remains unclear how behavioural and personal characteristics influence the behaviours of urban consumers in developing countries regarding food waste. In this study, we extended the integrative model of behavioural prediction to examine the determinants of food waste behaviour amongst a sample of 698 urban dwellers in Addis Ababa, Ethiopia. The empirical results revealed that attitudes and perceived behavioural control were the most important predictors of intention toward food waste reduction. With regard to food waste behaviours, the results showed that the more an individual feels obliged to discard less food, the higher the odds that the quantity of food that gets wasted by the household would be reduced. Likewise, knowledge about the negative impacts of wasting food and an ability to interpret information on labels of food products were associated with decreased quantities of household food waste. In addition, lower psychological distance to food waste was generally associated with lower quantities of wasted food. Finally, sociodemographic characteristics and food-shopping routines were found to be significant predictors of food waste behaviours. Overall, these findings constitute an entry point for more research and policy measures in order to understand determinants of household food waste behaviours in developing countries and to design effective interventions to reinforce their behaviours towards more sustainable food consumption patterns.
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| 6. |
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| 7. |
- Forsén, Emmanuel, et al.
(författare)
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Predicted implications of using percentage weight gain as single discharge criterion in management of acute malnutrition in rural southern Ethiopia
- 2015
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Ingår i: Maternal and Child Nutrition. - : Wiley. - 1740-8695 .- 1740-8709. ; 11:4, s. 962-972
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Tidskriftsartikel (refereegranskat)abstract
- Mid-upper arm circumference (MUAC) is increasingly used in identifying and admitting children with acute malnutrition for treatment. It is easy to use because it does not involve height assessment, but its use calls for alternative discharge criteria. This study examined how use of percentage weight gain as discharge criterion would affect the nutritional status of children admitted into a community-based management programme for acute malnutrition in rural southern Ethiopia. Non-oedematous children (n = 631) aged 6-59 months and having a MUAC of <125 mm were studied. By simulation, 10%, 15% and 20% weight was added to admission weight and their nutritional status by weight-for-height z-score (WHZ) was determined at each target. Moderate and severe wasting according to World Health Organization WHZ definitions was used as outcome. Applying the most commonly recommended target of 15% weight gain resulted in 9% of children with admission MUAC <115 mm still being moderately or severely wasted at theoretical discharge. In children with admission MUAC 115-124 mm, 10% of weight gain was sufficient to generate a similar result. Children failing to recover were the ones with the poorest nutritional status at admission. Increasing the percentage weight gain targets in the two groups to 20% and 15%, respectively, would largely resolve wasting but likely lead to increased programme costs by keeping already recovered children in the programme. Further research is needed on appropriate discharge procedures in programmes using MUAC for screening and admission.
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| 8. |
- Tadesse, Elazar, 1976-, et al.
(författare)
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An integrated community-based outpatient therapeutic feeding programme for severe acute malnutrition in rural Southern Ethiopia : Recovery, fatality, and nutritional status after discharge.
- 2018
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Ingår i: Maternal and Child Nutrition. - : Wiley. - 1740-8695 .- 1740-8709. ; 14:2
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Tidskriftsartikel (refereegranskat)abstract
- A scaled up and integrated outpatient therapeutic feeding programme (OTP) brings the treatment of severely malnourished children closer to the community. This study assessed recovery from severe acute malnutrition (SAM), fatality, and acute malnutrition up to 14 weeks after admission to a programme integrated in the primary health care system. In this cohort study, 1,048 children admitted to 94 OTPs in Southern Ethiopia were followed for 14 weeks. Independent anthropometric measurements and information on treatment outcome were collected at four home visits. Only 32.7% (248/759) of children with SAM on admission fulfilled the programme recovery criteria at the time of discharge (i.e., gained 15% in weight, or oedema, if present at admission, was resolved at discharge). Of all children admitted to the programme for whom nutritional assessment was done 14 weeks later, 34.6% (321/928) were severely malnourished, and 37.5% (348/928) were moderately malnourished; thus, 72.1% were acutely malnourished. Of the children, 27/982 (2.7%) had died by 14 weeks, of whom all but one had SAM on admission. Children with severe oedema on admission had the highest fatality rate (12.0%, 9/75). The median length of admission to the programme was 6.6 weeks (interquartile range: 5.3, 8.4 weeks). Despite children participating for the recommended duration of the programme, many children with SAM were discharged still acutely malnourished and without reaching programme criteria for recovery. For better outcome of OTP, constraints in service provision by the health system as well as challenges of service utilization by the beneficiaries should be identified and addressed.
