Burden and Determinants of Anemia among Under-Five Children in Africa: Systematic Review and Meta-Analysis: Introduction. Globally, anemia among under-five children is a serious public health problem. Even if there are pocket studies here and there, there is limited evidence on the pooled prevalence of anemia among under-five children in Africa. Therefore, the aim of this study was to determine the pooled prevalence and determinants of anemia. Methods and Analysis. This systematic review and meta-analysis was done following the PRISMA guidelines. A comprehensive search was made in PubMed/MEDLINE, Cochrane Library, HINARI, and Ethiopian Journal of Health Development for studies published since 2009. It was supplemented with Google Scholar search. Study selection, data extraction, and quality of studies were assessed by eight reviewers. The Cochrane Q test and I² test statistic were used to test the heterogeneity of studies. A random-effects model of DerSimonian-Laird method was used. Result. A total of 37 articles were included in this systematic review and meta-analysis. The pooled prevalence of anemia among under-five children in Africa was 59 (95 CI: 55, 63). Being female (AOR=0.71; 95 CI: 0.57, 0.87), maternal education (AOR=1.47; 95 CI: 1.31, 1.66), residence (AOR=0.80; 95 CI: 0.67, 0.95), and family size (AOR=0.93; 95 CI: 0.89, 0.98) were the determinants of anemia among African under-five children. Conclusion and Recommendation. This pooled study revealed that anemia was a severe public health problem. Sex, maternal education, residence, and family size were the determinants of anemia. Therefore, anemia prevention strategy should include sex consideration, educating mothers through youth education, area specific intervention, and encouraging birth spacing.

Iodine deficiency disorder is the leading cause of mental retardation and poor economic performance in developing countries. Worldwide, universal salt iodization has been implemented to eliminate iodine deficiency. However, the adequacy of iodine in salts needs close monitoring to meet its intended goal and this study was aimed at investigating the adequacy of iodine in dietary salt at household level in Dessie and Combolcha Towns. A community-based cross-sectional study was employed at household level in Dessie and Combolcha towns from January to February, 2017. Data were collected from 753 households using systematic sampling technique. The adequacy of iodine in salt was analyzed using rapid testing kit. Socio-demographic and economic, dietary sources, labeling, packaging, storage and cooking methods of household’s characteristics were collected via questionnaire developed using open data kit tool and STATA version 12 was used for further statistical analysis. Ordinal Logistic regression was performed to assess associations between explanatory variables and the response variable. Nearly one-thrid (31.2%) of the households used inadequate iodized salt, which was below the World Health Organization recommendation level (≥15 ppm at the household level). Most of the respondents from Combolcha town (64.6%) were affected by inadequate use of iodized salt as compared to Dessie Town residents (22.2%). Being Dessie resident (OR = 2.53; 95% CI: 1.31–4.90), households with better socioeconomic status (OR = 2.54; 95% CI:1.10–5.87), site of labeling and packing (salt from open market (OR = 0.10; 95% CI: 0.04–0.23) and no exposure to sunlight (OR = 2.54; 95% CI:1.31–4.91) were the predictors of adequacy of iodized salt at household level. Availability of adequately iodized salt at the household level in the study area was low. There should be regular quality control and regulatory enforcement of salt iodization at production, labeling and packaging sites of small scale industries and at household level.

Background. Malnutrition among adolescents is a global public health problem. Nutrient intake is a proxy measure of nutritional status, but studies in developing countries describing the actual nutrient intake condition associated with nutrition in the adolescents are limited. On top of this, there is inconsistent finding on the extent of malnutrition among adolescents. Hence, the aim of this study was to assess malnutrition and the associated factors among adolescents at Dessie high school. Methods. A school-based cross-sectional study was conducted among 365 randomly selected high school adolescents. The data were collected using a structured questionnaire adapted from previous literature studies. Nutrient intakes were estimated by ESHA food processor software from a 24-hour recall, and anthropometric indices were calculated from weight, height, age, and sex. The data analysis was managed by SPSS version 23. Binary logistic regression and multinomial logistic regression were used to report the associated factors of malnutrition. Adjusted odds ratio with 95 CI was used to reveal the presence of statistical association. Results. The percentage of being stunted, underweight, and overweight/obese was 15.7, 6.3, and 8.2, respectively. Snack consumption (AOR=0.38, 95 CI: 0.20, 0.71) was negatively associated with stunting, while MAR <1 (AOR=3.36, 95 CI: 1.15, 7.82) was positively associated with stunting. Being a male (AOR=2.76, 95 CI: 1.03, 7.44) and meal consumption <3 times per day (AOR=4.21, 95 CI: 1.35, 13.11) were factors positively associated with being underweight/thin. Dietary diversity score <5 (AOR=0.35, 95 CI: 0.13, 0.89) was negatively associated with overweight/obesity, while MAR < 1 (AOR=3.14, 95 CI: 1.09, 9.09) was positively associated with overweight/obesity. Conclusion. The percent of overweight/obesity among adolescents in the study area was higher compared with the national and regional prevalence, and this was found to be a public health concern. Therefore, increasing snack consumption, sex consideration, increasing meal consumption, and intake of diversified foods should be included in the prevention strategies of malnutrition among adolescents.

