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Tadesse Misgana,1 Berhe Gebremichael,2 Dejene Tesfaye,1 Dawit Tamiru,3 Daniel Alemu,1 Adisu Birhanu Weldesenbet,2 Mandaras Tariku,1 Merga Dheresa4 1Department of Psychiatry, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 2School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 3Department of Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 4School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, EthiopiaCorrespondence: Berhe Gebremichael, Email berhegere09@gmail.comIntroduction: Maternal common mental disorders (CMD) and inadequate child feeding practices are significant public health concerns in Ethiopia. Nevertheless, the impact of maternal CMD on infant feeding practices remains poorly comprehended. Hence, the objective of this research was to examine the impact of maternal CMD on the practice of exclusive breastfeeding (EBF) in the rural districts of eastern Ethiopia.Methods: A prospective cohort study was carried out within a community setting, involving 986 pregnant women (371 exposed and 615 non-exposed). The assessment of maternal CMD during pregnancy and the postpartum period was conducted using the Self-Reported Questionnaire-20 (SRQ-20) from the World Health Organization (WHO). To determine the impact of maternal CMD on EBF, a modified Poisson regression model was employed. Statistical significance was set at P< 0.05.Results: The cumulative incidence of suboptimal EBF practice was higher among infants’ mothers who had only prenatal CMD (61.3%) and persistent/chronic CMD (64.7%) compared to those with no CMD at all (51.9%). However, the incidence was slightly lower in mothers having only postnatal CMD (51.1%). The risk of suboptimal EBF was 1.21 times more likely among women with prenatal CMD (Adjusted Relative Risk (ARR)=1.21, 95% Confidence Interval (CI): 1.04, 1.40) and 1.25 times more likely in those with persistent CMD (ARR=1.25, 95% CI: 1.02, 1.52) compared with those having no CMD.Conclusion: Maternal CMD is a significant predictor of suboptimal EBF practice in the rural part of Ethiopia. Community-based screening and early management of maternal CMD and integration of mental health services into community-based nutrition could improve EBF.Keywords: common mental disorders, Eastern Ethiopia, exclusive breastfeeding, maternal

Barkhad Aden Abdeeq,1 Ahmed Ismail Mohamed,2 Abdiwahab Ismail Abdi,3 Jama Mohamed,4 Dessalegn Tamiru,5 Kalkidan Hassen Abate5 1Department of Child Survival, Save the Children International, Hargeisa, Somaliland; 2Faculty of Nutrition and Food Science, University of Hargeisa, Hargeisa, Somaliland; 3School of Medical Laboratory Science, Edna Aden University, Hargeisa, Somaliland; 4Faculty of Statistics and Data Science, University of Hargeisa, Hargeisa, Somaliland; 5Department of Nutrition and Dietetics, Jimma University, Jimma, EthiopiaCorrespondence: Barkhad Aden Abdeeq, Email Barkhadabdek@gmail.comBackground: Stunting, a consequence of prolonged malnutrition, remains a critical global health issue affecting 165 million children under the age of five, with 10.6 million associated deaths. Its stunting prevalence is particularly pronounced in developing nations, notably Sub-Saharan Africa. Chronic protein-energy malnutrition, identified as a major cause of morbidity and mortality in displaced settings, underscores the urgency of understanding its impact in such contexts.Objective: This study aimed to assess the prevalence and associated factors of stunting among children aged 12– 59 months and residing in IDP camps in Hargeisa, Somaliland.Methods: A community-based cross-sectional study was conducted in Hargeisa from May 5 to July 30, 2022, utilizing systematic random sampling, online mobile surveys, and caregiver interviews with anthropometric measurements. The SPSS version 25 was utilized in handled data entry, processing and analysis. Multivariable logistic regression, with p < 0.05 significance, included variables from bivariate analysis (p < 0.2). Stunting assessment utilized WHO AnthroPlus software, categorizing HAZ scores < − 2.0 SD.Results: The prevalence of stunting among children living in IDP camps was found to be 21.1% [95% CI: 17.0– 24.91%]. Vaccination status (adjusted odds ratio [aOR] = 0.19, 95% CI: 0.09– 0.38), deworming practice (aOR = 6.5, 95% CI: 2.91– 14.52), place of delivery (aOR = 0.14, 95% CI: 0.07– 0.30), measles experience in the last year (aOR = 0.12, 95% CI: 0.04– 0.34), ANC visits (aOR = 0.33, 95% CI: 0.14– 0.81), and maternal insufficient extra food intake (aOR = 2.15, 95% CI: 1.11– 4.15) were significantly associated with stunting.Conclusion: The observed stunting prevalence in IDP camps (21.1%) was substantial, highlighting the need for targeted interventions. Future efforts should aim to reduce stunting from the current rate to an estimated 5– 10%, emphasizing comprehensive measures such as deworming, maternal nutrition, postnatal care improvement, robust immunization, and promoting healthcare facility deliveries.Keywords: stunting, IDP, Somaliland

Rediet Regassa,1 Markos Duguma,2 Tefera Belachew,1 Dessalegn Tamiru1 1Nutrition and Dietetics Department, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia; 2Jimma University Laboratory of Drug Quality (JuLaDQ) and School of Pharmacy, Jimma, EthiopiaCorrespondence: Rediet Regassa, Email regassaakaku@gmail.comBackground: The most important anemia next to iron deficiency is anemia of inflammation. Micronutrient deficits, such as those in zinc and iron, can be caused by intestinal permeability and gut inflammation brought on by environmental enteric dysfunction. This study was aimed to evaluate the prevalence and association of anemia with Environmental Enteropathy.Methods: Data on water sanitation and hygiene indicators and sociodemographic characteristics were collected using structured questionnaire. The lactulose to mannitol ratio (L:M) was calculated from the concentration of both sugars in the urine. Level of Hemoglobin was detected by using Hemocue− 301 digital photometer. Blood and urine sample was collected from three hundred children aged 12– 59 months to determine the status of Anaemia and Environmental Enteropathy respectively.Results: Data were analyzed by using Descriptive statistics, cross-tabulation, and logistic regression model to indicate prevalence and association of anemia with environmental Enteropathy in children less than five years old. The prevalence of anemia in children with environmental enteropathy was 63.8% (95% CI: 57.6, 71.7), and there was a significant association (p = 0.0001, AOR 3.502, 95% CI: 1.929– 6.371) between anemia and environmental enteropathy. In a multivariate analysis, children aged 1– 3 years with caretakers who had no or only primary education and with monthly income of less than 3000 ETB were more likely to develop anemia.Conclusion: The result of this study indicated that two-thirds of children less than five with environmental enteropathy had developed anemia, and there is a significant association between environmental enteropathy and anemia. Even though there are other causes of anemia, based on the findings of this study, more research is needed to identify factors associated with environmental enteropathy to mitigate anemia due to intestinal permeability or malabsorption and its impact in children under the age of five.Keywords: environmental enteropathy, environmental enteric dysfunction, inflammation, lactulose mannitol test, Anaemia, WASH, Malnutrition

