Medium Dietary Diversity Research Articles

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.

Dietary Diversity in Adolescents at State Junior High School 4 Depok, Sleman Regency, Yogyakarta: A Descriptive Study

<p><strong>Adolescents require balanced nutrition for their future growth and development. Adolescence is a time when there is a high risk of weight gain, especially in eating habits. A diverse diet for adolescents makes it easier to fulfill their need for various nutrients. This study aims to describe the dietary diversity of adolescents in state junior high school 4 Depok, Sleman Regency, Yogyakarta. This research was quantitative, using an analytic observational approach and a cross-sectional design. A purposive sampling technique was used to select 41 respondents. IDDS (Individual Dietary Diversity Scores) was used to measure dietary diversity based on nine food groups such as starch; green vegetables; vitamin A-rich fruits and vegetables; other fruits and vegetables; organ meats; fish, meat, and other processed meats products; legumes, nuts, and seeds; and dairy products. The majority of the adolescents, i.e. 21 individuals (51.2%), had a medium dietary diversity, while the remaining 20 individuals (48.8%) had a low dietary diversity. The adolescents consumed mainly starch (staple foods), other fruits and vegetables; eggs; fish, meat, and processed products; and dairy products. Adolescents from state junior high school 4 Depok Sleman Yogyakarta were mainly classified as having medium dietary diversity.</strong></p><p><strong> </strong></p><p><strong>Keywords: adolescents, dietary diversity, school age</strong><strong></strong></p>

Dietary diversity, hygiene, and lifestyle practices among adult residents during COVID-19 pandemic: A cross-sectional study from Bangladesh

BackgroundCOVID-19 is an international emergency public health concern that poses significant challenges. Intake of adequate immune-boosting nutrients from natural sources, proper hygiene practices, and ideal lifestyle practices must be adhered to during this condition, along with the discovery of protective vaccines. The purpose of the current study was to evaluate the dietary, hygiene, and lifestyle practices among adult residents during the COVID-19 pandemic situation in the Jashore district, Bangladesh. MethodologyThis cross-sectional study was conducted through face-to-face interviews with 500 adult respondents of both genders (age ≥ 18 years). A structured and validated questionnaire was used to collect data on socio-demographic information, dietary diversity, hygiene, and lifestyle practices. Multivariate logistic regression was employed to evaluate and predict factors that influence the study variables. ResultsThe study found that about 44.60% had medium, 27% had low, and 28.40% had high dietary diversity. Regarding the dietary practices, age (p = 0.001), education (p = 0.005), occupation (p = 0.015), and COVID-19 experience (p = 0.001) of respondents were significantly associated with both residential. Hygiene practices such as using a face mask, hand sanitizer use, covering the face during coughing, and hand shaking were significantly associated (p < 0.05) with respondents in both residential areas. In logistic regression analysis, factors associated with poor hygiene practices were being male, illiterate, > 40 years of age, smokers, malnourished respondents in rural areas, obese, > 40 years of age, and having income < 10000 BDT in urban areas. About 40.4% of urban and 45.6% of rural respondents were found to be engaged in physical activity. ConclusionThe study found that the respondents mostly had access to medium dietary diversity, and rural residents maintained a better lifestyle while urban respondents practiced better hygiene. Based on the findings, the study suggests increasing public awareness regarding dietary diversity, hygiene, and lifestyle practices in both rural and urban areas to mitigate the consequences of COVID-19.

Effect of market participation on the food and nutrition security status of the rural smallholder farmers: the case of Limpopo and Mpumalanga provinces, South Africa

