Determinants Of Undernutrition Research Articles

Determinants of undernutrition among settled pastoralists' children aged 6–59 months in Kenya

AbstractThe transition from nomadism to sedentary lifestyle has introduced changes in diets and undernutrition is endemic among settled pastoral households. This study aimed to investigate the underlying factors affecting stunting, underweight, and wasting of children aged 6–59 months in Marsabit County, Kenya. A cross‐sectional household survey was conducted in six wards capturing pastoral, agro‐pastoral, and urban livelihood practices. Using multistage sampling method, 394 children aged 6–59 months participated with written consent from the caregivers. A pretested questionnaire and anthropometric measures were used during data collection. Population characteristics were summarized into means and proportions, while chi‐square and analysis of variance were used to evaluate associations between variables. Backward logistic regressions were used to explore predictors of stunting, underweight, and wasting, respectively. The results showed that the mean Height for Age Z‐score, Weight for Age Z‐score, and Weight for Height Z‐score were −1.51, 1.54, and 1.02, respectively. The prevalence of stunting, underweight, and wasting was 38.1%, 23.0%, and 18.5%, respectively. The age of child, source of drinking water, and waste disposal were some of the main factors influencing stunting among children. In conclusion, the prevalence of undernutrition was high compared to the World Health Organization recommended cutoffs. Water sources hygiene, and caregiver's income were some of the main predictors of undernutrition among children. Development agencies need to focus on the supply of potable water, access to toilet facilities, in addition to nutrition education on hygienic complementary feeding practices among pastoral caregivers.

Prevalence and Determinants of Undernutrition in Schoolchildren in the Kilombero District, South-Eastern Tanzania.

Childhood undernutrition is a major issue in low- and middle-income countries, affecting the health, well-being, and educational outcomes of schoolchildren. This study aimed to assess the prevalence and associated factors of stunting, wasting, and underweight among schoolchildren in peri-urban areas in the south-eastern part of Tanzania. A cross-sectional study was conducted involving 930 children aged 6-12 years from four primary schools from July to August 2019. The WHO Anthro Survey Analyzer was employed to estimate the prevalence of stunting, wasting, and underweight, while logistic regression analyses examined sociodemographic background, malaria infection, anaemia, anthropometric measures, and dietary diversity score as potential factors. The prevalence of stunting, wasting, underweight, overweight, and obesity was 11.8%, 4.3%, 3.9%, 11.1%, and 2.0%, respectively. Overall, 1.5% of the children had malaria, as determined by rapid diagnostic tests, and 0.4% had severe anaemia. Univariate analysis indicated higher odds of undernutrition among children aged 9-12 compared to their younger peers. Stunting was more common among children with low and medium dietary diversity. Anaemia was found in 11.2% of schoolchildren, and severe anaemia was associated with wasting. Multivariate analysis revealed that age and low dietary diversity were significantly associated with undernutrition. These findings emphasise the need for school-based health and nutrition programmes targeting children beyond the age of 5 to improve their nutritional status and mitigate potential adverse effects on health, cognition, and academic achievement. Regular assessment of the nutritional status of schoolchildren is warranted.

Determinants of Undernutrition among Children Admitted to a Pediatric Hospital in Port Sudan, Sudan.

Severe acute undernutrition (SAU) is still a crucial global health issue in the 0-59 months population, increasing the risk of mortality as well as of long-term consequences. In Sudan, 3.3 million children suffered from acute malnutrition between 2018 and 2019. This study was planned to evaluate, in the area of Port Sudan, the prevalence of acute undernutrition after the COVID-19 pandemic and to identify the most important factors favoring the development of acute undernutrition. The available clinical records of all the under-five children (n = 1012) admitted to the Port Sudan Emergency Pediatric Hospital from 1 February 2021 to 31 January 2022 were analyzed. The presence of wasting and kwashiorkor was assessed and children were categorized according to age, gender, place of residence, main reason for hospitalization, and underlying comorbidities. Acute undernutrition was evidenced in 493 (48.7%) children. Of them, only 16 (3.2%) were diagnosed with kwashiorkor. Children with SAU had a higher prevalence of acute gastroenteritis (p < 0.05) and parasitosis (p < 0.05). Infants aged 0-6 months were those with the lowest risk of undernutrition, whereas those aged 7-12 months were those with the greater risk. In these patients, multivariate analysis revealed that SAU and MAU were 2.5 times (OR 2.51; 95% CI, 1.79-3.55) and 5.5 times (OR 5.56; 95% CI, 2.59-18.7) higher. This study shows that the area of Port Sudan is still suffering from an alarming prevalence of severe wasting and the risk of developing acute undernutrition seems strictly related to the introduction of complementary feeding and tends to reduce with increasing age. Measures already in place to prevent acute malnutrition should be reinforced with improvement of mother education on child feeding.