Solomon Berhanu Mogas,1 Temamen Tesfaye,2 Belay Zewde,3 Yonas Tesfaye,4 Ayantu Kebede,1 Mulualem Tadesse,5 Esayas Kebede Gudina,6 Dessalegn Tamiru,7 Lelisa Sena Dadi1 1Department of Epidemiology, Jimma University, Jimma, Oromia Region, Ethiopia; 2School of Nursing and Midwifery, Jimma University, Jimma, Oromia Region, Ethiopia; 3Department of Biomedical Sciences, Jimma University, Jimma, Oromia Region, Ethiopia; 4Department of Psychiatry, Jimma University, Jimma, Oromia Region, Ethiopia; 5School of Medical Laboratory Science, Jimma University, Jimma, Oromia Region, Ethiopia; 6Department of Internal Medicine, Jimma University, Jimma, Oromia Region, Ethiopia; 7Department of Nutrition and Dietetics, Jimma University, Jimma, Oromia Region, EthiopiaCorrespondence: Solomon Berhanu MogasDepartment of Epidemiology, Jimma University, P.O.Box-378, Oromia Region, EthiopiaTel +251913458961Email solo.berhanu@gmail.comBackground: Hypertension (HTN) is the leading risk factor for mortality due to cardiovascular diseases, it accounts for 7% of global disability adjusted life years. In 2015, it was estimated that around 1.13 billion adults had HTN globally with a high prevalence in low and middle-income countries where the health system is weak to diagnose, treat, and control HTN. Most people with HTN are asymptomatic and go undiagnosed for years. Therefore, the aim of this study was to assess the burden of undiagnosed HTN among adults in urban communities of Southwest Ethiopia.Methods: A community-based cross-sectional study involving 915 adults from June 17 to July 27, 2019 was performed. WHO STEPS questionnaire was used to collect data, and the collected data were entered using Epi Data version 3.1and analyzed using SPSS version 20, respectively. Binary logistic regression was used to check for a possible association between outcome and independent factors. P-value < 0.05 and 95% CI were used on multivariable logistic regression analysis as threshold for significant statistical association.Results: Undiagnosed HTN in the study area was 21.2% (194). Age (AOR=1.04, 95% CI=1.02– 1.05), BMI with overweight (AOR=2.52, 95% CI=1.35– 4.71), triglyceride (AOR=1.83, 95% CI=1.29– 2.59), and waist to hip ratio (AOR=1.62, 95% CI=1.03– 2.54) were factors significantly associated with HTN.Conclusion: As compared to studies performed before, the risk of undiagnosed HTN in the current study was high. Age, BMI, triglyceride, and waist to hip ratios were found to be the significant factors for it. Preventing the risk factors and screening of HTN should be promoted for early detection, prevention, and treatment of the burden of the disease on the population.Keywords: adult, burden, Ethiopia, hypertension, Jimma town, risk, undiagnosed

Gebremedhin Gebreegziabiher,1 Tefera Belachew,2 Kibriti Mehari,3 Dessalegn Tamiru2 1Department of Human Nutrition, Adigrat University, Adigrat, Ethiopia; 2Department of Nutrition and Dietetics, Faculty of Public Health, Jimma University, Jimma, Ethiopia; 3Tigray Health Research Institute, Mekelle, EthiopiaCorrespondence: Gebremedhin GebreegziabiherJimma University, P.O. Box: +251378, Addis Ababa, EthiopiaEmail ghingherg@gmail.comBackground: Metabolic Syndrome (MetS) is becoming a big public health problem in developing countries like Ethiopia. Developing countries have an almost two-fold higher risk of death due to non-communicable diseases (NCDs) compared to high-income countries. This study aimed to assess the magnitude and factors associated with MetS among adult residents of Mekelle city.Methods: A population-based cross-sectional study was carried out among 266 randomly selected adults from July to September 2019. Data were collected on socio-demographic, clinical, anthropometric, and lifestyle characteristics using a structured questionnaire adapted from the WHO STEPs survey tool. Fasting Blood Glucose (FBG) and lipid profiles were tested using a blood sample. Bivariate and multivariable logistic regression analyses were used to identify factors associated with MetS and variables were considered statistically significant at p ≤ 0.05.Results: The findings of this study showed the magnitude of MetS was 21.8%. The proportion of MetS was relatively higher among women (24.6%) than men (18.5%). Raised blood pressure was the most prominent (42.5%) component of MetS followed by central obesity (41.7%). The magnitude of the other components of MetS was 38.0%, 21.4%, and 14.3% for elevated triglyceride, raised FBG, and low HDL-C, respectively. Advanced age, medium and high monthly income, walking less than 10 minutes per day, raised Body Mass Index (BMI), higher waist to hip ratio, and elevated total cholesterol were significantly associated with a higher risk of metabolic syndrome.Conclusion: In this study, we found a high prevalence of metabolic syndrome and its components, which highlights an urgent need for a public health strategy for its prevention, early diagnosis, and management.Keywords: magnitude, metabolic syndrome, adult, Northern Ethiopia

Sileshi Kenate,1 Temamen Tesfaye,2 Solomon Berhanu Mogas,3 Belay Zawdie,4 Yonas Tesfaye,2 Lelisa Sena Dadi,3 Mulualem Tadesse,5 Ayantu Kebede,3 Esayas Kebede Gudina,6 Dessalegn Tamiru4 1Jimma Town Health Office, Jimma, Ethiopia; 2School of Nursing, Jimma University, Jimma, Ethiopia; 3Department of Epidemiology, Jimma University, Jimma, Ethiopia; 4Department of Nutrition and Dietetics, Jimma University, Jimma, Ethiopia; 5Department of Medical Laboratory Sciences, Jimma University, Jimma, Ethiopia; 6Department of Internal Medicine, Jimma University, Jimma, EthiopiaCorrespondence: Dessalegn TamiruDepartment of Nutrition and Dietetics, Jimma University, P. O. Box-378, Jimma, Oromia Region, EthiopiaTel +251912373397Email dessalegn97@gmail.comIntroduction: Lack of regional- and local-based cut-off points of lipid profile and/or anthropometric measurements remains one of the challenges in prevention, early detection and control of non-communicable diseases. This study aimed to validate anthropometric-based screening of lipid profiles to develop locally appropriate optimal cut-off points for metabolic syndrome screening.Methods: A community-based cross-sectional study was conducted among randomly selected 977 adults in Jimma Town, Ethiopia. Data were collected using structured questionnaire, anthropometric and biochemical measurements. Data were analyzed using SPSS windows version 21 and Kappa statistic was used to validate the agreement between anthropometric measurement and lipid profile. A p-value of < 0.05 was considered statistically significant.Results: Body mass index (BMI) at ≥ 24.5 was used as screening of dyslipidemia (TG≥ 150mg/dl) with slight Kappa coefficient of 0.138 (P< 0.001) among females while it was ≥ 22.2 among males with fair (0.275) Kappa coefficient (P< 0.001). Waist circumference-based screening of dyslipidemia (TG≥ 150mg/dl) at ≥ 78.0cm had negative (− 0.005) Kappa coefficient (Pp< 0.001) among females (sensitivity: 72.6% and specificity: 26.7%). Yet, waist circumference at ≥ 83.7cm had slight Kappa coefficient of 0.13 (P< 0.005) among males (sensitivity: 38% and specificity: 74.9%). Waist hip ratio-based screening of dyslipidemia (TG≥ 150mg/dl) at ≥ 0.82 among females had negative (− 0.001) Kappa coefficient (p=0.763), whereas among males at ≥ 0.88, there was a slight (0.105) Kappa coefficient of (p=0.002) (sensitivity:77.5% and specificity:36.8%). This study showed that anthropometric-based high-density lipoprotein measurement was not applicable.Conclusion: This study indicated that BMI-based screening of triglyceride was more applicable for both sexes than other anthropometric measurements. Waist circumference and waist-to-hip ratio-based screening of triglyceride were slightly applicable only for males. However, anthropometric-based screening of high-density lipoprotein measurement was not applicable for both sexes. In conclusion, researchers and policy makers need to consider locally validated cut-off points to be used for screening metabolic syndrome in the community.Keywords: metabolic syndrome, lipid profile, anthropometric measurements, Jimma