IntroductionHunger and malnutrition remain serious issues in developing countries, particularly in rural regions. Increased market participation of smallholder farmers can result in improved livelihood and nutrition outcomes. However, smallholder farmers encounter several obstacles that hinder their ability to participate in the market. As a result, the objective of this study is to investigate the factors that influence market participation and its impact on household nutrition security.MethodsThe study relied on secondary data gathered from a sample size of 1,520 people. About 389 of smallholder farmers participated in the market.Results and DiscussionThe results from Food Consumption Score (FSC) cut-off points showed that in the overall sample households, 54% were within the acceptable food consumption diets (&amp;gt;35), while 30 and 16% were in the borderline (21.5–35) and poor diets (0–21), respectively. According to the Household Dietary Diversity Score (HDDS) findings, 57% of smallholder farmers in the total population sample consumed highly diverse diets (consisting of at least six food groups), while 25 and 18% of smallholder farmers consumed diets with medium dietary diversity (consisting of 4–5 food groups) and low dietary diversity (consisting of at most three food groups), respectively. The results from marginal analysis showed that gender of household head, receiving social grants and higher wealth index had a positive impact on market participation. The results from Poisson endogenous treatment effect model showed that household size, ownership of livestock, social grant, wealth index, access to market information, and involvement in crop production had a positive and statistically significant impact on household nutrition security. On the other hand, agricultural assistance showed a negative and significant impact on household nutrition security.Conclusion and RecommendationsIt can be concluded that an improvement in agricultural assistance can improve the household nutrition security status. The improvement of agricultural assistance is more associated with improvement of extension services, which can lead to more production of diverse crops and more market participation. Health extension workers need to do more nutrition programs and workshops in rural areas. These programs and workshops will be intended on providing nutrition education, which will create awareness to smallholder farmers on diverse and balanced food items they should produce, sell, and consume.

Undernutrition and associated factors among adult prisoners in Fiche town, central Ethiopia: a facility-based cross-sectional study.

Undernutrition is a major public health problem worldwide, particularly in developing countries like Ethiopia. However, nutritional problems are frequently overlooked in low-income countries, especially among vulnerable populations such as imprisoned people. The scientific data on the rate of undernutrition among imprisoned people in Ethiopia is limited. Hence, this study aimed to assess the magnitude and associated factors of undernutrition among adult prisoners in Fiche town, central Ethiopia. A facility-based cross-sectional study was conducted from August 15 to September 15, 2020. A systematic random sampling technique was used to select participants. All prisoners whose age was 18 years and above who have been in prison for at least 6 months were included. Data were collected using interviewer-administered pretested semi-structured questionnaires and standard anthropometric measurements. A cut-off point of body mass index <18.5 kg/m2 was used to measure undernutrition. Data were coded, entered into Epi-data version 3.1, and analyzed using Statistical Package for Social Sciences version 20.0. A binary logistic regression analysis was conducted to identify factors associated with undernutrition. The adjusted odds ratio (AOR) with a 95% confidence interval (CI) was calculated to measure the strength of the association and a p-value of less than 0.05 was considered statistically significant. The overall magnitude of undernutrition among adult prisoners was 20% (95% CI: 16.5-23.6). Duration of imprisonment, incarcerated for 25 to 59 months (AOR = 3.07; 95% CI: 1.33, 7.04) and for greater than 59 months (AOR = 4.56; 95% CI: 2.0, 10.45), mild and moderate depression (AOR = 1.9; 95% CI: 1.05, 3.45), and moderately severe and severe depression (AOR = 2.78; 95% CI: 1.17, 6.60) were significantly associated with increased odds of undernutrition. However, being female (AOR = 0.51; 95% CI: 0.26, 0.98), having financial support (AOR = 0.36; 95% CI: 0.15, 0.87), engaging in income-generating work within the prison (AOR = 0.27; 95% CI: 0.15, 0.47), having medium dietary diversity (AOR = 0.35; 95% CI: 0.15, 0.80), and having good dietary diversity (AOR = 0.23; 95% CI: 0.08, 0.61) significantly decreased the odds of undernutrition. The magnitude of undernutrition among adult prisoners was high, with one in five prisoners in Fiche town prison having undernutrition. Sex, financial support, duration of imprisonment, income-generating work in the prison, dietary diversity, and depression were predictors of undernutrition. Hence, access to healthy food and diversified diets should be ensured for prisoners, and implementing early screening and treatment of depression, as well as encouraging prisoners to engage in income-generating work within the prison is recommended to reduce the burden of undernutrition.

The Role of Smallholder Farming on Rural Household Dietary Diversity.

