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Concurrent wasting and stunting (WaSt) is a condition where both wasting and stunting exist in a child at the same time. This study aimed to assess the prevalence of WaSt and to identify potential associated factors in Ethiopia.  A total of 33,650 children aged between 0 and 59 months were included in the analysis from the four waves of the Ethiopian Demographic and Health Survey. A mixed-effects logistic regression model was used to identify the determinants of WaSt. The prevalence of WaSt was found to be 4.7% (95% confidence interval [CI]: (4.5-4.9)), with respectively 2.5% (95% CI: 2.1-3.1) and 4.9% (95% CI: 4.7-5.2) among children in urban and rural settings. Children: (i) in the age group 12-23 months (adjusted odds ratio [AOR]: 4.16, 95% CI: (3.20-5.42)) and 24-59 months (AOR: 3.08, 95% CI: (2.28-4.17)); (ii) who were perceived by their mothers to be smaller than normal at birth (AOR: 1.98, 95% CI: (1.57-2.50)); (iii) had diarrhoea (AOR: 1.38, 95% CI: (1.11-1.71)); and (iv) fever in the past 2 weeks (AOR: 1.38, 95% CI: (1.10-1.71)) reported higher odds of WaSt. Being a female child (AOR: 0.57, 95% CI: (0.48-0.69)), having received measles vaccination (AOR: 0.71, 95% CI: (0.55-0.89)), having a mother with a normal body mass index (18.5-24.9 kg/m 2 ) (AOR: 0.57, 95% CI: (0.48-0.68)), having a wealthier household (AOR: 0.67, 95% CI: (0.50-0.90)), and living in rural setting (AOR: 0.49, 95% CI: (0.32-0.74)) were associated with reduced odds of WaSt. The prevalence of WaSt was high, with approximately 1 in 20 Ethiopian children suffering from the condition and needing a prompt response to minimize the poor health and developmental outcomes. Children perceived by their mother to be smaller than normal at birth, older children, and babies with diarrhoea and fever had higher odds of WaSt., (© 2023 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd.)

This study aims to examine the effect of undernutrition on loss to follow-up (LTFU) in adults living with human immunodeficiency virus (HIV) receiving antiretroviral therapy (ART) in Ethiopia. We conducted an institution-based retrospective cohort study using medical records of 844 adults living with HIV receiving ART between June 2014 and June 2020 at Debre Markos Comprehensive Specialized Hospital (Northwest Ethiopia). The effect of undernutrition on LTFU was examined using a proportional hazards regression model after adjusting potential confounders. The significance level was set at p < 0.05. At the end of the study period, 109 (12.9%) participants were considered LTFU, with an overall LTFU incidence of 5.3 per 100 person-years (95% CI 4.4, 6.4). The incidence of LTFU was higher in undernourished participants (8.2 per 100 person-years) compared to well-nourished participants (4.3 per 100 person-years). After adjusting for potential confounders, the adjusted risk of LTFU among undernourished participants was two times higher than in their well-nourished counterparts (AHR [adjusted hazard ratio]: 2.1, 95% CI 1.4, 3.2). This study found that undernutrition significantly increased the risk of LTFU among adults living with HIV on ART., (© 2022. The Author(s).)

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., (© 2022. The Author(s).)