Gebremedhin Gebreegziabiher,1 Tefera Belachew,2 Dessalegn Tamiru2 1Department of Human Nutrition, School of Public Health, College of Medicine and Health Sciences, Adigrat University, Adigrat, Ethiopia; 2Department of Nutrition and Dietetics, Faculty of Public Health, Jimma University, Jimma, EthiopiaCorrespondence: Gebremedhin Gebreegziabiher Tel +251914754562Email ghingherg@gmail.comBackground: In the past decade, the prevalence of diabetes has grown more rapidly in low- and middle-income countries than in high-income countries. In 2019, Ethiopia is the fourth highest contributor to cases with diabetes in Africa with 1.7 million total cases. The present study was aimed to determine the prevalence of abnormal glucose metabolism and associated factors in Mekelle city, Northern Ethiopia.Methods and Materials: Community-based cross-sectional study was conducted among 321 randomly selected participants aged 20 years and above. Sociodemographic, lifestyle, clinical, and anthropometric data were collected in accordance with the STEPwise approach as recommended by the World Health Organization (WHO) for non-communicable disease (NCDs) surveillance. Blood glucose and lipid profiles were determined using a fasting venous blood sample. Bivariate and multivariable logistic regression analysis was used to identify factors associated with abnormal glucose metabolism. The level of statistical significance was set at p ≤ 0.05.Results: More than half (54.8%) of the participants were women with an overall mean (±SD) age of 39.0 (± 14.2) years. The overall prevalence of pre-diabetes and diabetes was 12.5% and 9.3%, respectively, with a mean (±SD) fasting blood glucose of 97.42 (± 38.03) mg/dL. More than two-thirds (70.0%) of adults with diabetes were not aware of being diabetes. Advanced age, hypercholesterolemia, medium and high rank of heart rate, and raised waist to height ratio were significantly associated with a higher risk of pre-diabetes, whereas having house servant, systolic hypertension, and hypercholesterolemia were significantly associated with diabetes.Conclusion: We found a high prevalence of prediabetes and diabetes with more than two-thirds (70.0%) of newly diagnosed adults with diabetes, which showed a lack of awareness in the community. Awareness creation together with access to basic diagnostics in the primary health-care settings should therefore be a top priority to prevent its progression and complication.Keywords: abnormal glucose metabolism, diabetes, associated factor, adult, Ethiopia

Temamen Tesfaye Yunka,1 Solomon Berhanu Mogas,2 Belay Zawdie,3 Desalegn Tamiru,4 Yonas Tesfaye,5 Ayantu Kebede,2 Mulualem Tadesse,6 Esayas Kebede Gudina,7 Lelisa Sena Dadi2 1School of Nursing and Midwifery, Jimma University, Jimma, Oromia Region, Ethiopia; 2Department of Epidemiology, Jimma University, Jimma, Oromia Region, Ethiopia; 3Department of Biomedical Sciences, Jimma University, Jimma, Oromia Region, Ethiopia; 4Department of Nutrition and Dietetics, Jimma University, Jimma, Oromia Region, Ethiopia; 5Department of Psychiatry, Jimma University, Jimma, Oromia Region, Ethiopia; 6Department of Medical Laboratory, Jimma University, Jimma, Oromia Region, Ethiopia; 7Department of Internal Medicine, Jimma University, Jimma, Oromia Region, EthiopiaCorrespondence: Temamen Tesfaye YunkaSchool of Nursing and Midwifery, Jimma University, P.O.Box-378, Oromia region, EthiopiaTel +251913153299Email tekanetesfu@gmail.comIntroduction: Early detection of the unrecognized diabetes mellitus (DM) and its risk factors in the community is crucial to minimizing the burden of DM and associated complications. Hence, this study aimed to assess unrecognized DM and its relationship with behavioral characteristics, physical characteristics, and lipid profile among adults in Jimma Town, Southwest Ethiopia.Methods: A community-based cross-sectional study was conducted on 915 adults in Jimma Town from June 17 to July 27, 2019. Physical measurements, lipid profile, and blood sugar levels were measured. The collected data were entered and analyzed using Epi Data 3.1 and SPSS version 21, respectively. Multivariable logistic regression was fitted to assess predictors of unrecognized DM where adjusted odds ratio (AOR) with its corresponding 95% confidence interval (CI) was used to assess the strength of association at P-value ≤ 05.Results: The prevalence of unrecognized DM and impaired glucose metabolism (pre-diabetes) were 3.1% (95% CI; 2.0– 4.4) and 14.8% (95% CI; 12.5– 17.2), respectively. The risk of unrecognized DM was higher among male participants (AOR = 2.94, 95% CI: 1.19, 7.29), age group of 35 years and above (AOR = 3.45, 95% CI: 1.16, 10.27), and high waist circumference (AOR = 4.21, 95% CI: 1.72, 10.33). On the other hand, participants who perform sufficient physical activity (AOR = 0.14, 95% CI: 0.03, 0.58) had low risk of undetected DM.Conclusion: The prevalence of unrecognized diabetes mellitus was relatively high. Male sex, advanced age, physical inactivity, and high waist circumference were found to be predictors of unrecognized DM. Thus, awareness needs to be created among the community to practice regular physical activity and maintaining normal body weight. Additionally, screening of DM should be promoted for early detection, prevention, and treatment.Keywords: unrecognized DM, diabetes mellitus, adult, lipid profile, physical measurement

Dereje Tsegaye, Dessalegn Tamiru, Tefera Belachew Department of Nutrition and Dietetics, Institute of Health, Jimma University, Jimma, EthiopiaCorrespondence: Dereje TsegayeDepartment of Nutrition and Dietetics, Institute of Health, Jimma University, Jimma, EthiopiaTel +251 911835273Email deretsegaye@gmail.comBackground: Maternal under-nutrition due to macro and micronutrient deficiencies is a challenging public health problem worldwide, disproportionately affecting women in low-income nations. Hence, this study aimed at assessing factors associated with dietary practice and nutritional status of pregnant women in Illu Aba Bor Zone, Southwest Ethiopia.Methods: A community-based cross-sectional study was conducted among 403 randomly selected pregnant women, from May to June, 2019. Socio-demographic and socio-economic data were collected using a structured interviewer-administered questionnaire. Dietary Diversity was obtained using a qualitative 24-hr dietary recall method and nutritional status was assessed using mid-upper arm circumference (MUAC) measurements. Data were entered onto Epidata version 3.5.3 and exported to SPSS version 20 for analysis. Binary and multivariable logistic regression analyses were used to identify independent predictors of nutritional status and dietary practice. Odds ratio with 95% Confidence interval was estimated to identify the predictors of the outcome variables. Statistical significance was affirmed at a p-value ≤ 0.05.Results: The prevalence of under-nutrition among the pregnant women was 17.4% and the mean (±SD) dietary diversity score was 4.88 ± 1.27. Family-size (AOR=3, 95% CI: (1.18, 7.21)), wealth status (AOR=3.65 (1.02, 12.99)), household food security (AOR=2.59 (1.21, 5.63)) and birth interval (AOR=2.3 (1.10, 4.87)) were significantly associated with nutritional status of pregnant women. Educational status (AOR = 3.49, 95% (1.53, 7.99)), household food security (AOR = 1.61, 95% (1.02, 2.56)), nutrition knowledge (AOR = 1.74, 95% (1.08, 2.79)), and meal frequency (AOR = 2.88, 95% (1.65, 5.03)) were significantly associated with dietary practice of the respondents.Conclusion: Finding of the study revealed that the prevalence of under-nutrition and poor dietary practice was high which were significantly associated with educational and economic status. Hence, it is imperative to improve the nutritional status of pregnant women, strengthening sustainable income-generating activities and saving strategies.Keywords: dietary diversity, nutritional status, pregnant women, Ethiopia

Anxiety is the top mental health concern for undergraduates. While researchers have identified ways that in-person science courses can affect anxiety, little is known about how online science courses affect anxiety. In this study, 2111 undergraduates at a large research-intensive institution completed survey questions about their anxiety in large-enrollment online science courses. Specifically, we assessed students' anxiety in the context of online science courses and asked what aspects of online science courses increase and decrease their anxiety. Students also identified what instructors can do to lessen anxiety in online classrooms. We used open coding and logistic regression to analyze student responses. More than 50% of students reported at least moderate anxiety in the context of online college science courses. Students commonly reported that the potential for personal technology issues (69.8%) and proctored exams (68.0%) increased their anxiety, while being able to access content at a later time (79.0%) and attending class from where they want (74.2%) decreased their anxiety. The most common ways that students suggested that instructors could decrease student anxiety is to increase test-taking flexibility (25.0%) and be understanding (23.1%). This study provides insight into how instructors can create more inclusive online learning environments for students with anxiety.