The importance of smallholder farming is increasingly recognized in rural areas where increased crop productivity and market participation can effectively improve their dietary diversity and nutrition quality. However, rural households are still faced with severe food insecurity and malnutrition. The study sought to assess the role of smallholder farming in crop productivity and market access on rural household dietary diversity. The secondary data were collected using a quantitative research method, and 1520 participants were selected using a stratified random sampling technique. The descriptive results showed that cereals were the most (98%) consumed food group, while vegetables and fruits were the least consumed food groups, at 37% and 23%, respectively. The results from the Household Dietary Diversity Score (HDDS) showed that 57% of smallholder farmers consumed highly diverse diets (more or equal to six food groups), whereas 25% and 18% of smallholder farmers consumed medium dietary diversity (four to five food groups) and low diverse diets (less or equal to three food groups), respectively. The findings from the Conditional Mixed Process (CMP) and Poisson endogenous treatment effect models showed that household size, ownership of livestock, wealth index, and involvement in crop production positively influenced household dietary diversity. On the other hand, output and access to market information showed a negative effect. Social grants had contradicting effects: they had a negative impact on the HDDS received from crop productivity while they had a positive effect on the HDDS from market participation. Providing different ways smallholder farmers can use their funds effectively can help improve household dietary diversity and nutrition quality. The study recommended that more workshops and training be conducted that cover all the sustainable production systems that smallholder farmers can undertake to produce different food groups. These will raise awareness among smallholder farmers about the requirements for balanced diets for food and nutrition security.

Dietary Diversity and Determinants of Nutritional Status of Primary School Children in Anambra State, Nigeria.

Proper nutrition accomplished through consumption of diverse foods is very vital as it provides the foundation for optimum health, strength, cognitive development and academic achievement, especially during the school age. Aim: this study aimed at assessing dietary diversity and determinants of nutritional status of primary school children in Anambra State, Nigeria. Materials and methods: a descriptive cross-sectional survey involving primary school children from two selected local government areas (one urban and one rural) of Anambra State was carried out over a 3-month period. A total of 637 participants comprising 297 males and 340 females were selected using multistage sampling technique. Interviewer-administered questionnaires were used to obtain needed information from the pupils and their parents/guardians. Anthropometric parameters such as height and weight were measured using a digital scale and a measuring tape. Nutritional status was determined using the WHO AnthroPlus version 1.0.4 and data was analyzed using SPSS version 25. Results: Findings revealed that 69.54% of study participants had medium dietary diversity score and the least consumed food groups were animal products (7.2%). The results further showed that 146 pupils (22.92%) had at least one form of malnutrition with the prevalence of wasting, stunting, overweight and obesity being 6.9%, 5.5%, 5.3% and 5.2%, respectively. Findings also suggested that male gender and large family size predicted the likelihood of stunting; while urban residence, attending private school, belonging to high socio-economic class increased the likelihood of overweight and obesity. Conclusion: The present study showed that a high percentage of the population had normal nutritional status while only a small proportion was stunted, wasted, overweight or obese. Factors such as place of residence, family size, birth order, type of school, parental educational level and socio-economic status had significant impact on nutritional status.

Dietary diversity in primary schoolchildren of south-central Côte d’Ivoire and risk factors for non-communicable diseases

BackgroundA balanced nutrition is important for children’s physical and cognitive development; yet, remains a challenge in many parts of low- and middle-income countries (LMICs). Early detection of nutritional deficiency and metabolic syndrome in school-aged children is necessary to prevent non-communicable diseases (NCDs) in later life. This study aimed at obtaining baseline data on health, nutritional status, and metabolic markers of NCDs among primary schoolchildren in Côte d’Ivoire.MethodsA cross-sectional survey was conducted among 620 children from 8 public primary schools located in the south-central part of Côte d’Ivoire. Underweight and overweight were defined as a body mass index (BMI; kg/m2) < 5th and 85th up to 95th percentile for sex and age, respectively. Dietary diversity of children was calculated based on a 24-hour recall conducted with the primary caretaker according to the guideline of Food and Agriculture Organization. Anaemia, malaria, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and blood glucose levels (HbA1c) were assessed, using capillary blood samples. Logistic models were performed to identify risk factors associated with overweight, HDL-C, LDL-C, and HbA1c.ResultsAmong the 620 children (330 girls, 290 boys; Mage 8.0 (± 1.7) years), 530 children attended school in a semi-urban and 90 in a rural area. Around 60% of children had a medium dietary diversity score (DDS). Children in peri-urban areas consumed more cereals (80.2% vs. 63.3%, p < 0.05). Most children were normal weight (n = 496), whereas 3.9% of children classified as prediabetic, 5% were underweight, and 15% overweight. LDL-C and HDL-C levels of children were associated with age, high DDS, and moderate anaemia. A significant association was found between prediabetes and malaria infection, as well as medium and high DDS. Overweight was associated with malaria infection and moderate anaemia.ConclusionOverweight, prediabetes, low HDL-C, malaria, and anaemia are the main concerns of children’s health in Taabo. Our findings highlight interactions between infectious diseases, particularly malaria, and NCD risk factors. Monitoring NCD risk and infectious disease comorbidity in LMIC paediatric populations simultaneously is essential to better understand the dual diseases burden and apply early prevention measures.

