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      Cross-Sectional Study of Malnutrition and Associated Factors among School Aged Children in Rural and Urban Settings of Fogera and Libo Kemkem Districts, Ethiopia

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          Abstract

          Introduction

          Little information is available on malnutrition-related factors among school-aged children ≥5 years in Ethiopia. This study describes the prevalence of stunting and thinness and their related factors in Libo Kemkem and Fogera, Amhara Regional State and assesses differences between urban and rural areas.

          Methods

          In this cross-sectional study, anthropometrics and individual and household characteristics data were collected from 886 children. Height-for-age z-score for stunting and body-mass-index-for-age z-score for thinness were computed. Dietary data were collected through a 24-hour recall. Bivariate and backward stepwise multivariable statistical methods were employed to assess malnutrition-associated factors in rural and urban communities.

          Results

          The prevalence of stunting among school-aged children was 42.7% in rural areas and 29.2% in urban areas, while the corresponding figures for thinness were 21.6% and 20.8%. Age differences were significant in both strata. In the rural setting, fever in the previous 2 weeks (OR: 1.62; 95% CI: 1.23–2.32), consumption of food from animal sources (OR: 0.51; 95% CI: 0.29–0.91) and consumption of the family's own cattle products (OR: 0.50; 95% CI: 0.27–0.93), among others factors were significantly associated with stunting, while in the urban setting, only age (OR: 4.62; 95% CI: 2.09–10.21) and years of schooling of the person in charge of food preparation were significant (OR: 0.88; 95% CI: 0.79–0.97). Thinness was statistically associated with number of children living in the house (OR: 1.28; 95% CI: 1.03–1.60) and family rice cultivation (OR: 0.64; 95% CI: 0.41–0.99) in the rural setting, and with consumption of food from animal sources (OR: 0.26; 95% CI: 0.10–0.67) and literacy of head of household (OR: 0.24; 95% CI: 0.09–0.65) in the urban setting.

          Conclusion

          The prevalence of stunting was significantly higher in rural areas, whereas no significant differences were observed for thinness. Various factors were associated with one or both types of malnutrition, and varied by type of setting. To effectively tackle malnutrition, nutritional programs should be oriented to local needs.

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          Most cited references22

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          Maternal and child undernutrition and overweight in low-income and middle-income countries

          The Lancet, 382(9890), 427-451
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            The interaction between nutrition and infection.

            Infection and malnutrition have always been intricately linked. Malnutrition is the primary cause of immunodeficiency worldwide, and we are learning more and more about the pathogenesis of this interaction. Five infectious diseases account for more than one-half of all deaths in children aged <5 years, most of whom are undernourished. Micronutrient deficiencies have effects such as poor growth, impaired intellect, and increased mortality and susceptibility to infection. The worldwide magnitude of parasite infection is enormous. It is understood that parasites may lead to malnutrition, but the extent to which malnutrition causes increased parasite infestation is not known; thus, the conditions need to be addressed together. Nutritional deficiencies associated with pregnancy are associated with poor immune response to infection. Because this immune deficiency is partially compensated by breast-feeding, this is the single best way to protect infants from infection. Malnutrition and nutritional alterations, common complications of human immunodeficiency virus infection, include disorders of food intake, nutrient absorption, and intermediary metabolism and play a significant and independent role in morbidity and mortality. The 21st century provides new information and new challenges. With new technologies and political changes, it is hoped that a healthier, more disease-free, and better-nourished population will emerge.
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              Prevalence and risk factors of malaria in Ethiopia

              Background More than 75% of the total area of Ethiopia is malarious, making malaria the leading public health problem in Ethiopia. The aim of this study was to investigate the prevalence rate and the associated socio-economic, geographic and demographic factors of malaria based on the rapid diagnosis test (RDT) survey results. Methods From December 2006 to January 2007, a baseline malaria indicator survey in Amhara, Oromiya and Southern Nation Nationalities and People (SNNP) regions of Ethiopia was conducted by The Carter Center. This study uses this data. The method of generalized linear model was used to analyse the data and the response variable was the presence or absence of malaria using the rapid diagnosis test (RDT). Results The analyses show that the RDT result was significantly associated with age and gender. Other significant covariates confounding variables are source of water, trip to obtain water, toilet facility, total number of rooms, material used for walls, and material used for roofing. The prevalence of malaria for households with clean water found to be less. Malaria rapid diagnosis found to be higher for thatch and stick/mud roof and earth/local dung plaster floor. Moreover, spraying anti-malaria to the house was found to be one means of reducing the risk of malaria. Furthermore, the housing condition, source of water and its distance, gender, and ages in the households were identified in order to have two-way interaction effects. Conclusion Individuals with poor socio-economic conditions are positively associated with malaria infection. Improving the housing condition of the household is one of the means of reducing the risk of malaria. Children and female household members are the most vulnerable to the risk of malaria. Such information is essential to design improved strategic intervention for the reduction of malaria epidemic in Ethiopia.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, USA )
                1932-6203
                2014
                29 September 2014
                : 9
                : 9
                : e105880
                Affiliations
                [1 ]National Centre of Tropical Medicine, Instituto de Salud Carlos III (ISCIII), Madrid, Spain
                [2 ]Tropical Diseases Research Network (RICET in Spanish), Madrid, Spain
                [3 ]National Centre of Epidemiology, ISCIII, Madrid, Spain
                [4 ]Department of Preventive Medicine and Public Health, Faculty of Medicine, Complutense University, Madrid, Spain
                [5 ]Network Biomedical Research Centers, Epidemiology and Public Health (CIBERESP in Spanish), Madrid, Spain
                [6 ]Armauer Hansen Research Institute, Addis Ababa, Ethiopia
                [7 ]National Centre of Microbiology, ISCIII, Madrid, Spain
                University of Cape Town, South Africa
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Conceived and designed the experiments: LS EG JM JN AA CC EC. Performed the experiments: ZH AB LS EG EC. Analyzed the data: ZH AB LS EC. Contributed reagents/materials/analysis tools: AB JM AA JN CC. Wrote the paper: ZH EC LS. Critically reviewed the manuscript: EG JM JN AB AA CC.

                Article
                PONE-D-13-48813
                10.1371/journal.pone.0105880
                4179248
                25265481
                57a7a9f5-f098-44d9-956b-596c56229968
                Copyright @ 2014

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 20 November 2013
                : 29 July 2014
                Page count
                Pages: 11
                Funding
                The authors gratefully acknowledge the financial support of the UBS-Optimus Foundation in Switzerland, ( www.ubs.com/global/en/wealth_management/optimusfoundation.html), via the Visceral Leishmaniasis and Malnutrition in Amhara State, Ethiopia project, and the Tropical Diseases Research Network in Spain ( www.ricet.es/es/) via the VI PN de I+D+I 2008–2011, ISCIII -Subdirección General de Redes y Centros de Investigación Cooperativa RD12/0018/0001 and RD12/0018/0003. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Biology and Life Sciences
                Nutrition
                Malnutrition
                Physical Anthropology
                Anthropometry
                Medicine and Health Sciences
                Epidemiology
                Pediatric Epidemiology
                Social Epidemiology
                Health Care
                Socioeconomic Aspects of Health
                Pediatrics
                Child Health
                Public and Occupational Health
                Global Health
                Social Sciences
                Anthropology

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                Uncategorized

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