Teshager Worku Kegne,1,&ast; Zelalem Alamrew Anteneh,2,&ast; Tadios Lidetu Bayeh,2,&ast; Birhanu Melaku Shiferaw,3,&ast; Desiyalew Habtamu Tamiru4,&ast; 1Department of Health Services, Management Sciences for Health, Addis Ababa, Ethiopia; 2Department of Epidemiology and Biostatistics, School of Public Health, Bahir Dar University, Bahir Dar, Ethiopia; 3Department of Public Health, Gamby Medical and Business College, Bahir Dar, Ethiopia; 4Department of Public Health Emergency, Humedica e.V International Aid Organization, Addis Ababa, Ethiopia&ast;These authors contributed equally to this workCorrespondence: Desiyalew Habtamu Tamiru, Tel +251912717030, Email desehabt@gmail.comBackground: Tuberculosis and human immunodeficiency virus co-infection pose a major public health concern, particularly in developing countries. The survival and predictors of mortality were not sufficiently studied among TB-HIV co-infected patients in Ethiopia.Objective: This study aimed to investigate the survival rate and predictors of mortality among TB-HIV co-infected patients during TB treatment at public health facilities in Bahir Dar, Northwest Ethiopia.Methods: A retrospective follow-up study was conducted among 401 TB-HIV co-infected patients who were treated for tuberculosis between July 2018 and June 2022 at public health facilities in Bahir Dar city, Ethiopia. Data were collected using a structured checklist from patient charts. Data entry and analysis were done using EpiData 3.1 and Stata version 15, respectively. A Cox proportional Hazard regression model was used to identify predictors of mortality. Predictors with P < 0.05 in the multivariable regression were considered statistically significant.Results: Among the 401 TB-HIV co-infected patients, 59 (14.7%) died during the follow-up period. Predictors like lower BMI (AHR = 3.00, 95% CI = 1.44, 6.28), extrapulmonary TB infection (AHR = 3.30, 95% CI = 1.50, 7.29), presence of opportunistic infection (AHR = 5.07, 95% CI = 2.55, 10.08), functional status (bedridden: AHR = 4.49, 95% CI = 1.63, 12.33), and adherence to TB treatment (fair = AHR = 2.74, 95% CI = 1.41, 7.20, and poor = AHR = 3.75, 95% CI = 1.52, 9.23) were associated with mortality.Conclusion: Mortality among TB and HIV coinfected people was high at public health facilities in Bahir Dar city. This result suggested that in order to increase patient survival, it would be necessary to enhance nutritional status, increase adherence to TB treatment, and prevent opportunistic infections.Keywords: TB, HIV, mortality, predictors, retrospective, survival, Ethiopia

PURPOSEBreast cancer (BC) is the leading cause of cancer morbidity and mortality in Ethiopia, yet financial hardship is often overlooked. Herein, we examined the financial hardship of BC among women newly diagnosed with the disease in Addis Ababa, Ethiopia.MATERIALS AND METHODSWe conducted a comparative cross-sectional study of financial hardship between 353 women diagnosed with BC from 2017 to 2018 in Addis Ababa and 618 women without a history of the disease but with medical expenses selected by multistaging sampling from the city's general population. Financial hardship measures, coded as binary variables (yes, no), included selling assets to pay for medical expenses, borrowing money to meet medical expenses, and worrying about family's financial security. The associations between BC diagnoses and each of the financial hardship measures were evaluated using the multivariable logistic regression model.RESULTSWomen with BC compared with those without a history of the disease were more likely to report out-of-pocket costs (98% v 38.9%), sell properties (10.2% v 4.2%), and worry about families' financial security (53.8% v 41.8%), but they were equally likely to report borrowing money (19.8% v 17.8%). In the multivariable-adjusted model, women with BC compared with those without the disease were three times as likely to sell their property to cover medical expenses (adjusted odds ratio [AOR], 2.94 [95% CI, 1.49 to 5.83]) and 1.4 more likely to worry about their family's financial security (AOR, 1.42 [95% CI, 1.02 to 1.96]).CONCLUSIONThe material and psychological burden of BC is considerably high among women in Addis Ababa, Ethiopia, suggesting the need for discussion of cost as part of delivering high-quality care and expanding health care coverage.

IntroductionBreast cancer (BC) is the most common malignant neoplasm among women in Addis Ababa, Ethiopia. The willingness and ability to pay (WATP) for treatment is a contributing factor in the utilization of health care services. The World Health Organization Breast Cancer Initiative calls for 80% of patients to complete multimodality treatment and indicates payment as central factor to improve BC outcome. The objectives of this study are to identify how much female BC patients paid in Addis Ababa for BC treatment, their WATP for BC treatment, and the factors that affect WATP.MethodsThe researchers collected data from 204 randomly selected BC patients who were treated in one of four different health facilities (one public and three private) between September 2018 and May 2019. A structured questionnaire was used to assess their WATP for BC treatment and multivariable regression to investigate factors associated with patients' WATP.ResultsOf interviewed patients, 146 (72%) were at reproductive age. Patients' median expenditure for all BC treatment services was 336 US dollars (USD) in a public cancer center and 926 USD in privately owned health facilities. These amounts are in contrast with a reported WATP of 50 USD and 149 USD. WATP increased with increasing expenditure (OR 1.43; 95% CI 1.09 to 1.89 per 100 US), educational level (OR 1.37; 95% CI 1.02 to 1.85) and service quality (OR 1.34; 95% CI 1.04 to 1.72). In contrast, a monthly income increase by 100 USD corresponds to a 17% decrease of WATP (OR 0.83; 95% CI 0.70 to 0.99).ConclusionsWe demonstrated that BC treatment was very expensive for patients, and the cost was much higher than their WATP. Thus, we suggest that BC should be included in both social and community-based health insurance plans and treatment fees should consider patients' WATP.

The introduction of stool as a readily obtainable sample and the recently developed simple one-step (SOS) stool processing method on Xpert MTB/RIF Ultra (Xpert Ultra) offer an opportunity for TB diagnosis in children. We conducted this study in secondary health facilities in Ethiopia, which are the first-level referral facilities for childhood TB diagnosis and treatment, with the aim to determine if stool-based TB diagnosis can be performed with a reasonable level of concordance with sputum tests using Xpert MTB/RIF Ultra. Eligible children 0–14 years old with presumptive pulmonary TB were asked to provide stools in addition to routinely requested sputum samples. We determined the level of agreement between the stool and sputum test results. Of the 373 children included in the study, 61% were p < 0.001). There were more Xpert Ultra positive results on stool (n = 27 (7.2%)) than on sputum/NGA (n = 23 (6.2%)). Laboratories in secondary hospitals can perform stool-based TB diagnosis in children, with high concordance between stool and sputum test results reaffirming the applicability of the SOS stool method.