Determinants of undernutrition in children under five years in the Southern Africa sub-region: a scoping review

Determinants of undernutrition in children under five years in the Southern Africa sub-region: a scoping review

Determinants of undernutrition and overnutrition among reproductive-age women in Bangladesh: Trend analysis using spatial modeling.

Bangladesh is facing a dual burden of malnutrition, with high rates of undernutrition and increasing rates of overnutrition. The complex scenario of malnutrition in Bangladesh varies across different regions, making it a challenging public health concern to address. This study analyzes the spatial and temporal dependence of underweight and overweight Bangladeshi women of reproductive age. Nationally representative cross-sectional data from the Bangladesh Demographic and Health Surveys in 2014 and 2017-18 were utilized to study the changes in weight status in 15-49-year-old women who were either underweight or overweight. A Bayesian geo-additive regression model was used to account for non-linear and linear effects of continuous and categorical covariates and to incorporate spatial effects of geographical divisions. The prevalence of overweight or obese women in rural, city corporations, and other urban areas increased significantly over the four years from 2014 to 2017-18. Women in the categories 'richer' and 'richest' were more likely to be overweight or obese. Women from Sylhet were more likely to be underweight in both survey years; however, the spatial effects were significant for underweight women in Mymensingh for the year 2017-18. Women in Rajshahi and Khulna were more likely to be overweight or obese in 2014, and women from Barishal and Chittagong were more likely to be overweight in the year 2017-18. Underweight and overweight statuses in women vary unevenly across Bangladesh, with a substantially higher prevalence of overweight or obese women in more urbanized areas. The growing burden of overweight and obesity among Bangladeshi women should be addressed with interventions aimed at those in the reproductive age group.

Determinants of undernutrition among children aged 6-59 months during the COVID-19 pandemic: A hospital-based cross-sectional study in Ethiopia.

The public health problem of undernutrition is common in Ethiopia, particularly among children aged 6-59 months. However, determinants of undernutrition among children in this age group are not well investigated particularly within the context of COVID-19 pandemic. This study was, therefore, designed to assess the magnitude and determinants of undernutrition among children aged 6-59 months at Tirunesh Beijing general hospital, Ethiopia. An institutional-based cross-sectional study was conducted involving 283 children aged 6-59 months in March 2022. The data were collected using structured questionnaire and anthropometric measurements. Undernutrition was defined as a Z-score value of weight for height (WFH), height-for-age (HFA), and weight-for-age (WFA) <2SD as calculated by the world health organization plus software. A multivariable logistic regression model was used to identify the independent factors associated with undernutrition. p-values less than 0.05 were considered statistically significant. The response rate in this study was 97.9%. The overall magnitude of undernutrition was 34.3%, of which 21.2%, 12.7%, and 9.5% were stunted, underweight, and wasted, respectively. Occupation of mothers [AOR = 13.64, 95% CI (4.21-14.77)], amount of meal [AOR = 14.68, 95% CI (4.09-52.81)], feeding by caregivers [AOR = 8.96, 95% CI (2.81-18.60)], and breastfeeding [AOR = 0.06, 95% CI (0.02-0.22)] were significant predictors of undernutrition. The prevalence of undernutrition among children under the age of five remains high. Therefore, promoting breastfeeding and motivating children to feed adequate amount of meal are recommended. Besides, counseling and/or guiding caregivers on how to feed children shall be suggested. The findings could help inform the design and prioritization of effective intervention strategies at early life stage.