Dietary diversity, food insecurity and the double burden of malnutrition among children, adolescents and adults in South Africa: Findings from a national survey.

Childhood stunting remains a global public health problem. Many stunted children live in the same household as overweight or obese adults (the so-called double burden of malnutrition), evidence that quality as well as quantity of food is important. In recent years, food security measurement has shifted away from anthropometry (e.g., stunting) to experiential measures (e.g., self-reported hunger). However, given the continued problem of stunting, it is important that national surveys identify malnutrition.ObjectivesTo examine the associations between a variety of food security indicators, including dietary diversity, with adult, child (0–4 years) (5–9 years) and adolescent (10–17 years) anthropometry. To estimate the prevalence of double burden households.MethodsThe study utilized cross-sectional data from the South African National Income Dynamics Survey NIDS (2008). We examined the associations between five food security indicators and anthropometry outcomes. The indicators were adult and child hunger in the household, self-reported household food sufficiency, food expenditure>60% of monthly expenditure and household dietary diversity. Multinomial and logistic regression models were employed to examine the associations with adult BMI categories and children's stunting and BMI.ResultsThe prevalence of stunting was 18.4% and the prevalence of wasting and overweight was 6.8 and 10.4%, respectively. Children <5 and adolescents with medium dietary diversity were significantly more likely to be stunted than children with high dietary diversity. Among children <5, child hunger and medium dietary diversity were significantly associated with wasting. None of the food security indicators were associated with stunting in children aged 5–9. Among stunted children, 70.2% lived with an overweight or obese adult. Among adults, increased dietary diversity increased the risk of overweight and obesity.ConclusionDietary diversity can be used as a proxy for poor nutritional status among children <5 years and adolescents but the relationship between dietary diversity and adult obesity is more complex. Given the double burden of malnutrition in many low- and middle-income countries, indicators of dietary quality remain important. These tools can be further refined to include an extra category for processed foods. Given the relative simplicity to collect this data, national surveys would be improved by its inclusion.

NUTRITIONAL ASSESSMENT AND NUTRITION EDUCATION NEEDS OF RETIREES IN ABIA STATE, NIGERIA

Retirement is a transition from paid occupation to other life ventures and is associated with aging, which isa degenerative process and thus points at the need for a continuous nutritional assessment of this age groupin other to identify their nutrition educational needs. The study was a cross sectional design. A systematicrandom sampling technique was used to select 100 retirees for the study. Questionnaire and interview wasthe instruments for data collection. Height and weight measurement were also taken and used to obtain theirBMI. A 24 hours dietary recall was used to get their dietary diversity score. Blood pressure was measuredwith a mercury sphygmomanometer at least twice in each participant. Random Blood Glucose was checkedwith venous blood. Descriptive statistics (frequency and percent) was employed using SPSS version 21 whilesignificance was accepted at p&lt;0.05. Result showed that 65% of the participants were female while 35%were males. The prevalence of overweight and obesity observed in this study was 30% and 46% respectively,39% were hypertensive, 8% had diabetes. Many (85%) of the retirees were at high risk of metabolicconditions while 6% and 9% of the retirees were at moderate and low risk respectively. Less than half (47%)of the retirees had medium dietary diversity, 39% had low dietary diversity while 14% had high dietarydiversity. Many 74%, 65% and 58% of them stated their need for education on dietary management ofdiabetes, hypertension and basic nutrition (foods) for the aged. The nutritional status and nutrition educationneed of the retirees needs to be checked most often which is aimed at reducing the risk factors of underand/or over nutrition for the retirees in Abia state as well manage those with health conditions such asdiabetes, hypertension and co-morbidities.