Background Breast cancer is the leading cancer among women with an annual crude incidence of 27.4 per 100,000 in Ethiopia. The aims of this study were to (a) estimate the unit cost of breast cancer treatment for the standard Ethiopian patient, (b) identify the cost drivers, (c) project the total cost of breast cancer treatment for the next five years, and (d) estimate the economic burden of the disease in the main specialized tertiary hospital—Tikur Anbessa Specialized Hospital (TASH) Addis Ababa. Methods Primary data were collected from health and non-health professionals. Secondary data were collected from patient`s charts and official reports from various national and international organisations including data from TASH. To establish work-time estimates, we asked professionals on their time usage. Result A total of US$ 33,261 was incurred to treat 52 Addis Ababa resident female breast cancer patients in TASH between July 2017 and June 2019. The unit cost of treatment for a hypothetical breast cancer patient to complete her treatment was US$ 536 for stage I and US$ 705 for stage II and III using the existing infrastructure. This cost increased to US$ 955 for stage I and US$ 1157 for stage II and III when infrastructure amortization was considered. The projected total costs of breast cancer treatment in TASH is between US$ 540,000 and US$ 1.48million. However, this will increase to US$ 870,000 and US$ 2.29 million when the existing fixed assets are changed. Conclusion The economic burden of breast cancer treatment is high compared to the economic status of the country. Thus, it is recommended that TASH should revise its charges and breast cancer should be included in the Social and Community based health insurance scheme. JEL classification: H51, H75, I18, P46

Quantification of gene expression and characterization of gene transcript structures are central problems in molecular biology. RNA sequencing (RNA-Seq) and chromatin immunoprecipitation sequencing (ChIP-Seq) are important methods, but can be cumbersome and difficult for beginners to learn. To teach interested students and scientists how to analyze RNA-Seq and ChIP-Seq data, we present a start-to-finish tutorial for analyzing RNA-Seq and ChIP-Seq data: SeqAcademy (source code: https://github.com/NCBI-Hackathons/seqacademy, webpage: http://www.seqacademy.org/). This user-friendly pipeline, fully written in markdown language, emphasizes the use of publicly available RNA-Seq and ChIP-Seq data and strings together popular tools that bridge that gap between raw sequencing reads and biological insight. We demonstrate practical and conceptual considerations for various RNA-Seq and ChIP-Seq analysis steps with a biological use case - a previously published yeast experiment. This work complements existing sophisticated RNA-Seq and ChIP-Seq pipelines designed for advanced users by gently introducing the critical components of RNA-Seq and ChIP-Seq analysis to the novice bioinformatician. In conclusion, this well-documented pipeline will introduce state-of-the-art RNA-Seq and ChIP-Seq analysis tools to beginning bioinformaticians and help facilitate the analysis of the burgeoning amounts of public RNA-Seq and ChIP-Seq data.

The aim of this study was to assess the magnitude, socio-demographic, and clinical characteristics of oesophageal cancer patients in selected referral hospitals of Ethiopia. A retrospective document review was employed in ten referral hospitals in different regions of Ethiopia. A structured data extraction tool was used to extract data from clinical care records of all clinically and pathologically confirmed oesophageal cancer patients who were diagnosed and treated in those hospitals from 2012 to 2017. During the study period, a total of 777 oesophageal cancer cases were identified, and the median age of these patients was 55 years, with an interquartile range of 19. More than half (55.1%, n = 428) of the cases were males, and the majority of them were reported from Oromia (49.9%, n = 388) and Somali (25.9%, n = 202) regional states. The highest numbers of oesophageal cancer cases were recorded in 2016 (23.8%, n = 185), while the lowest were in 2012 (12.6%, n = 98). Eighty per cent of oesophageal cancer cases were diagnosed in later stages of the disease. More than one-fourth (27.0%, n = 210) of patients had surgical procedures where the majority (74.3%, n = 156) required insertion of a feeding tube followed by transhiatal oesophagectomy (10.9%, n = 23). Of the 118 patients for which there was histology data, squamous cell carcinoma (56.7%, n = 67) and adenocarcinoma (36.4%, n = 43) were the predominant histologic type. One-fourth (25.0%, n = 194) of the patients were alive, and more than two-thirds (71.7%, n = 557) of the patients' current status was unknown at the time of the review. In these referral hospitals of Ethiopia, many oesophageal cancer patients presented during later stages of the disease and needed palliative care measures. The number of patients seen in Oromia and Somali hospitals by far exceeded hospitals of the other regions, thus postulating possibly unique risk factors in those geographic areas.

Abstract Background Studies have shown that sub-optimal breastfeeding is major contributor to infant and young child mortality in Ethiopia. To address this problem, infant and young child feeding guideline was developed in 2004 and interventions have been going on based on the guidelines. There is no study that assessed whether the infant and child feeding practices are according the guideline or not. This study was carried out to assess sub-optimal breastfeeding practices and associated factors among infants from birth to six months in rural communities of Jimma Arjo Woreda in the Southwest Ethiopia. Methods A cross-sectional study was carried out from December to January 2009. Quantitative data were collected from a sample of 382 respondents supplemented by qualitative data generated using in-depth interviews of 15 index mothers. Multivariable logistic regression model was used to identify predictors of timely initiation of breast feeding and non-exclusive breast feeding among mother-infant pairs. Results More than three fourth of mothers breastfeed their infants sub-optimally. Thirty-seven percent of mothers initiated breastfeeding later than one hour after delivery, which was significantly associated with not attending formal education (AOR = 1.05[95%CI: 1.03, 1.94]) and painful breastfeeding experiences (AOR = 5.02[95%CI: 1.01, 10.08]). The majority (67.02%) of mothers had no knowledge about exclusive breastfeeding. Non-exclusive breastfeeding was negatively associated with child’s age of 0-2 months (AOR: 0.27[95%CI: 0.16, 0.47) and 3-4 months (AOR = 0.43 [95%CI: 0.25, 0.73) and ownership of radio (AOR = 0.56[95%CI: 0.37, 0.88]), but positively associated with the practice of discarding colostrums (AOR = 1.78[95%CI: 1.09, 4.94]). Conclusion The findings showed that the majority of mothers sub-optimally breastfeed their children in the study area. As most of the mothers do not have knowledge on the exclusive breast feeding. Enhancing community based behavior change communications using multiple channels including radio and folk media is recommended to reduce sub-optimal breast feeding practices and associated consequences among children in the study area.

Background: The loss of vaccination cards is a momentous public health challenge in the prevention of vaccine-preventable diseases in most developing countries. There is a paucity of studies on the magnitude of vaccination card losses and associated factors in Ethiopia. Therefore, the aim of the current study was to assess the level of vaccination card loss and associated factors in Ethiopia., Methods: Data were extracted from the 2019 Ethiopia Mini Demographic and Health Survey, a nationally representative household survey of women aged 15-49 years with children aged 0-35 months. Data from a total of 3208 mother-child pairs was extracted for the study. A multilevel logistic regression model with random effect analysis techniques was used to identify individual and regional-level determinants of vaccination card loss. We checked the model's fitness by using Akaike Information Criteria and Bayesian Information Criteria. Odds ratios with a 95% Confidence intervals were used to declare statistical significance., Results: A total of 3208 mother-child pairs from nine regions and two city administrations were included in the analysis. The result revealed that 1933 (60.26%) mother-child pairs did not have vaccination cards during home visits. illiterate mother 2.239 (95% CI: 1.297, 3.864), lowest wealth index category 2.089 (95% CI: 1.432, 3.048), ANC non-user 2.047 (95% CI: 1.605, 2.609), children living with their caretaker 6.749 (95% CI: 1.425, 13.654), having no access to television 1.384 (95% CI: 1.150, 1.664), longer birth interval 1.325 (95% CI: 1.027,1.710), giving birth at home and private health facilities 1.985 (95% CI: 1.579, 2.497), 1.696 (1.086, 2.648), contraceptive non-users 1.295 (95% CI: (1.042,1.609) and children aged 12-23 months and 24-35 months 1.577 (95% CI: 1.252, 1.985) and 2.282 (1.803, 2.889) were associated with vaccination card loss., Conclusions: Overall vaccination card loss among mothers of 0-35-month-old children is considerably high. To enhance maternal awareness regarding the significance of vaccination cards, promote antenatal care and public health facility delivery, and future researchers have to explore how to enhance vaccination card retention in Ethiopia., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Edossa et al. 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.)