Nutritional status and its determinants among adolescents with HIV on anti-retroviral treatment in low- and middle-income countries: a systematic review and meta-analysis

PurposeThis review aimed to determine what methods are used to assess nutritional status, the levels of nutritional status, determinants of undernutrition, and nutritional interventions employed for adolescents with HIV on Anti-Retroviral Therapy follow-up in Low- and Middle-Income countries.MethodsEstablished methods were used to systematically identify and retrieve studies published in five databases between January 2000 to May 2021, and citation searching. Quality was appraised and findings were synthesized using narrative analysis and meta-analysis.ResultBody Mass Index is the major indicator of nutritional status. The pooled prevalence of stunting, wasting, and overweight were 28.0%, 17.0%, and 5.0%, respectively. Adolescent males are 1.85 and 2.55 times more likely than adolescent females to suffer from both stunting and wasting at AOR = 1.85 (95%:1.47, 2.31) and AOR = 2.55 (95%: 1.88, 3.48), respectively. Similarly, adolescents with a history of opportunistic infections were 2.97 times more likely to be stunted than uninfected adolescents, AOR = 2.97 (95%:1.73, 5.12). One single intervention study found significant improvements in anthropometric status after nutritional supplementation.Conclusion and recommendationThe few studies that have been conducted on nutritional status in adolescents living with HIV in low- and middle-income countries indicate that stunting and wasting are common in this population. Avoiding opportunistic infections is an important protective factor but the review highlighted the generally inadequate and fragmented nature of nutritional screening and support programs. Development of comprehensive and integrated systems for nutritional assessment and intervention services during ART follow-up should be prioritized to improve adolescent clinical outcomes and survival.

Undernutrition and associated factors among older adults in Ethiopia: systematic review and meta-analysis

ObjectiveUndernutrition contributes to decreased physical and cognitive functional status, higher healthcare consumption, premature institutionalisation and increased mortality. So, the objective of this study was to determine the pooled prevalence and...

Prevalence and Determinants of Undernutrition among People Living With HIV at Ngarama Hospital, Rwanda

Background &#x0D; Undernutrition is one of the important health problems in developing countries, which has undesirable health effect among people living with HIV (PLWHA).&#x0D; Objectives&#x0D; To determine prevalence and determinants of undernutrition among PLWHA in Ngarama District Hospital.&#x0D; Methods&#x0D; Cross sectional study was conducted among 267 PLWHA who were selected systematically as they came for care. Questionnaire and anthropometric measurements were used to collect data. Descriptive and inferential statistics were performed.&#x0D; Result&#x0D; The prevalence of undernutrition was 22.0%. After controlling all the possible confounders using multivariable analysis, the following variables were predictors of undernutrition: respondents’ age 21 to 30 (AOR = 17.24; 95% CI = 5.55 – 53.56; p &lt; 0.001) and 31 to 40 (AOR = 19.15; 95%CI = 5.97 – 61.40; p &lt;0.001) compared to those aged 41 years and above, social category one (AOR = 3.54; 95%CI = 1.18 – 10.59; p = 0.024); experienced gastrointestinal discomfort (AOR = 19.87; 95%CI = 5.09 – 77.55; p &lt;0.001) and not received dietary counseling (AOR = 7.45; 95%CI = 2.83 – 19.62; p &lt;0.001).&#x0D; Conclusion &#x0D; The prevalence of undernutrition among PLWHA was high. Therefore, the Ministry of Health and other stakeholders should campaign, counsel and assist with provision of dietary diversity using locally available foods.&#x0D; Rwanda J Med Health Sci 2022;5(3):291-301