Background: Undernutrition is a significant public health challenge and one of the leading causes of child mortality in a wide range of developing countries, including Ethiopia. Poor access to water, sanitation, and hygiene (WASH) facilities commonly contributes to child growth failure. There is a paucity of information on the interrelationship between WASH and child undernutrition (stunting and wasting). This study aimed to assess the association between WASH and undernutrition among under-five-year-old children in Ethiopia., Methods: A secondary data analysis was undertaken based on the Ethiopian Demographic and Health Surveys (EDHS) conducted from 2000 to 2016. A total of 33,763 recent live births extracted from the EDHS reports were included in the current analysis. Multilevel logistic regression models were used to investigate the association between WASH and child undernutrition. Relevant factors from EDHS data were identified after extensive literature review., Results: The overall prevalences of stunting and wasting were 47.29% [95% CI: (46.75, 47.82%)] and 10.98% [95% CI: (10.65, 11.32%)], respectively. Children from households having unimproved toilet facilities [AOR: 1.20, 95% CI: (1.05,1.39)], practicing open defecation [AOR: 1.29, 95% CI: (1.11,1.51)], and living in households with dirt floors [AOR: 1.32, 95% CI: (1.12,1.57)] were associated with higher odds of being stunted. Children from households having unimproved drinking water sources were significantly less likely to be wasted [AOR: 0.85, 95% CI: (0.76,0.95)] and stunted [AOR: 0.91, 95% CI: (0.83, 0.99)]. We found no statistical differences between improved sanitation, safe disposal of a child's stool, or improved household flooring and child wasting., Conclusion: The present study confirms that the quality of access to sanitation and housing conditions affects child linear growth indicators. Besides, household sources of drinking water did not predict the occurrence of either wasting or stunting. Further longitudinal and interventional studies are needed to determine whether individual and joint access to WASH facilities was strongly associated with child stunting and wasting., (© 2022. The Author(s).)

Background: Opportunistic infections (OIs) are the leading causes of hospitalization, morbidity, and mortality (accounting for 94.1% of all deaths) in people living with human immunodeficiency virus (PLHIV). Despite evidence suggested that undernutrition significantly increases the risk of OIs in PLHIV, to our knowledge, no study has examined the actual effects of undernutrition on OIs in this population, particularly in low-income countries. Thus, this study examined the effects of undernutrition on OIs in adults living with HIV receiving antiretroviral therapy (ART)., Methods: We conducted a retrospective cohort study among 841adults living with HIV receiving ART between June 2014 and June 2020 at Debre Markos Comprehensive Specialized Hospital, Northwest Ethiopia. Study participants were selected using a simple random sampling technique. Data from participants' medical records were extracted using a project-specific data extraction checklist. The Kaplan Meier survival curve estimated the OIs free survival time. The effects of undernutrition on time to develop OIs was estimated using inverse-probability weighting. Finally, regression coefficients with 95% confidence intervals (95% CIs) were reported, with a statistical significance of p < 0.05., Results: Of 841 study participants, 262 (31.2%) developed OIs, and the overall incidence rate was 16.7 (95% CI: 14.8, 18.8) per 100 person-years. The incWidence of OIs in undernourished participants (21/100 person-years, 95% CI: 17.8, 27.4) was higher than well-nourished participants (15.0/100 person-years, 95% CI: 12.9, 17.4). When everyone in the population of interest is well-nourished, average time to develop OIs is estimated as 26.5 (coefficient: 26.5, 95% CI: 20.6, 32.4, p < 0.001) months. When everyone in the population of interest is undernourished, average time to develop OIs is estimated as 17.7 (95% CI: 12.8, 22.6) months. However, when everyone is undernourished, average time to develop OIs decreases by 8.8 (coefficient: -8.8, 95% CI: -16.6, -1.0, p = 0.026) months. Lastly, exposure to undernourishment (intervention) (ratio of average treatment effects to well-nourished potential outcome means in this study was a 32.5% reduction in OIs among adults living with HIV on ART., Conclusion: We found that undernutrition significantly shortened time to develop OIs in adults living with HIV. This implies that the occurrence of OIs in this vulnerable population can be improved through different cost-effective nutritional interventions, such as routine nutritional assessments and education., Competing Interests: The authors have declared that no competing interests exist.