Background: Childhood multimorbidity, characterized by the simultaneous occurrence of multiple medical conditions in children, is a global concern. Notably, exposure to household air pollution has been linked to various health issues, particularly affecting vulnerable segments of the population residing in poorly ventilated homes. However, evidence regarding the impact of household air pollution on the risk of multimorbidity in low-income settings remains scarce. Therefore, this study aims to investigate the association between household air pollution and childhood multimorbidity in Jimma, Ethiopia., Methods: A comparative cross-sectional study was conducted to collect data from 280 children under the age of five who lived in households using solid fuel ( n  = 140) and clean fuel ( n  = 140). The Demographic Health Survey morbidity questionnaire was used to collect information from mothers about common childhood illnesses. Multiple logistic regression analysis was employed to explore the relationship between the use of solid fuel for cooking in households and the likelihood of childhood multimorbidity. In addition, Poisson regression estimation was used to determine if exposure to solid fuel could increase the number of morbidities., Results: The overall prevalence of childhood multimorbidity was 34.3% [95% CI: 0.29-0.40]. Among these cases, 23.9% were among children from solid fuel user households, whereas about 10.4% were from clean fuel user households. Adjusted for all possible socioeconomic, demographic, water, sanitation, hygiene, and health care covariates, children living in solid fuel user households had more than three times the odds of childhood multimorbidity compared to children living in clean fuel user households (AOR = 3.14, 95% CI [1.42-6.95], p < 0.001). Moreover, household air pollution from solid fuel use was positively associated with an increased number of individual morbidity conditions, with an adjusted β coefficient of 0.46 (IRR = 1.58, 95% CI [1.17-2.13], p = 0.003)., Conclusion: Solid fuel use was an independent predictor of childhood morbidity risk. Efficient policies and strategies, such as the integration of environmental regulation policies into the healthcare system aimed at the reduction of harmful air pollutants and their adverse health effects on children, need to be implemented., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Mulat, Tamiru and Abate.)

Background: Cutaneous leishmaniasis (CL) is a neglected tropical skin disease, caused by the protozoan parasite Leishmania. In Ethiopia, CL is mainly caused by Leishmania aethiopica and can present in different clinical forms. The aim of this study was to assess whether these different forms are associated with differences in parasite genetic and host systemic immune signatures., Methods: Here we analysed the whole genome sequence data for 48 clinical parasite isolates and the systemic immune signature from a cohort of CL patients, who were recruited in Nefas Mewcha, Northern Ethiopia, from January 2019 to January 2022., Results: Our results show that parasites from CL cases with different presentations in a single Ethiopian setting are from the same genetic population based on a permutation test of genome-wide similarity. Furthermore, a logistic regression test for genome wide association did not identify any individual genetic variants significantly associated with disease presentation. We also measured plasma chemokine and cytokine levels of 129 CL patients presenting with different forms of CL. None of the chemokine [eotaxin, eotaxin-3, interleukin (IL)-8, interferon (IFN)-γ-induced protein-10 (IP-10), monocyte chemoattractant protein (MCP)-1, MCP-4, macrophage-derived chemokines (MDC), macrophage inflammatory protein (MIP)-1α, MIP-1β and thymus- and activation-regulated chemokine (TARC)] or cytokine (IFN-γ, IL-1β, interleukin-2, IL-4, IL-6, IL-10, IL-12p70, IL-13, tumor necrosis factor-α) levels measured were significantly different between the different clinical presentations of CL, as measured by Kruskal-Wallis test. We also compared those with healthy nonendemic controls: our results show a chemokine (IP-10, MCP-1, MCP-4, MDC, MIP-1α, MIP-1β and TARC) but not a cytokine immune signature in patients with CL as compared to healthy nonendemic controls, as measured by Mann-Whitney test., Conclusions: The results of our study did not identify a systemic immune signature or parasite genetic factors associated with different clinical presentation of CL., (© 2024. The Author(s).)

Background: Age-appropriate vaccination is a crucial public health measure to prevent morbidity and mortality worldwide. Despite its importance, there has been insufficient emphasis on tackling this problem. Therefore, this study aimed to determine the prevalence of age-appropriate vaccination and associated factors in Ethiopia., Method: Data from 1077 children aged 12-35months were extracted from the Ethiopian Mini Demographic and Health Survey 2019 using a prepared data extraction checklist and included in the analysis. The extracted data was analyzed using STATA version 14.0. Descriptive and inferential statistics were applied, followed by multilevel logistic regression. Significant variables were identified at p-value < 0.05 within 95% confidence level and AOR., Result: The pooled prevalence of age-appropriate vaccination in this study was 21.17% (95%CI: 18.73-23.61). Factors like mothers age > = 40 years (AOR = 4.05, 95%CI: 1.03, 15.83), 35-39 years (AOR = 4.62, 95%CI: 1.27,16.71), 25-29 years (AOR = 4.07, 95%CI: 1.18,14.03), Maternal secondary education (AOR = 1.85, 95% CI: 1.06, 3.22), Maternal primary education (AOR = 1.60, 95% CI: 1.07, 2.41) and rural residence (AOR = 0.34, 95%CI: 0.23,0.51) were significant predictors of age-appropriate vaccinations., Conclusion: This study concluded that the prevalence of age-appropriate vaccination of children in Ethiopia is below the desired level. Hence, the stakeholders should prioritize timely vaccination of children, similar to as the efforts made to increase overall coverage., Competing Interests: The authors have declared that no competing interests exist, (Copyright: © 2024 Worku et al. 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.)

Worldwide, nearly 45 million children under the age of 5 years were affected by wasting in 2022. Ethiopia has been challenged by disasters increasing the caseload of children with wasting. This study aimed to determine the effect of a simplified approach on recovery of children with acute malnutrition as compared with the standard protocol. A cluster randomized, controlled, noninferiority trial was carried out in three regions of Ethiopia from December 4, 2021, to July 30, 2022. A total of 58 clusters (health posts) were randomized into intervention and control groups. Children with SAM in the intervention groups received two sachets of Ready-to-Use Therapeutic Food (RUTF), whereas children in the control groups received RUTF based on their body weight. Children with moderate acute malnutrition (MAM) received one sachet of RUTF and one sachet of Ready-to-Use Supplementary Food (RUSF) daily in the intervention and control groups, respectively. Per protocol (PP) and intention-to-treat analysis were used to compare recovery at a noninferiority margin of 15%. Data were collected from 55 health posts and 1032 children. In the PP analysis, the recovery rate of children with wasting among the simplified group (97.8%) was noninferior to the standard protocol group (97.7%), p = 0.399. The RUTF cost per treatment of child with SAM was 56.55 USD for the standard versus 42.78 USD for the simplified approach. The simplified approach is noninferior to the standard protocol in terms of recovery and has a lower cost of RUTF. Further study is recommended to assess the effectiveness of the simplified approach in emergency contexts., (© 2024 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd.)