Determinants of undernutrition among young children in Ethiopia

Ethiopia is one of the countries in sub-Saharan Africa with the highest burden of childhood undernutrition. Despite the high burden of this scourge, little is known about the magnitude and contributing determinants to anthropometric failure among children aged 0–23 months, a period regarded as the best window of opportunity for interventions against undernutrition. This study examined factors associated with undernutrition (stunting, wasting, and underweight) among Ethiopian children aged 0–23 months. This study used a total weighted sample of 2146 children aged 0–23 months from the 2019 Ethiopian Mini Demographic and Health Survey. The data were cleaned and weighted using STATA version 14.0. Height-for-age (HFA), weight-for-height (WFH), and weight-for-age (WFA) z-scores < − 2 SD were calculated and classified as stunted, wasting, and underweight, respectively. Multilevel mixed-effects logistic regression models adjusted for cluster and survey weights were used. Adjusted odds ratio (AOR) and 95% confidence interval (CI) were estimated. Statistical significance was declared at p < 0.05. The overall weighted prevalence of stunting, wasting, and underweight respectively were 27.21% [95% CI (25.32–29.18)], 7.80% [95% CI (6.71–9.03)], and 16.44% [95% CI (14.90–18.09)] among children aged 0–23 months in Ethiopia. Female children were less likely to be associated with stunting [AOR: 0.68, 95% CI (0.54–0.86)], wasting [AOR: 0.70, 95% CI (0.51, 0.98)], and underweight [AOR: 0.64, 95% CI (0.49, 0.83)] than their male counterparts. Conversely, older children aged 12–17 months [AOR: 2.22, 95% CI (1.52, 3.23)] and 18–23 months [AOR: 4.16, 95% CI (2.75, 6.27)] were significantly at an increased odds of becoming stunted. Similarly, the likelihood of being underweight was higher in older age groups: 6–11 months [AOR: 1.74, 95% CI (1.15, 2.63)], 12–17 months [AOR: 2.13, 95% CI (1.40, 3.24)], and 18–23 months [AOR: 4.08, 95% CI (2.58, 6.44)] compared with the children younger than 6 months. Lower wealth quintile was one of the other significant determinants of stunting and underweight. The study’s findings indicated that the most consistent significant risk factors for undernutrition among children aged 0–23 months are: male sex, older age groups and lower wealth quintile. These findings emphasize the importance of strengthening nutrition-specific and sensitive interventions that address the immediate and underlying drivers of childhood undernutrition in early life, as well as targeting low-income households with male children, in order for Ethiopia to meet the Sustainable Development Goals (SDGs) 1,2 and 3 by 2030.

Prevalence and Determinants of Undernutrition among Under-Five Children in Nigeria: A Systematic Review

BACKGROUND: Child undernutrition is a key public health issue that both causes and contributes to disease and death. Undernutrition accounts for 45% of under-five deaths globally most of which occur in Low- and Middle-income countries (LMIC). Malnutrition has a substantial and long-lasting effect on individuals, families, communities and the entire nation. This study aimed to assess the prevalence and determinants of undernutrition in under-five children in Nigeria.&#x0D; &#x0D; METHODOLOGY: This systematic review was done following the Cochrane library guidelines. A search of literature written in English language and published between 2000 and 2022 was done using PubMed, CINAHL, MEDLINE and ProQuest databases. The initial search resulted in 760 studies. These were exported to End note version 9 to remove duplicates. Titles and abstracts were screened for studies that met the inclusion criteria. Finally, 11 studies that met the inclusion criteria were thoroughly assessed and data that were relevant to this systematic review were captured. The study findings were analyzed using descriptive statistics.&#x0D; &#x0D; RESULTS: The prevalence of undernutrition was between 1.0% and 43.3%. The highest prevalence of underweight, wasting and stunting were 43.3%, 29.3% and 41%, respectively. Factors associated with undernutrition were age, sex, birth order, recent acute diarrhoea and acute respiratory infection, maternal literacy level, maternal income &amp;lt;$20 and socio-economic class among others.&#x0D; &#x0D; CONCLUSION: Under-five undernutrition is a huge public health issue in Nigeria. Prevalence of undernutrition varies widely across geo-political zone with a myriad of associated risk factors. Multi-level and multidisciplinary interventions are required to sustainably address the determinants of under-five undernutrition.

Determinants of Undernutrition and Associated Factors of Low Muscle Mass and High Fat Mass among Older Men and Women in the Colombo District of Sri Lanka.