Introduction: Undernutrition is considered a marker for poor prognosis among people living with HIV (PLHIV), particularly in sub-Saharan Africa (SSA), where undernutrition and HIV are both highly prevalent. Evidence suggests that undernutrition (body mass index <18.5 kg/m 2 ) is one of the main factors that significantly increases the risk of lost to follow-up (LTFU) in PLHIV. However, primary studies in SSA have reported inconsistent findings on the relationship between undernutrition and LTFU among adults living with HIV. To the best of our knowledge, no systematic review which aimed to summarise the available evidence. Hence, this review aims to determine the pooled effect of undernutrition on LTFU among adults living with HIV in SSA., Methods and Analysis: PubMed, EMBASE, Web of Science, Scopus, and, for grey literature, Google Scholar will be systematically searched to include relevant articles published since 2005. Studies reporting the effect of undernutrition on LTFU in adults living with HIV in SSA will be included. The Newcastle-Ottawa Scale will be used for quality assessment. Data from eligible studies will be extracted using a standardised data extraction tool. Heterogeneity between included studies will be assessed using Cochrane Q-test and I 2 statistics. The Egger's and Begg's tests at a 5% significance level will be used to evaluate publication bias. As heterogeneity is anticipated, the pooled effect size will be estimated using a random-effects model. The final effect size will be reported using the adjusted HR with a 95% CI., Ethics and Dissemination: Ethical approval is not required for a protocol for a systematic review. The results of this systematic review will be published in a peer-reviewed journal and will be publicly available., Prospero Registration Number: CRD42021277741., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Undernutrition is one of the most common problems among people living with HIV, contributing to premature death and the development of comorbidities within this population. In Sub-Saharan Africa (SSA), the impacts of these often inter-related conditions appear in a series of fragmented and inconclusive studies. Thus, this review examines the pooled effects of undernutrition on mortality and morbidities among adults living with HIV in SSA., Methods: A systematic literature search was conducted from PubMed, EMBASE, CINAHL, and Scopus databases. All observational studies reporting the effects of undernutrition on mortality and morbidity among adults living with HIV in SSA were included. Heterogeneity between the included studies was assessed using the Cochrane Q-test and I 2 statistics. Publication bias was assessed using Egger's and Begg's tests at a 5% significance level. Finally, a random-effects meta-analysis model was employed to estimate the overall adjusted hazard ratio., Results: Of 4309 identified studies, 53 articles met the inclusion criteria and were included in this review. Of these, 40 studies were available for the meta-analysis. A meta-analysis of 23 cohort studies indicated that undernutrition significantly (AHR: 2.1, 95% CI: 1.8, 2.4) increased the risk of mortality among adults living with HIV, while severely undernourished adults living with HIV were at higher risk of death (AHR: 2.3, 95% CI: 1.9, 2.8) as compared to mildly undernourished adults living with HIV. Furthermore, the pooled estimates of ten cohort studies revealed that undernutrition significantly increased the risk of developing tuberculosis (AHR: 2.1, 95% CI: 1.6, 2.7) among adults living with HIV., Conclusion: This review found that undernutrition has significant effects on mortality and morbidity among adults living with HIV. As the degree of undernutrition became more severe, mortality rate also increased. Therefore, findings from this review may be used to update the nutritional guidelines used for the management of PLHIV by different stakeholders, especially in limited-resource settings.