Skipping breakfast during pregnancy presents several challenges and potential health risks for both the mother and her baby. Breakfast plays a crucial role in providing essential nutrients and energy after an overnight fast. Skipping breakfast during pregnancy creates an unhealthy environment for the fetus. Thus, this study aimed to identify the determinants of breakfast skipping among pregnant women. An unmatched, community-based case-control study was conducted among 116 randomly selected cases (breakfast skippers) and 232 neighboring controls (regular breakfast consumers). Data was collected using pre-tested interviewer-administered structured questionnaire. Binary logistic regression analysis was employed to determine predictors of breakfast skipping using STATA version 16. The odds of non-formal education (AOR = 3.92; 95% CI: 1.75, 8.78), low socioeconomic status (AOR = 2.93; 95% CI: 1.12, 7.68), poor dietary knowledge (AOR = 2.89; 95% CI: 1.29, 6.47), and experiencing morning sickness (AOR = 2.57; 95% CI: 1.13, 5.84) were higher among cases than controls. The odds of breakfast skipping were higher for every increase in family size (AOR = 1.65; 95% CI: 1.25, 2.18), but decrease with every unit increase in mid-upper arm circumference (AOR = 0.58; 95% CI: 0.46, 0.72) and weekly frequency of drinking coffee leaf tea beverage (AOR = 0.84; 95% CI: 0.78, 0.89). Findings of this study showed that poor economic status, lack of formal education, poor dietary knowledge, having morning sickness, having large family size, maternal nutritional status, and frequent consumption of coffee leaf tea beverage were significantly associated with breakfast skipping among pregnant women. Thus, efforts should focus on improving dietary awareness during pregnancy, strengthening dietary counseling during antenatal care, enhancing access to contraceptive services, and ensuring timely management of morning sickness., (© 2024. The Author(s).)

Background: Malnutrition during pregnancy increases the risk of chronic illness later in life and adverse birth outcomes in subsequent generations. In this regard, consumption of diets rich in adequate energy, protein, vitamins, and minerals from a variety of foods is essential. Evidence on the status of maternal dietary pattern is very crucial. Hence, the aim of this study was to assess factors associated with dietary patterns and nutritional status of pregnant women in South Ethiopia., Methods: A community-based cross-sectional study was conducted among 638 randomly selected pregnant women using a validated, a pre-tested, contextualized food frequency questionnaire using interviewer-administered structured questionnaire by digital open-source toolkit. Principal component factor analysis was employed to determine dietary patterns. Bivariable and multivariable ordinal logistic regression analyses were used to identify factors associated with dietary patterns and nutritional status, using STATA version 16., Result: The dietary habits of pregnant women were best explained by three distinct dietary patterns. Urban dwellers (AOR = 2.18; 95% CI: 1.33, 3.59), from high socio-economic status (AOR = 2.43; 95% CI: 1.68, 3.51), from middle socio-economic status (AOR = 1.72; 95% CI: 1.19, 2.48), primigravida mothers (AOR = 1.72; 95% CI: 1.07, 2.78), and multigravida mothers (AOR = 2.08; 95% CI: 1.39, 3.10) were high likelihood to consume the highest tercile of "Cereals-Pulses and Dairy" compared to rural dwellers, from low socio-economic status and grand multigravida, respectively. Attending formal education (AOR = 1.60; 95% CI: 1.02, 2.51), from higher socioeconomic status (AOR = 1.56; 95% CI: 1.02, 2.38), not having food aversion (AOR = 1.98; 95% CI: 1.16, 3.39), and had good dietary knowledge (AOR = 2.16; 95% CI: 1.08, 4.32) were associated with a higher tercile consumption of "Nutrient-Dense" food compared to those without formal education, having food aversion and had poor dietary knowledge, respectively. Not attending formal education (AOR = 2.22; 95% CI: 1.48, 3.36), had decision-making autonomy (AOR = 1.91; 95% CI: 1.26, 2.90), and had good dietary knowledge (AOR = 1.86; 95% CI: 1.13, 3.08) were found to consume the highest tercile of "Leafy local food" compared to their counterpart. Consumption of lower terciles "Nutrient-Dense" food (AOR = 1.63; 95% CI: 1.07, 2.47) and "Leafy local food" (AOR = 2.32; 95% CI: 1.54, 3.51) were found to be factors associated with under nutrition during pregnancy., Conclusion: Three distinct dietary patterns were identified. Factors associated with these major dietary patterns included place of residence, socio-economic status, educational level, dietary knowledge, food aversion, number of pregnancies, and maternal decision-making autonomy. Under nutrition among pregnant women was found to be high and associated with the consumption of 'Nutrient-Dense' and 'Leafy local' foods. Therefore, concerned health authorities should strengthen dietary counseling during pregnancy, provide family planning services, and promote women's education., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Fikadu, Tamiru and Ademe.)

Cutaneous leishmaniasis (CL) is a neglected tropical disease caused by Leishmania parasites, that can cause long-term chronic disabilities. The clinical presentation of CL varies in both type and severity. CL presents as three main clinical forms: localised lesions (localised cutaneous leishmaniasis, LCL); mucocutaneous leishmaniasis (MCL) that affects the mucosa of the nose or the mouth; or as disseminated not ulcerating nodules (diffuse cutaneous leishmaniasis, DCL). Here we recruited a cohort of CL patients in a newly established leishmaniasis treatment centre (LTC) in Lay Gayint, Northwest Ethiopia, and collected detailed demographic and clinical data. The results of our study show that more males than females present to the LTC to seek diagnosis and treatment. 70.2% of CL patients presented with LCL and 20.8% with MCL. A small number of patients presented with DCL, recidivans CL (a rare form of CL where new lesions appear on the edges of CL scars) or with a combination of different clinical presentations. The duration of illness varied from 1 month to 180 months. Over a third of CL patients had additional suspected CL cases in their household. Despite the majority of CL patients having heard about CL, only a minority knew about its transmission or that it could be treated. Most CL patients lived in areas where environmental factors known to be associated with the transmission of CL were present. This work highlights that CL is an important public health problem in Lay Gayint and emphasises the urgent need for more CL awareness campaigns, better health education and better disease management practices., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Yizengaw et al. 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.)

Background: Academic achievement is crucial for the social and economic development of young people and determines the quality of education of a nation. According to different studies, food insecurity adversely affects children's health, nutrition, and subsequent decline in academic performance by impairing students' ability to learn and therefore affects the achievement of the Sustainable Development Goals (SDGs) of quality education and lifelong learning opportunities for all. To provide evidence on the association of food insecurity with academic performance is necessary. The current study assessed household food insecurity and its association with academic performance among primary school adolescents in Hargeisa City, Somaliland., Methods: A school-based cross-sectional study was conducted among 630 primary school adolescents from December 2021 to March 2022. Students were selected using a multistage sampling technique. An interviewer-administered questionnaire was used to collect data on household food security and socio-demographic variables and entered into Epi data version 3.1. The data was exported to SPSS version 26 for descriptive and multivariable logistic regression analysis. Odds ratios and their 95% confidence intervals together with p <0.05 were utilized to declare statistical significance., Results: The prevalence of food insecurity among school adolescents was 59.21%. The majority (55.40%) of the school adolescents were poor academic performers. The frequency of adolescents' poor academic performance was significantly high (71.05%) among food insecure households (P < 0.001) as compared to their counterparts whose households were food secure (32.68%). On multivariable analysis, household food insecurity (AOR = 5.24, 95%CI = 3.17-8.65), school absenteeism (AOR = 3.49, 95%CI = 2.20-5.53), spending >2h/day watching TV / screen media use (AOR = 9.08, 95%CI = 4.81-17.13), high and middle wealth households (AOR = 0.51, 95%CI = 0.30-0.88) (AOR = 0.40, 95%CI = 0.21-0.76) and habitual breakfast consumption (AOR = 0.08, 95%CI = 0.03-0.20) had shown statistically significant association with academic performance among primary school adolescents., Conclusion: The present study revealed that household food insecurity has a high association with adolescents' academic performance. The prevalence of food insecurity is moderate, based on the household food insecurity access scale. The results indicate the need for policies and programs intended to improve household income by developing income-generation programs for lower-income families and enhance feeding programs such as national school lunch and school feeding across schools in the country., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Adam et al. 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.)