Anaemia among school-aged adolescent boys in the Sagnarigu District of Northern Ghana

Background: The increased nutritional requirement in pregnancy and that associated with growth spurt in adolescence has skewed nutritional interventions towards pregnant women and girls. Among school-aged adolescents, physical and cognitive development peaks. This affects both males and females but overall nutritional deficiency in males has not been fully described. We assessed prevalence of anaemia and its predictors among school-aged adolescent boys in the Sagnarigu district, Northern Region. Method: We used cross-sectional design with multi-stage sampling involving 349 adolescents in eleven (11) public JHSs. We included adolescent girls for comparison on the prevalence of anaemia and to answer the question whether anaemia in the boys was any different from their female colleagues. We estimated household wealth using Principal Component Analysis (PCA). We assessed Dietary Diversity and food security using 24-hour recall and FANTA-USAID Household Hunger Scale (HHS) module respectively. We analysed capillary blood samples using HaemoCue (Hb-301) to determine anaemia. We measured weight and height and determined nutritional status using the WHO 2007 growth reference. We conducted data analysis using STATA Version 15 and used Two-sample t-test to determine mean differences and Chi-square (χ2) or fisher’s exact tests for associations. We fitted logistic regression models to the data to determine factors associated with anaemia among boys. Findings: We found overall mean haemoglobin concentration of 13.3±1.7g/dl and anaemia prevalence of 25.2%. We found no statistical difference between anaemia in boys and girls (24.2% for boys vs. 26.8% for girls, p=0.59). Low dietary diversity was 29.5%, medium dietary diversity was 33.5%, high dietary diversity was 37.5% and food insecurity was (21.2%). In total, 14.3% of children had nutritional challenges, with 8.5% underweight, 5.8% Overweight/obese and 9.9% stunted. Among boys, anaemia was predicted by wealth (OR=0.5, 95% CI=0.2 -1.0, P=0.049) and stunting (OR=2.7, 95%CI=1.1 - 6.8, p=0.034). Living in upper 60% household wealth was a protective factor with 50% less odds of anaemia as compared to their counterparts living in the lower 40%. Similarly, stunted boys had 2.7times odds of anaemia as compared to those not stunted. Conclusion: We concluded that anaemia equally affects boys and girls in the Sagnarigu district. Family/household circumstances may determine anaemia among these adolescents rather than biology (menstruation in girls). Indeed, irrespective of the age, educational level of parents and household food security, anaemia among boys in the district was predicted by household wealth and stunting.

Dietary diversity among households living in Kilombero district, in Morogoro region, South-Eastern Tanzania

Adequate nutrition is essential for good health and active life. However, diets in most low and middle-income households lack diversity, especially in settings where people eat predominantly starchy foods. In this study, we assessed the associations between socio-economic status and household dietary diversity in families living in South-eastern Tanzania. A cross-sectional questionnaire was administered to 925 parents of school children in four wards in South-eastern Tanzania, as part of a trial; assessing the effects of physical activity and micronutrient supplementation on overall growth, health and well-being of school children. The dietary intake was assessed by 24-h dietary recall and dietary diversity score (DDS) was calculated. Socio-economic status was derived from a weighted score using principal component analysis (PCA). Multinomial logistic regression was used to investigate the association between dietary diversity and socio-economic status. This baseline data assessment was completed in July and August 2019. Cereals, oils and fats were the most consumed food groups, legumes were the most common source of protein and fish was the most common animal protein. More than three quarters of the households had medium dietary diversity (MDD). Higher household education and large farm size were the only factors significantly associated with having high dietary diversity. A majority of the households in South-eastern Tanzania have medium dietary diversity, comprised of cereal, fats and oils and proteins. Having high dietary diversity was associated with higher education and large farm sizes. Improving community members’ knowledge and awareness of nutritional benefits could improve the dietary diversity at household level. • Majority of respondents had primary school education and do farming as their main income generating activity. • Cereals and oils and fats were the most consumed food groups. • More than three quarters of the households had medium dietary diversity. • Household dietary diversity influenced by some factors like education and farm size.