Background: In Ethiopia about 25% of rural women are chronically malnourished. Non-pregnant and non-lactating women present an opportunity to implement strategies to correct maternal and child health status and to potentiate improved pregnancy outcomes in developing countries like Ethiopia. The determinant factors of chronic energy deficiency vary across settings and contexts; hence, it is important to identify local determinant factors in order to implement effective and efficient intervention strategies., Objective: To assess the determinants of chronic energy deficiency of non-pregnant, non-lactating rural women within the reproductive age group (15-49 years), in rural kebeles of Dera district, North West Ethiopia, 2019., Methods: A community based unmatched case control study was conducted. A total of 552 participants were involved and a multi-stage sampling technique was used to select the samples. Data was collected from January 15 to February 30, 2019 using face-to-face interviews and anthropometric assessments. EPI-info version 7 and SPSS™ version 23 were used for data entry and analysis, respectively. Bivariable and multivariable logistic regression models were used to analyze the association between dependent and independent variables. Association was considered statistically significant at 95% CI with p-value < 0.05 in multivariable logistic regression., Result: A total of 548 non-pregnant, non-lactating women with 137 cases and 411 controls were included in the study with a response rate of 99.3%. High family size (AOR = 1.88, 95% CI: 1.085, 3.275), low educational status (AOR = 3.389, 95% CI: 1.075, 10.683), inadequate meal frequency (AOR = 5.345, 95% CI: 2.266, 12.608), absence of home garden (AOR = 5.612, 95% CI: 3.177, 9.915) and absence of latrine facility (AOR = 6.365, 95% CI: 3.534, 11.462) were found positively associated with chronic energy deficiency., Conclusion and Recommendation: Inadequate meal frequency, absence of home gardening, absence of latrine facility, high family size and educational status of illiterate were the determinants of chronic energy deficiency, thus indicating the imperative for a multi-sectoral approach with health, agriculture and education entities developing and delivering interventions., Competing Interests: The authors have declared that no competing interests exist.

Background: Undernutrition remains a major public health concern affecting both children and adolescents in Ethiopia. However, little attention has been given to the undernutrition of primary school-aged children, with their exclusion within national surveys. Therefore, this systematic review and meta-analysis was conducted to determine pooled estimate and determinant factors of undernutrition among primary school-aged children (6 to 15 years of age) in Ethiopia., Method: We systematically retrieved available articles on the prevalence of undernutrition in primary school-aged children in Ethiopia by using a number of computerized databases, including PubMed, Scopus, Cochrane Library, Google Scholar, and Science Direct between September 1 and November 25, 2019. Two authors independently extracted relevant data using a standardized data extraction form. Heterogeneity among included studies was assessed with the Cochrane Q test statistics and Higgins I 2 tests. The pooled estimates and determinant factors of school-aged undernutrition were assessed with random-effects model using Stata/se Version 14., Result: We have retrieved 30 eligible articles with pooled sample size of 16,642 primary school- aged children to determine the prevalence of undernutrition in Ethiopia. Hence, the pooled prevalence of stunting, underweight, and wasting were found to be 21.3% (95% CI: 17.0, 25.5), 18.2% (95% CI: 14.4, 22.0) and 17.7% (95% CI, 13.5, 21.8) respectively. Heterogeneity was assessed by doing subgroup analysis for study province/region. Thus, the highest prevalence of stunting was 27.6% (95% CI, 20.7, 34.5) and underweight 22.7% (95% CI, 19.2, 26.3) in Amhara Region while, in the instance of wasting, it was 19.3%(95% CI: 5.1, 33.4) in Southern Nations, Nationalities and People's Region. Maternal educational status (OR = 1.91, 95% CI: 1.33, 2.73), age of school-aged child (OR = 0.56, 95% CI: 0.44, 0.72) and sex of school-aged child (OR = 0.73, 95% CI: 0.62, 0.85) were found to be significantly associated with stunting. Maternal educational status (OR = 0.6, 95% CI: 0.36, 0.9) and age of school-aged child (OR = 2.74, 95% CI: 1.81, 4.14) were associated with thinness/wasting. Parasitic infection (OR = 2.02, 95% CI: 1.10, 3.73) were associated with underweight of school age children., Conclusion: The prevalence of stunting and underweight among primary school-aged children are moderately high while acute undernutrition (wasting) is more critical than under-five national average as reported in the 2016 Ethiopian Demography and Health Survey. Therefore, this finding warrants the need to design a school-aged children nutrition survey and expand school feeding programs to improve the nutritional status of primary school-aged children in the country. In addition, emphasis should be given to female school-aged children in the early school years, creating awareness for those mothers who lack formal education, and preventing and treating/deworming parasitic infection. Moreover, researchers must conduct research in province/regions which have not yet studied school aged children's nutritional status to date.