Undernutrition is a health challenge due to an expanding older population. The aims of the study were to assess the prevalence and determinants of undernutrition and, associated factors of low muscle and high fat mass among older men and women in the Colombo district of Sri Lanka. A cross sectional study was conducted using a multistage cluster sampling technique. Undernutrition was defined based on anthropometry and body composition assessed using bio-electrical impedance. Sex-specific multivariable logistic regression analyses were conducted. Of 800 participants (30.6% men), 35.3% were undernourished. The factors significantly associated with undernutrition among older women were hypertension with an adjusted odds ratio (aOR) (1.97; 1.36–2.88) and musculoskeletal disabilities aOR (2.19; 1.36–3.53). Among women, age ≥ 70 (1.79; 1.18–3.34) and diabetes (1.77; 1.10–2.84) were associated with low muscle mass and age ≥ 70 (2.05; 1.21–3.47), diabetes (2.20; 1.35–3.59) and disability in chewing (2.39; 1.30–4.40) were associated with high fat mass. Among men, age ≥ 70 years, no/up to grade 5 education, diabetes, visual disability, little/no responsibility in food shopping and not getting nutritional advice from media were associated with reduced odds of low muscle mass and no/up to grade 5 school education, disability in chewing and little/no responsibility in food shopping were associated with reduced odds of high fat mass. Undernutrition among older people is common in Sri Lanka. We have identified key factors associated with low muscle mass and high fat mass in this setting. Given the potential consequences of these conditions, our study provides potential targets for prevention of undernutrition and sarcopenic obesity.

Prevalence and determinants of undernutrition among adolescents in India: A protocol for systematic review and meta-analysis.

Undernutrition is one of the serious health problems among adolescents in India where 253 million adolescents are in the age group of 10-19 years. Since adolescents represent the next generation of adults, it is important to understand the nutritional status of adolescents. Even though several studies have been carried out in different states in India on adolescent undernutrition (stunting, wasting /underweight), there is no study or review that estimated the national pooled prevalence of adolescent undernutrition and its determinants. Therefore, this review aims to determine the pooled prevalence and determinants of undernutrition (stunting, underweight/wasting) among Indian adolescents. A systematic review of eligible articles will be conducted using preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines. A comprehensive searching of the literature will be made in Pub Med, EMBASE, SCOPUS, Google, Google Scholar, and Cochrane databases. The quality of the articles included in the review will be evaluated using the Newcastle-Ottawa Scale (NOS) for observational studies in meta-analyses. The pooled prevalence and odds ratio of the associated risk factors or determinants with their 95% confidence interval will be computed using STATA version 16 software. The existence of heterogeneity among studies will be assessed by computing p-values of Higgins's I2 test statistics and Cochran's Q-statistics based on chi-square with a 5% level of significance among reported prevalence. Sensitivity analysis and subgroup analysis will be conducted based on study quality to investigate the possible sources of heterogeneity. Publication bias will be assessed through visual examination of funnel plots and objectively by Egger's regression test. This review protocol has been registered at PROSPERO (CRD42021286814). By collecting and summarizing information on adolescent undernutrition can be a step towards a better understanding of the prevalence of nutritional status of Indian adolescents and how the associated factors influence the prevalence of undernutrition. This review will provide directions for further research and healthcare practitioners. This summarized finding at the national level will provide impetus to build nutritional strategies and proper healthcare services to fight against undernutrition among the most ignored population.

Magnitude and Determinants of Undernutrition among Pregnant Women Attending a Public Hospital in Kenya