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| 9. |
- Tadesse, Elazar, 1976-, et al.
(författare)
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Barriers to appropriate complementary feeding and the use of ultra-processed foods : A formative qualitative study from rural Oromia, Ethiopia
- 2024
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Ingår i: Maternal and Child Nutrition. - : John Wiley & Sons. - 1740-8695 .- 1740-8709. ; 20:1
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Tidskriftsartikel (refereegranskat)abstract
- Children's consumption of ultra-processed foods (UPF) is increasing in Ethiopia, but relatively little is known about the specific feeding practices that underlie this pattern. The objective of this study was to explore patterns of consumption of UPF by infants and young children within a broader context of inappropriate complementary feeding practices in extremely poor households in rural Oromia, Eastern Ethiopia. A formative qualitative study was conducted using semistructured interview questionnaires developed drawing on a socioecological model. A total of 16 focus group discussions with mothers (45 respondents), fathers (21 respondents) and grandmothers (23 respondents) of children aged 6-23 months in households that were beneficiaries of the Productive Safety Net Program were conducted, along with four key informant interviews with health workers. Qualitative transcripts were complemented with field notes before qualitative content analysis was applied. The key findings suggest that UPF were widely provided to infants and young children as part of a pattern of suboptimal complementary feeding, including both early and late initiation of complementary foods. In particular, UPF (including juice, biscuits and lipid-based nutrient supplements) were diluted with or dissolved in water and fed to infants via bottle, often before the recommended age of initiation of 6 months. Mothers and caregivers reported that they perceived the products to be affordably priced and packaged, ready to use and convenient given their time constraints. The level of consumption of UPF and its effects on infant and young child feeding feeding practices and children's nutritional status in rural Ethiopia should be further explored. This qualitative analysis explored patterns of complementary feeding and consumption of ultra-processed foods by infants and young children in poor rural households that are beneficiaries of the Productive Safety Net Program in Ethiopia. The evidence shows that these foods are often introduced during the period of complementary feeding because mothers and caregivers believe them to be nutritious, convenient (when diluted and provided to infants via bottle) and affordably priced.image A range of inappropriate complementary feeding practices for infants and young children were observed in this sample of extremely poor households in rural Oromia, including both early and late initiation of complementary foods and an overreliance on a liquid diet.The perception that young children should initiate complementary feeding with liquids resulted in the heavy use of ultra-processed foods (UPF), such as biscuits and packed juice, soft drinks and lipid-based nutrient supplements; these foods were reported to be dissolved in or diluted with water.Respondents reported that UPF were available for purchase in small and affordable quantities, and also convenient to provide given maternal time constraints.Provision of UPF may increase the risk of gastrointestinal illness due to exposure to unclean water, and may also increase the risk of a nutritionally inadequate diet.
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| 10. |
- Tadesse, Elazar, et al.
(författare)
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Challenges in Implementing the Integrated Community-Based Outpatient Therapeutic Program for Severely Malnourished Children in Rural Southern Ethiopia
- 2016
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Ingår i: Nutrients. - : MDPI AG. - 2072-6643. ; 8:5
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Tidskriftsartikel (refereegranskat)abstract
- Currently, treatment of uncomplicated severe acute malnutrition is managed inthe integrated Community based Outpatient Therapeutic Program (C-OTP) using ready-to-usetherapeutic foods (RUTFs). The aim of this study was to determine challenges in implementingthe critical steps in C-OTP and caregivers’ perceptions of service provision in southern Ethiopia.A total of 1048 caregivers of children admitted to the OTP and 175 Health Extension Workers (HEWs)from 94 selected health posts were included in the study. Program admission, follow-up and exitinformation was collected from caregivers during home visits. HEWs were interviewed at theirrespective health posts. Only 46.6% (481/1032) were given the recommended amount of RUTF and19.3% (196/1015) were given antibiotics on admission. During C-OTP participation 34.9% (316/905)had uninterrupted provision of the recommended amount of RUTF. Of the children who left theprogram, 220/554 (39.7%) exited the program in line with the national recommendation. Caregivers(42.9% (394/918) and HEWs (37.1%, 62/167) perceive that RUTFs were being sold as a commodity.Inadequate provision and unintended usage of RUTFs, lack of antibiotics and inappropriate exitfrom the program were major constraints. For successful saving of lives, adequate resources must beallocated, and providers must be trained regularly, and supervised properly.
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