Background: The relationship between undernutrition and HIV is bidirectional, ultimately contributing to quality of life and survival of affected individuals. Ethiopia is a sub-Saharan nation influenced by both undernutrition and HIV. In Ethiopia, although individuals are often dually impacted, the effect of undernutrition on the survival of HIV positive children on anti-retroviral therapy (ART) has not been well investigated. Therefore, this study assessed the effect of undernutrition on survival rates of HIV positive children on ART in Amhara Regional State of Ethiopia., Methods: An institution-based retrospective cohort study was conducted among 390 HIV positive children on ART from the 1st of January, 2012 to the 28th of February, 2017 in Amhara Regional State Referral Hospitals. A simple random sampling technique was used to select the study participants. Data were extracted by reviewing patients' ART intake and follow-up forms. Data were entered into Epi-Data Version 3.1, and analysis was done using STATA Version 13. The Kaplan-Meier survival curve was used to estimate the cumulative survival time of the sample. Log rank tests were employed to compare the survival time between different categories of explanatory variables. Bivariable and multivariable Cox proportional hazards models were fitted to identify predictors of mortality., Results: Among the 390 records included in the final analysis, 9.7% of the individuals died within the follow-up period. In this study, the overall mortality rate was found to be 4.4 per 100 child-years (95% CI: 3.2, 6.0) while undernourished children had a lower survival time than well-nourished children. Low hemoglobin level (AHR: 3.2, 95% CI: 1.4, 7.4), CD4 cell count or percent below the threshold (AHR: 5.2, 95% CI: 1.9, 14.1), severe stunting (AHR: 3.9, 95% CI: 1.7, 9.4), severe wasting (AHR: 3.0, 95% CI: 1.3, 6.9) and advanced disease stage (III and IV) (AHR: 2.6, 95% CI: 1.1, 6.6) were found to be predictors of mortality., Conclusion: There was a high rate of mortality. A significant difference was observed in the survival rate of undernourished and well-nourished children. Low hemoglobin level, CD4 count or percent below the threshold, severe wasting, severe stunting, and advanced disease stage were found to be predictors of mortality.

Childhood undernutrition is a global health challenge impacting child growth and survival rates. This deficit in nutritional status contributes to the increasing chronic disease prevalence and economic burden in individuals and throughout developing contexts. A community‐based cross‐sectional study was conducted in Arusha District of Tanzania to determine the prevalence and predictors of undernutrition in 436 children. A structured questionnaire was used to collect data on demographic and socio‐economic factors as well as feeding practices and prevalence of preventable childhood diseases. Anthropometric data were collected through the measurement of length/height and weight of all children. The prevalence of undernutrition was estimated based on Z‐scores indices below −2SD of the reference population for weight for age (underweight), height for age (stunting), and weight for height (wasting). Fifty percent, 28%, and 16.5% of the children were stunted, underweight, and wasted, respectively. The age above 2 years and being a male were associated with stunting. The age above 2 years, nonexclusive breastfeeding children, and living at Seliani and Oturumeti were associated with being underweight. Similarly, morbidity, none exclusively breastfed children, living at Oturumeti, and being born to a mother 35 years and above were associated with wasting. In this study, we found the prevalence of child undernutrition in Arusha District is high in comparison with national and regional trends and appears to be associated with being a male. It is recommended that nutritionists and health planners should focus on these key predictors when planning nutrition interventions to address the problem of undernutrition among underfive children in Arusha District. The contents of this page will be used as part of the graphical abstract of html only. It will not be published as part of main article. The prevalence of undernutrition is estimated by using anthropometric indicators: stunting, underweight, and wasting. [ABSTRACT FROM AUTHOR]

An amendment to this paper has been published and can be accessed via the original article. [ABSTRACT FROM AUTHOR]