Background: Undernutrition during pregnancy in the developing countries is a major public health problem due to its strong association with maternal and child morbidity and mortality. The available data on the extent and determinants of under-nutrition among pregnant women in Kenya is scant. This main objective of the study is to establish the extent and determinants of undernutrition in pregnant women attending a public hospital in Kenya. Methods: A cross-sectional study was conducted among 162 randomly selected pregnant women who attended antenatal clinic at Pumwani Maternity Hospital, a well-known public health facility in Nairobi. A semi-structured questionnaire was used to collect the data. Nutritional status of the pregnant mothers was determined using mid-upper arm circumference measurement. Hemoglobin level was extracted from the maternal antenatal card to determine their anemic status. Descriptive and inferential analyses were done using SPSS Software (version 22.0). Frequencies and proportions were generated for categorical variables. While mean and standard deviation were computed for continuous variables. The chi-square test of independence was employed to establish the relationship between the independent variables and dependent variable. Multivariable logistic regression analysis was used to identify the variables independently linked to maternal undernutrition. Results: The overall prevalence of undernutrition and anemia among the pregnant women was 27% and 39.7%, respectively. Multivariable logistic analysis showed that being single [AOR = 4.27; 95% CI = 2.21 - 8.32, P = 0.001], divorced/separated [AOR = 2.25; 95% CI = 1.13 - 4.87; P = 0.021], self-employed [AOR = 4.27; 95% CI = 2.21 - 8.32; P = 0.022], illiterate [AOR = 4.31; 95% CI = 2.55 - 8.20; P = 0.007), having short birth interval (Conclusions: Our findings show that the burden of undernutrition during pregnancy is still high in Kenya which requires urgent attention. Pregnant women who were never married, divorced/separated, self-employed, illiterate, and those with short birth interval were at increased risk of undernutrition. Nutrition intervention targeting social determinants of maternal undernutrition may result in positive outcomes. This will significantly help achieve the SDGs by reducing maternal child mortality.

Determinants of undernutrition among older adults in South Gondar Zone, Ethiopia: a community-based study

ObjectivesThe objectives of this study were to assess the prevalence and determinants of undernutrition among older adults aged 65 years in the south Gondar Zone, Ethiopia, in 2020.DesignA community-based cross-sectional...

Determinants of undernutrition among private and public primary school children: A comparative cross-sectional study toward nutritional transition in northwest Ethiopia

ObjectivesUndernutrition is a major public health concern, particularly in children. The burden is higher in developing countries. Undernutrition is considered when there is one or more of the following: stunting, underweight, or wasting. Childhood undernutrition can have numerous long-term effects: a lower physical capacity for work, lower intellectual quotients, greater risk for morbidity and mortality, and cognitive impairment. Undernourished children also can have poor cognitive scores, a high absenteeism rate, and high class repetition compared with non-undernourished children. The aim of this study was to assess undernutrition and its associated factors among public and private primary school children in Gondar town, northwest Ethiopia. MethodsA school-based, cross-sectional study was conducted from March 5 to April 9, 2019. A multistage sampling technique was applied to select study participants. A simple random (lottery) sampling method was used to select seven public schools and five private schools. Systematic random sampling was used to select 774 study participants. The data were collected through face-to-face interviews. Multivariable logistic regressions were conducted to identify factors associated with undernutrition. The World Health Organization (WHO) AnthroPlus software was used to determine the status of undernutrition. Participants with a Z-score less than –2 were considered to be undernourished. Statistical significance was declared at P < 0.05 and odds ratios (ORs) were reported with a 95% confidence interval (CI). ResultsThe prevalence of undernutrition was higher among public school children (37.1%) than those attending private schools (28.3%). Not having family car (adjusted OR [aOR], 0.28; 95% CI, 0.09–0.84), snack frequency no more than twice a day (aOR, 5.29; 95% CI, 1.37–20.37), and vigorous intensity sports (aOR, 0.53; 95% CI, 0.32–0.91) were significantly associated with undernutrition among public primary school students. Family income below the median (aOR, 2.12; 95% CI, 1.23–3.53), no preference for sweets (aOR, 0.59; 95% CI, 0.36–0.97), and not habits while reading (aOR, 0.42; 95% CI, 0.19–0.89) were the factors significantly associated with undernutrition among private primary school students. ConclusionThe prevalence of undernutrition was high. Children in public schools were highly vulnerable to undernutrition compared with those in private schools. Not having a family car, snack frequency no more than twice daily, and vigorous intensity sports increase the risk for undernutrition among public school children. Family income below the median, not preferring sweets, and not having a habit of eating while reading increase the risk for undernutrition among private school children. It is better to give attention to healthy dietary habits and healthy lifestyles to reduce childhood undernutrition.

