An observational study was conducted to determine dietary fluoride intake, diet, and prevalence of dental and skeletal fluorosis of school age children in three fluorosis endemic districts of the Ethiopian Rift Valley having similar concentrations of fluoride (F) in drinking water (~5 mg F/L). The duplicate plate method was used to collect foods consumed by children over 24 h from 20 households in each community (n = 60) and the foods, along with water and beverages, were analyzed for fluoride (F) content. Prevalence of dental and skeletal fluorosis was determined using presence of clinical symptoms in children (n = 220). Daily dietary fluoride intake was at or above tolerable upper intake level (UL) of 10 mg F/day and the dietary sources (water, prepared food and beverages) all contributed to the daily fluoride burden. Urinary fluoride in children from Fentale and Adamitulu was almost twice (>5 mg/L) the concentration found in urine from children from Alaba, where rain water harvesting was most common. Severe and moderate dental fluorosis was found in Alaba and Adamitulu, the highest severity and prevalence being in the latter district where staple foods were lowest in calcium. Children in all three areas showed evidence of both skeletal and non-skeletal fluorosis. Our data support the hypothesis that intake of calcium rich foods in addition to using rain water for household consumption and preparation of food, may help in reducing risk of fluorosis in Ethiopia, but prospective studies are needed.

Background: Iron deficiency is the most prevalent nutritional deficiency in adolescent girls from the developing world. One of the recommended interventions to improve iron status in adolescent girls is iron supplementation. Yet the provision of iron supplements to adolescent girls proved to be a challenging task for the health systems across the developing world. Objective: The objective of the study was to examine means of reaching adolescent girls for iron supplementation in Northern Ethiopia. Methodology: Analytical cross-sectional study consisting of both quantitative and qualitative approaches to data collection and analysis was used in this study. Stratified multi-stage systematic random sampling technique was adopted and primary quantitative data were collected from 828 (578 school attending and 250 non school attending) adolescent girls recruited from nine districts of Tigray. The primary quantitative data were analyzed using SPSS version 20 software. The qualitative data collected through key informant interviews and focus group discussions were transcribed verbatim and qualitatively analyzed. Results: The mean (SD) age of the girls was 16.7 (1.4) years. Four hundred forty seven (54%), 355 (42.9%) and 26 (3.1%) of the adolescent girls had low, medium and high diet diversity scores, respectively. More than half, 467 (56%), of the adolescent girls believed that adolescent girls were overloaded with household jobs everyday compared to boys from their respective communities. Key informants said that, there is no adolescent nutrition message promoted in the study area. Low community awareness, perceiving iron tablet as a contraceptive, religious and cultural influences, and lack of confidence in supplementation value of iron tablets, are some of the potential barriers mentioned by the key informant and focus group discussion participants. Schools (45%), health centers (27%) and health posts (26%) were the preferred public facilities for provision of iron supplements to student adolescent girls whereas schools (11%), health centers (47%) and health posts (41%) were the preferred public facilities for provision of iron supplements to adolescent girls who were not attending schools from the study communities. Conclusion: The health posts and health centers were the preferred health facilities for iron supplementation to adolescent girls who were not attending schools while the school was the preferred facility for iron supplementation of student adolescent girls.

Better macro and micro nutrient status and their adequate intake by the athletes have great role in balancing losses associated with strenuous exercise, then for better performance. The objective of this study was to determine iron, folate and vitamin B₁₂ status of Ethiopian professional athletes. A cross sectional study was conducted using a point time convenient sample of 101 male and female Ethiopian professional athletes of different distance categories in the period of February to April 2014. Biochemical samples, detail health and exercise related interview, performance data, 24 h dietary diversity and weekly food frequency were collected. The low, medium and high dietary diversity terciles were 36.1, 60.9 and 3.3 % respectively. The mean ± Sd of dietary diversity was 5.44 ± 1.8. Prevalence of iron overload (Serum ferritin >200 μg/L) was 11 %, whereas that of anemia (Hb < 12 g/dL), iron deficiency (ferritin < 12 μg/L) and moderate folate deficiency (210 pg/ml). The iron status of male athletes was significantly different by running-distance categories. In contrast, such difference was absent for female athletes. Performance of the athletes was associated with their red blood cell count (RBC) at p = 0.03. The high performer athletes exhibited high mean value of micronutrient status and hematological variables than their counter parts. However, the RBC of the athletes was the only parameter whose association was statistically significant. The observed gender difference in the association of running-distance category with iron and folate in this study needs further investigation. Given the 11 % iron overload in the present study; there is a need of awarance creation activities and diet intervention in the athletics federation, the athletes and the coaches in order not aggravate the present overload. Prescription of supplements such as iron-folate, multivitamins and minerals should not be based on broad spectrum rather it should be based on recent history of confirmed deficiency, clinical signs and/or laboratory testing to prevent trace element toxicity.

Adequate zinc intake is essential for the growth and neurobehavioral development of young children. Zinc deficiency in children is recognized as risk factor for stunting. In Ethiopia, 38% of children under five years of age are stunted. This analysis was conducted to measure dietary zinc intake and to identify its determinants among children 6–35 months of age to design appropriate intervention. Nationally and regionally representative data available from 6752 children 6–35 months of age from the Ethiopian national food consumption survey were analyzed. A multivariate model was used to identify determinants of dietary zinc intake. We found low dietary zinc intake among children 6–35 month age. National average dietary zinc intake was 1.74 mg/day. Socio-economic status, maternal education, and maternal age were positively associated with dietary zinc intake, while the number of children under 5 years-of-age in a household was negatively associated with dietary zinc intake (p < 0.0001). Children reportedly sick in the previous 2 weeks were most likely to have low dietary zinc intake (p < 0.0001). The observed low dietary zinc intake in Ethiopian children has a significant association with health status of children, providing evidence for nutrition and health planners to emphasize on promoting consumption of zinc rich foods and preventing morbidity from common infections.

In Ethiopia, poor infant and young child feeding practices and low household dietary diversity remain widespread. The Government has adopted the National Nutrition Programme that emphasizes the need for multi-sectoral collaboration to effectively deliver nutrition-sensitive and nutrition-specific interventions. The Sustainable Undernutrition Reduction in Ethiopia (SURE) programme is one such Government-led initiative that will be implemented jointly by the health and agriculture sectors across 150 districts in Ethiopia. Prior to the design of the SURE programme, this formative research study was conducted to understand how the governance structure and linkages between health and agriculture sectors at local levels can support implementation of programme activities. Data were collected from eight districts in Ethiopia using 16 key informant interviews and eight focus group discussions conducted with district and community-level focal persons for nutrition including health and agriculture extension workers. A framework analysis approach was used to analyze data. Few respondents were aware of the National Nutrition Programme or of their own roles within the multi-sectoral coordination mechanism outlined by the government to deliver nutritional programmes and services. Lack of knowledge or commitment to nutrition, lack of resources and presence of competing priorities within individual sectors were identified as barriers to effective coordination between health and agriculture sectors. Strong central commitment to nutrition, increased involvement of other partners in nutrition and the presence of community development workers such as health and agriculture extension workers were identified as facilitators of effective coordination. Federal guidelines to implement the Ethiopian National Nutrition Programme have yet to be translated to district or community level administrative structures. Sustained political commitment and provision of resources will be necessary to achieve effective inter-sectoral collaboration to deliver nutritional services. The health and agriculture extension platforms may be used to link interventions for sustained nutrition impact.