Dietary diversity and nutritional status of 2 to 5 years old children in households with and without home gardens in selected districts in Siem Reap province, Cambodia

Introduction: There is a high prevalence of malnutrition in Cambodia during the past 10 years. One of the programmes implemented to secure household food security in order to alleviate malnutrition was home gardening. This study aimed to compare the nutritional status of 2 to 5 years old children in households with and without home gardens. Methods: Twenty-five households with home gardens and 60 households without home gardens were sampled. Results: The households sampled had a mixed type of home garden with three to five crop varieties occupying 20 to 200 square meters area. The purpose of the garden was to increase vegetable consumption and produce additional income. Results showed that 72% and 65% of the children resided in households with and without home gardens, respectively. Majority had medium dietary diversity score, i.e. consumed four to five different food groups per day. Except for stunting, higher prevalences of undernutrition (32%) and wasting (8%) were observed among children residing in households with home gardens compared to children in households without home gardens. Conclusion: There were no associations for dietary diversity score and nutritional status of children from households with and without home gardens. Among the sociodemographic and economic factors, age, sex, family size, and vegetable consumption were significantly associated with dietary diversity score and nutritional status of the children.

Prevalence of undernutrition and its associated factors among pregnant women in Konso district, southern Ethiopia: a community-based cross-sectional study

BackgroundUndernutrition during pregnancy is an important public health problem. It is highly prevalent in Ethiopia but not sufficiently addressed yet. Hence, this study aimed to assess the prevalence of undernutrition and its associated factors among pregnant mothers in Konso district, Ethiopia.MethodsCommunity-based cross-sectional study was conducted with a qualitative inquiry from December 2018 to January 2019. A multistage stratified sampling technique was used to select 527 subjects and quantitative data were collected from these subjects using a structured interviewer-administered questionnaire and additionally qualitative data were generated through two focus group discussions among purposely selected discussants. Mid upper arm circumference (MUAC) was measured by standard non-stretchable MUAC tape. Data were entered into Epi-data version3.1 and analyzed by SPSS version 21. In multivariable binary logistic regression, a statistically significant association was declared at p-value < 0.05 while thematic framework analysis was employed for the qualitative data.ResultsAmong 501 participants, the overall prevalence of undernutrition (MUAC < 23 cm) was 43.1% (95% CI 38.7–47.5%). Household food security (AOR = 3.1; 95% CI: 2.1–4.6), low dietary diversity score (AOR = 4.9; 95% CI: 2.6–9.2), medium dietary diversity score (AOR = 2.3; 95% CI: 1.2–4.7), absence of latrine (AOR = 1.8; 95% CI: 1.2–2.6) and having family resource decision making by husband only (AOR = 1.7; 95% CI: 1.1–2.6) were significantly associated factors. Traditional believes to restrict food such as egg, milk, and milk products, avocado for women, weak nutrition education and malnutrition screening program, daily consumption of locally prepared alcoholic drink called “Cheka”, drought-prone nature of this setting, traditional way of farming practices and low socio-economic status were found to be barriers for women’s undernutrition.ConclusionsThe prevalence of undernutrition was found to be higher than previously reported findings. Household food security, dietary diversity, latrine availability, family resource decision making, food restrictions, weak maternal nutrition education, and malnutrition screening program, the practice of depending on a local alcoholic drink called “Cheka”, drought, traditional way of farming and low socio-economic status were identified factors. Hence, interventions targeting maternal nutrition education, hygiene, and sanitation promotion, household food insecurity improvement strategies should be implemented to improve the nutritional status of pregnant women.

Undernutrition and Associated Factors among Pregnant Women in Kacha Birra District, Southern Ethiopia

Background: Worldwide, malnutrition is a public health concern with noteworthy consequence especially in pregnant women. Maternal undernutrition may dispose mothers to poor wellbeing including infection, preeclampsia/ eclampsia, and adverse pregnancy outcomes such as preterm birth and intrauterine growth retardation. Pregnant women are exposed to nutritional deficiency because of increased metabolic needs as a result the usually end up in undernutrition. There is lack of updated information in the study area regarding nutritional status and factors among pregnant women. Objective: To assess undernutrition and associated factors among pregnant womenin Kacha Birra district, Southern Ethiopia in 2019. Methods: An institution-based cross-sectional study was conducted among 344 pregnant women attending antenatal care in public health facilities from February 21-March 20, 2019. A systematic sampling technique was employed. Data were collected using a structured questionnaire and analyzed by a statistical package for social science version 22 software. Both bivariate and multivariate logistic regression analyses were undergone to identify factors associated with the nutritional status of pregnant women. Result: Among 344 pregnant women who participated in the study, 52.6% were undernourished. On the multivariable analysis; having a history of peptic ulcer disease [(AOR=1.97 (1.23-3.17)], husband’s educational status with Illiterate to elementary [AOR=0.589 (0.369-0.940), medium dietary diversity score [AOR=2.931 (1.106-7.766)], high dietary diversity score [AOR=2.485 (0.915-6.747)], intestinal parasite infection [AOR=1.725 (1.086-2.742)], second trimester gestational age [AOR=0.338 (0.159-0.718)] had shown statistically significant association with maternal undernutrition. Conclusion: Over half of pregnant women were in undernurition. Multisectorial collaboration and coordination among related sectors and strengthening programs targeted on adult’s educational status, improved drinking water and sanitation against pregnant women’s, counseling on Antenatal clinic and prevention and treatment of chronic disease during pregnancy.