Spatial patterns and determinants of undernutrition among late-adolescent girls in Ethiopia by using Ethiopian demographic and health surveys, 2000, 2005, 2011 and 2016: a spatial and multilevel analysis

BackgroundUndernutrition among late-adolescent girls (15–19 years) in Ethiopia is the highest among Southern and Eastern African countries. However, the spatial variation of undernutrition as a national context is not well understood in Ethiopia. This study aimed at the spatial patterns and determinants of undernutrition among late-adolescent girls in Ethiopia.MethodsSecondary data analysis was conducted from women’s data of four consecutive Ethiopian Demographic and Health Surveys (EDHS) from 2000 to 2016. A total of 12,056 late-adolescent girls were included in this study. The global spatial autocorrelation was assessed using the Global Moran’s I autocorrelation to evaluate the presence of geographical clustering and variability of undernutrition. SaTScan cluster analysis by using the Bernoulli model to detect most likely SaTScan cluster areas of significant high-rate and low-rate of undernutrition was explored. A Multilevel binary logistic regression model with cluster-level random effects was fitted to determine factors associated with undernutrition among late-adolescent girls in Ethiopia.ResultsUndernutrition was clustered nationally during each survey (Global Moran’s I = 0.009–0.045, Z-score = 5.55–27.24, p-value < 0.001). In the final model, individual and community level factors accounted for about 31.02% of the regional variations for undernutrition. The odds of undernutrition among 18–19 years of adolescent girls, was 57% (AOR = 0.43; 95% CI: (0.35–0.53) lower than those 15–17 years old. Late-adolescent girls with higher educational status were 4.40 times (AOR = 4.40; 95% CI: (1.64–11.76) more likely to be undernourished than those with no educational status. The odds of undernutrition among late-adolescent girls, with the occupation of sales, was 40% (AOR = 0.60; 95% CI: 0.43–0.84) lower than those with not working adolescents. The odds of undernutrition, among late-adolescent girls, having an unimproved latrine type, was 1.79 times (AOR = 1.79; 95% CI: 1.15–2.79) higher than those participants with improved latrine type. The odds of undernutrition among late-adolescent girls with rural residents was 2.33 times higher (AOR = 2.33; 95% CI: 1.29–4.22) than those with urban residents.ConclusionUndernutrition among late-adolescent girls was spatially clustered in Ethiopia. The local significant clusters with high prevalence of undernutrition was observed in Northern and Eastern Ethiopia. Those regions with a high prevalence of undernutrition should design interventions to combat undernutrition.

Spatial distribution and determinants of undernutrition among reproductive age women of Ethiopia: A multilevel analysis.

IntroductionMalnutrition is one of the most devastating problems in Ethiopia and is inextricably linked with poverty. Women in the reproductive age group and children are most vulnerable to malnutrition due to low dietary intakes, inequitable distribution of food within the household, improper food storage and preparation, dietary taboos, infectious diseases, and care. Therefore, this study aimed to assess the spatial distribution and determinants of undernutrition among reproductive age of Ethiopia.MethodsThe study was based on the 2016 Ethiopian Demographic and Health Survey. The study included a total sampled weight of 15,139 women aged 15–49 years. The ArcGIS version 10.7 and SaTScan version 9.6 statistical software were used for exploring the spatial distribution of undernutrition. A multilevel logistic regression model was fitted to determine the individual and community level factors associated with women undernutrition. Finally, the factors which were significant at 95% confidence interval were reported.ResultThe spatial analysis revealed that women undernutrition was significantly varied across the country. The SaTScan analysis identified a total of 144 significant hotspot areas of maternal undernutrition with three significant spatial windows. Of these, 134 clusters were primary. The primary spatial window was identified in the southeast Tigray, northwest Afar, central and north Amhara regions (LLR = 57.48, P<0.01, RR = 1.51). Age at first marriage (AOR = 1.57: CI 1.33, 1.99), middle wealth index (AOR = 3.15: CI 1.4, 6.97), rural residence (AOR = 2.82: CI 1.22, 6.52), being in Afar region, Tigray region and Harari region (AOR = 4.88: CI 1.71, 13.91), (AOR = 4.17: CI 1.57, 11.06) and (AOR = 3.01: CI 1.05, 8.68) respectively were significantly associated with women undernutrition.ConclusionIn Ethiopia, undernutrition had significant spatial variations across the country. Residence, age at first marriage, wealth index and region were significantly associated with undernutrition. Therefore, public health interventions that reduce reproductive age women undernutrition and enhance women awareness towards undernutrition in hotspot areas of undernutrition is crucial.