Childhood stunting is still a global public health challenge, including in Ethiopia. Over the past decade, in developing countries, stunting has been characterized by large rural and urban disparities. To design an effective intervention, it is necessary to understand the urban and rural disparities in stunting. To assess the urban-rural disparities in stunting among Ethiopian children aged 6–59 months. This study was done based on the data obtained from the 2019 mini-Ethiopian Demographic and Health Survey, conducted by the Central Statistical Agency of Ethiopia and ICF international. The result of descriptive statistics was reported using the mean with standard deviation, frequency, percentages, graphs, and tables. A multivariate decomposition analysis was used to decompose the urban-rural disparity in stunting into two components: one that is explained by residence differences in the level of the determinants (covariate effects), and the other component is explained by differences in the effect of the covariates on the outcome (coefficient effects). The results were robust to the different decomposition weighting schemes. The prevalence of stunting among Ethiopian children aged 6–59 months was 37.8% (95% CI: 36.8%, 39.6%). The difference in stunting prevalence between urban and rural residences was high (rural prevalence was 41.5%, while in urban areas it was 25.5%). Endowment and coefficient factors explained the urban-rural disparity in stunting with magnitudes of 35.26% and 64.74%, respectively. Maternal educational status, sex, and age of children were the determinants of the urban-rural disparity in stunting. There is a significant stunting disparity among urban and rural children in Ethiopia. A larger portion of the urban-rural stunting disparity was explained by coefficient effects (differences in behaviour). Maternal educational status, sex, and age of children were the determinants of the disparity. So, to narrow this disparity, emphasis should be given to both resource distribution and the appropriate utilization of available interventions, including improvement of maternal education and consideration of sex and age differences during child feeding practices.

Background: Malnutrition among older age people is becoming significantly higher in spite of improvements in the health care system. Life expectancy of Ethiopian elders is increasing; but reliable and valid tools for screening and diagnosis of malnutrition in this subgroup are limited. This study aimed to assess the validity of anthropometric measurements: Mid Upper Arm Circumference (MUAC), Body Mass Index (BMI), and Calf Circumference (CC) in detecting malnutrition status of older age people in Ethiopia. Methods: A community based cross-sectional study was conducted in Borena District from January to March, 2020. A total of 421 participants aged were systematically included in the study. To test reliability and validity of the measurements,Cronbach’s α coefficient and Pearson’s correlations were used, respectively. The full Mini-Nutritional Assessment (MNA) tool was used to diagnosis malnutrition. Overall accuracy, sensitivity and specificity of BMI, MUAC and CC were estimated using Receiver Operating Characteristic curves. The Youden Index was used to determine the best cut-off point. Results: The reliability of BMI, MUAC and CC by Cronbach’s alpha was found 0.847. Significant positive correlations between MNA, BMI(r = 0.56, p < 0.01); MNA, MUAC(r = 0.43, p < 0.01; and MNA, CC(r = 0.52, p < 0.01) revealed. The area under the curve (AUC) of BMI, MUAC and CC were found: 0.98(95% CI, 0.96–0.99, p < 0.001), 0.94(95% CI, 0.89–0.98, p < 0.001) and 0.96(95% CI, 0.94–0.98, p < 0.001) indicating the overall accuracy respectively. The sensitivity and specificity of BMI, MUAC and CC using established cut off points were found: 90%, 96%; 78%, 94% and 84%, 95% respectively. However, using the Youden index the best cut-off point, the sensitivity and specificity of MUAC and CC were 88%, 86%; 92% and 89% respectively and adjusted for age and sex. Conclusions: The current study demonstrated that BMI was a reliable and valid method to identify the malnutrition status of older age people. A MUAC value of 19 cm and CC of 30 cm were simple and efficient cut-off points for the determination of malnutrition in the older age people. A future study is needed to validate the validity of BMI, MUAC and CC against biochemical tests as gold standard.

The first 2 years of life are a critical window of opportunity for ensuring optimal child growth and development. In Ethiopia, the magnitude of the minimum acceptable diet ranges from 7 to 74⋅6 %. The evidence revealed the variation and unrelated data on the prevalence of minimum acceptable diet. Therefore, the present study aimed to assess the minimum acceptable diet and its associated factors among children aged 6–23 months in Lalibela town administration, northeast Ethiopia. A community-based cross-sectional study was conducted in Lalibela town administration, northeast Ethiopia among 387 mothers/caregivers with children aged 6–23 months from May 1 to 30, 2022. The data were entered by Epidata version 3.1 and analysed by SPSS version 25.0. A multivariable binary logistic regression model was fitted to identify factors associated with minimum acceptable diet. The degrees of association were assessed using an adjusted odds ratio with a 95 % confidence interval and P-value of 0⋅05. The magnitude of minimum acceptable diet in the study area was 16⋅7 % (95 % confidence interval: 12⋅8–20⋅6 %). Sex of child, getting infant and young child feeding counselling at antenatal care, infant feeding practice-related knowledge and childhood illness are the variables that were found to be an independent predictor of minimum acceptable diet. Health facilities should strengthen infant feeding counselling starting from antenatal care visits during pregnancy for the recommended minimum acceptable diet is crucial.