Goiter and Its Associated Factors among Adolescent High School Girls at Tach Armachiho District, Northwest Ethiopia: An Institution-Based Cross-Sectional Study.

Introduction In Ethiopia, iodine deficiency disorder (IDD) is a major public health problem. The most visible effect of IDD is the appearance of goiters, and 28 million people are affected by goiter. Therefore, this study aimed to assess the prevalence and associated factors of goiter among high school adolescent girls at Tach Armachiho district, Northwest Ethiopia. Methods An institution-based cross-sectional study was conducted from October to November 2018. A total of 620 high school adolescent girls were selected using the simple random sampling technique, and structured questionnaires having observational check-list were used for data collection. The presence of goiter was estimated using criteria set by World Health Organization. Iodine content of the salt was estimated by using spot testing kits. Both bivariable and multivariable logistic regressions were used to identify associated factors. The degree of association between independent and dependent variables was assessed by using odds ratio with 95% confidence interval. Those variables having p value of less than 0.05 in the multivariable analysis were considered as significant factors for goiter. Results A total of 614 adolescent girls gave a complete response. The prevalence of goiter among adolescent girls was 24.1%. In the multivariable logistic regression analysis, age of adolescent girls (adjusted odds ratio (AOR) = 1.57, 95% CI: 1.01–2.46), residence (AOR = 1.91, 95% CI: 1.04–3.51), family history (AOR = 4.96, 95% CI: 3.19, 7.72), low dietary diversity (AOR = 8.39, 95% CI: 4.36–16.14), and medium dietary diversity (AOR = 2.26, 95% CI: 1.36–3.77) were significantly associated with adolescent girls goiter. Conclusions Goiter among high school adolescent girls in this study was high. Age of adolescent, residence, family history of goiter, and dietary diversity were statistically significant factors for goiter. Therefore, more emphasis will be given for late adolescent age, having family history of goiter, low dietary diversity, and rural residence to improve the burden of adolescent goiter.

Undernutrition Among HIV-Positive Adolescents on Antiretroviral Therapy in Southern Ethiopia.

PurposeAdolescents living with HIV are vulnerable to undernutrition secondary to elevated nutritional needs imposed by growth spurt and HIV-infection. Yet, in low-income countries, evidence on the epidemiology of undernutrition among adolescents living with HIV is scarce. We assessed the prevalence and predictors of stunting and thinness among adolescents receiving anti-retroviral therapy (ART) in Hawassa city, Southern Ethiopia.MethodsIn this facility-based cross-sectional study, we enrolled 260 adolescents (10–19 years of age) living with HIV on ART in two public hospitals and three health centers. Anthropometric measurements, household food insecurity and dietary diversity were measured following standard approaches. Predictors of stunting and thinness were identified using multivariable logistic regression analyses and interpreted using adjusted odds ratio (AOR) with 95% confidence interval (CI).ResultsOne-third of the adolescents were stunted, and 20% were thin. The prevalence of severe stunting (7.7%) and severe thinness (7.3%) was also high. Significant proportions of the adolescents (38.5%) were from food insecure households, and 28.1% had low or medium dietary diversity. Significant predictors of stunting were lack of food or financial support (AOR=2.71; 95% CI: 1.36–5.39); meal skipping (AOR=2.13; 95% CI: 1.16–3.91); recent history of opportunistic infections (AOR=2.25; 95% CI: 1.11–4.55) and disclosure of HIV status to the adolescent (AOR=1.88; 95% CI: 1.12–4.34). History of opportunistic infection was the only significant predictor of thinness (AOR=3.21; 95% CI: 1.54–6.73).ConclusionThe burden of undernutrition among adolescents living with HIV is disturbingly high. Prevention of opportunistic infections promoting social support and discouraging practice of meal skipping may help to reduce the problem.