Determinants of Undernutrition among Adult Tuberculosis Patients Receiving Treatment in Public Health Institutions in Shashemane Town, Southern Ethiopia.

Background Undernutrition and tuberculosis are the major concerns of underdeveloped regions of the world. Tuberculosis makes undernutrition worse and undernutrition weakens immunity, thereby increasing the likelihood that latent tuberculosis will develop into active disease. Nevertheless, little has been understood about undernutrition among patients with infectious disease like tuberculosis in Ethiopia. This study was conducted to determine the magnitude of undernutrition and its determinants among tuberculosis patients in Shashemane public health institutions, Southern Ethiopia. Methods An institution-based cross-sectional study was conducted in two public hospitals and ten health centers of Shashemane Town from March 12, to April 12, 2017, among 368 adult tuberculosis patients on treatment follow-up. Sociodemographic and socioeconomic characteristics and anthropometric data were collected. Data were entered into EpiData version 3.3 computer software and analyzed using SPSS version 20. Bivariable logistic regression analyses were done to assess the association between outcome variable at bivariate analysis, and multivariable logistic regression model was used to assess factors that were independently associated with undernutrition. Odds ratios along with 95% confidence interval (CI) were estimated to measure the strength of the association, and level of statistical significance was declared at P value ≤0.05. Result The overall magnitude of undernutrition among adult tuberculosis patients in this study was 28.8% (95% CI = 0.25–0.34). Patients in the age group of forty-five and above ((AOR = 3.39, 95% CI = (1.6–7.18)), residents in rural area ((AOR = 1.95, 95% CI = (1.07–3.54)), those with problem with eating ((AOR = 2.361, 95% CI = (1.332–4.185)), and those who are not on food supplementation ((AOR = 2.21, 95% CI = (1.06–4.58)) were significantly at higher risk of undernutrition. Conclusion The magnitude of undernutrition in the study setting was found to be significantly higher. Age greater than forty-five, living in rural area, and lack of nutritional care and support were identified as the factors associated with undernutrition. Thus, relevant actors should give attention to fast nutritional intervention together with standard therapeutic regimen in the management of pulmonary tuberculosis patients to curb their nutritional derangement.

Comparison of Growth in Children of 6 to 59 Months of Age According to Birth Order: Insights from the National Family Health Survey-4

Introduction: Undernutrition continues to be a major public health problem throughout the world. Higher birth order of the child contributes to higher chance of being undernutrition. But, the relationship between birth order and undernutrition has not been fully studied and understood, especially in India where the fertility rate was high. Aim: To understand the prevalence and determinants of undernutrition using National Family Health Survey-4 (NFHS-4) India. Materials and Methods: A national cross-sectional survey was conducted during January 2015 to December 2016. This study used information from a total weighted sample of 128859 children from India NFHS-4. Univariate and multivariate binary logistic regression were used to investigate the association of undernutrition with birth order, other child, maternal and socio-economic factors. Three models were constructed for the study, model 1 as univariate, model 2 adjusting with birth order and socio-economic predictors and model 3 adjusting with all the predictors included in the study. Results: Of the 128859 children, median Inter Quartile Range (IQR) age was 26 (16-41) months with female/male ratio was 1:1.2. The prevalence of stunting, underweight and wasting was 37.93% (95% Confidence Interval (CI) 37.67-38.20), 34.02% (95% CI 33.76-34.28) and 20.70% (95% CI 20.48-20.92), respectively. Model-1, 2 and 3 showed that the child's higher birth order was found to have higher odds of being stunted and underweight compared with first born children. Children with lower wealth quintiles, male, vaginal delivery had higher odds of being stunted, wasted and underweight in the model-3 adjusted analysis. Conclusion: This study indicates that higher birth order was a significant predictor of a child being stunted and underweight, as it is significant in all three models. However, further longitudinal studies are required to establish a cause-effect relationship between birth order and undernutrition and future interventions to prevent undernutrition should consider birth order as an important factor.