Socioeconomic Determinants of Dietary Diversity among Rural Households in Jaunpur District of Uttar Pradesh, India

Inadequate nutritional consumption is one of the decisive factors for weak immunity, a higher probability of various diseases and infections, weak mental and physical growth, and less working capability. The present study was conducted to assess the dietary diversity pattern and its correlates in a rural setting of Jaunpur, Uttar Pradesh, India. A cross-sectional household survey was conducted during August-November 2017, among 316 households. Women from these households were interviewed to know the variety of foods consumed in the past 24 hours. Descriptive statistics and ordinal logistic regression analysis have been used to meet the objective of the study. Results portray that, about 14 percent of the households were in the category of low dietary diversity, and 58 percent were under medium dietary diversity. A higher proportion of SCs and poor households were more prone to have low dietary diversity. Landless households or less than one bigha of agricultural land and household without livestock or less number of livestock were more prone to low dietary diversity. Results of ordered logistic regression analysis confirm that caste, working status of heads, family type, socioeconomic status of the household, agricultural land, and livestock showed a significant association with the dietary diversity pattern of households. There is a necessity for the informed rural population on the importance of a diverse diet to improve nutrient consumption and to achieve food and nutrition security. National or regional level surveys will be helpful to understand the food related challenges in India.

Factors Influencing Dietary Diversity of Pregnant Women Attending Antenatal Care in Western Regional Hospital, Nepal: A Cross-sectional Study

Background: Diet during pregnancy is important to fulfill the nutritional demand of physiological changes as well as to create environment for fetal development. Studies have shown that micronutrient deficiencies are high due to low dietary diversity. In Nepal, meal diversity scores of mother and children are low. The situation of dietary diversity among pregnant women was unknown in Western Region of Nepal. Thus, this study was conducted togenerate evidence regarding status and determinants of dietary diversity among pregnant women.&#x0D; Methods: It was a cross sectional study. Systematic random sampling was done to select 282 pregnant women of third trimester attending antenatal care in Western Regional Hospital, Nepal. Semi-structured questionnaire, 24 hour recall tool andHousehold Food Insecurity Access Scale were used to collect information from participants. Univariate, bivariate and multivariate analysis was done to assess the status, association as well as strength of association between study variables respectively.&#x0D; Results: The mean (±SD) Women's Dietary Diversity Score was 4.96 (±1.42). Pregnant women having education level &lt; SLC compared to ≥ SLC were 74.7% less likely to have high dietary diversity to lowest dietary diversity (AOR: 0.253, CI: 0.103 – 0.620, p=0.003). Similarly, pregnant women having unpaid occupation of husbands compared to paid were 74.5% less likely to have high dietary diversity to lowest dietary diversity (AOR: 0.255, CI: 0.074 – 0.876, p=0.030).&#x0D; Conclusions: Consumption of medium dietary diversity was predominant among pregnant women. Education of the pregnant women and occupation of her husband werethe two significantly associatedfactors with dietary diversity.

Food security and dietary diversity of tea workers of two tea gardens in greater Sylhet district of Bangladesh

The study analyzed the food security and dietary diversity of tea workers in Lakkatura Tea Garden and Ootterbhag Tea garden in greater Sylhet district of Bangladesh. A total of 200 respondents (100 from each tea estate) were interviewed to evaluate the food security and dietary diversity. The study found that average daily per capita calorie intake by tea workers was 2095.96 kcal. In addition, around 85.30% of the total calorie intake was received from the rice consumption. Average per capita daily intake of rice was estimated at 538.51 gm which is higher than the national average. It was also observed that 71.7 and 65.0% households were food secure in Lakkatura and Ootterbhag Tea garden, respectively. In Lakkatura Tea Garden, 61.67% tea workers have medium dietary diversity and in Ootterbhag Tea Estate 49.47% tea workers have low dietary diversity. Using the logit model analysis, this study provides food consumption patterns of tea workers and determine the factors responsible for food security. Household size, farm income and daily calorie intake were found having significant influence on households’ food security. For improving socioeconomic conditions of tea workers, educational institution should be set up to improve their educational status and government should give loans for them at a low interest rate and create alternative job opportunity in off season.