Background: Maternal common mental disorders have broad implications for maternal and child mental and physical health that may have a long-lasting social and economic impact. This study aimed to assess the association between symptoms of antenatal common mental disorders and obstetric and perinatal outcomes in Eastern Ethiopia., Methods: A community-based prospective cohort study was conducted and a total of 1011 randomly selected pregnant women were followed up from February 1, 2021, to January 30, 2022. The modified Poisson regression model with a robust variance was fitted to examine the effect of the symptoms of antenatal common mental disorders on obstetric and perinatal outcomes., Results: Antenatal common mental disorders (SRQ ≥ 6) were presented among 390 (38.58 %) pregnant women. In the final multivariate Poisson regression model, women with antenatal common mental disorders symptoms had an increased risk of some pregnancy complications (ARR = 1.65, 95 % CI: 1.59, 1.84). In the current study, symptoms of antenatal common mental disorders increased also the risk of preterm birth (ARR = 1.71; 95 % CI: 1.20, 2.42) and low birth weight (ARR = 1.93; 95 % CI: 1.36, 2.74)., Limitation: The indirect effects of some potential mediators and moderators were not assessed in this study., Conclusion: The study found a high rate of symptoms of antenatal common mental disorders and adverse obstetric and perinatal outcomes. Antenatal common mental disorders symptoms may have considerable effects on individual and combined pregnancy complications and adverse perinatal outcomes., Competing Interests: Declaration of competing interest None., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Introduction: Wasting occurs when the body's nutritional needs are unmet due to insufficient intake or illness. It represents a significant global challenge, with approximately 45 million infants and children under 5 years of age suffering from wasting in 2022., Methods: A cluster-randomized, controlled, non-inferiority trial was conducted in three regions of Ethiopia. A non-inferiority margin of 15%, along with a recovery rate of 90% and a minimum acceptable recovery rate of 75%, were considered alongside an intra-cluster correlation coefficient of 0.05 and an anticipated loss to follow-up of 10% in determining the total sample size of 1,052 children. Children with severe acute malnutrition (SAM) in the simplified group received two sachets of ready-to-use therapeutic food (RUTF) daily, while the standard group received RUTF based on their body weight. For moderate acute malnutrition (MAM) cases, the simplified group received one sachet of RUTF, whereas the standard group received one sachet of ready-to-use supplementary food daily. A non-parametric Kaplan-Meir curve was utilized to compare the survival time to recovery., Results: A total of 1,032 data points were gathered. For SAM cases, the average length of stay was 8.86 (±3.91) weeks for the simplified protocol and 8.26 (±4.18) weeks for the standard protocol ( P  = 0.13). For MAM cases, the average length of stay was 8.18 (±2.96) weeks for the simplified approach and 8.32 (±3.55) weeks for the standard protocol ( P  = 0.61). There was no significant difference ( P  = 0.502) observed between the simplified protocol [8 weeks, interquartile range (IQR): 7.06-8.94] and the standard protocol [9 weeks (IQR: 8.17-9.83)] among children with SAM on the median time to cure. There was no significant difference ( P  = 0.502) in the time to cure between the simplified approach [8 weeks (IQR: 7.53-8.47)] and the standard protocol [8 weeks (IQR: 7.66-8.34)] among children with MAM. The survival curves displayed similarity, with the log-rank test not showing significance ( P  > 0.5), indicating the non-inferiority of the simplified approach for cure time., Conclusion: The findings showed that the simplified and standard protocols demonstrated no significant differences in terms of the average duration of stay and time required for recovery., Clinical Trial Registration: https://pactr.samrc.ac.za/, Identifier (PACTR202202496481398)., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2024 Maru, Tamiru, Baye, Chitekwe, Kifle, Lailou and Belachew.)

Introduction: Stunting is a major public health issue with a significant influence on the health and development of children in low-income countries, where it affects up to 32% of children. Nutritional intake is impacted by alterations in intestinal permeability and underlying chronic inflammation, which hinder children's normal linear growth. Environmental enteropathy is a poorly understood condition with chronic intestinal inflammation. The purpose of this study was to identify the magnitude of stunting, change in growth, and factors associated with stunting and change in height for the age Z-score of children with an elevated lactulose-to-mannitol ratio., Methods: An observational follow-up study was conducted to follow children with an elevated lactulose-to-mannitol ratio for changes in their linear growth. A lactulose-mannitol test was performed to identify children with elevated lactulose-to-mannitol ratios, indicative of environmental enteropathy. After a 1-year follow-up, anthropometry was repeated to assess their linear growth. A multivariable logistic regression analysis was performed to identify the independent predictors for stunting in children with elevated lactulose-to-mannitol ratios. All tests were two-sided, and a p -value of <0.05 was considered significant., Results: The prevalence of stunting in children with an elevated L:M at baseline and end line was found to be 72.4% (95% CI: 60.3, 84.5) and 78.4% (95% CI: 66.7, 90.2), respectively. In a multivariate analysis, a low dietary diversity score (<4 food groups), presence of flies and insects in the toilet area, poor handwashing practices during a critical time, and MUAC z < -2 were significantly associated with stunting. Flies and insects in the toilet area and unsafe disposal of feces were significantly associated with changes in HAZ in children with elevated lactulose-to-mannitol ratios, an indicator of environmental enteropathy., Conclusion: Most of the children with an elevated lactulose-to-mannitol ratio in the study population were stunted, and no significant change in their linear growth was observed after 1-year follow-up. Therefore, further investigation and urgent intervention are needed to prevent environmental enteropathy and stunting among under-five children in this community who are exposed to very poor sanitary conditions and other risk factors for malnutrition., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Regassa, Belachew, Duguma and Tamiru.)

Inadequate intake of age-specific energy and nutrients is among the prime immediate causes of child malnutrition. Thus, this study aimed to determine the energy, protein and Fe densities of pre-processed dabi teff-field pea-based optimised novel complementary flour and its contribution to daily energy and nutrients demand by 6-8, 9-11 and 12-23 month-old children. The optimal formula at overall optimisation was identified to be 34·66 % dabi teff, 25 % barley, 15 % oats, 15·34 % field pea, 5 % linseed and 5 % maize with response values of 15·74 % protein, 5·09 % fat, 2·26 % ash, 2·88 % fibre, 73·05 % carbohydrate, 1591·72 kJ/100 g (380·43 kcal/100 g) energy, 32·21 mg/100 g Fe, 77·51 mg/100 g Ca and 2·59 mg/100 g Zn. The energy density of the optimised novel complementary flour was 1·27 kcal/g which fulfilled the Pan American Health Organization/WHO recommendation (≥ 0·8 kcal/g), protein density was 4·14 g/100 kcal and the Fe density was 8·47 mg/100 kcal, which was 2·12 to 10·59 times higher than the recommended value where the optimal had demonstrated to contribute more than 100 % of the daily energy and protein demand and notably more than 200 % of daily Fe demand at moderate bioavailability (0·8-4 mg/100 kcal). These findings showed that the daily recommended dietary allowance for energy, protein and Fe could be attained by the developed dabi teff-field pea-based optimised novel complementary flour and its contribution to the children's daily energy and nutrients demand met the standard, where the product can be used as food-based nutrition intervention to manage protein-energy malnutrition and Fe deficiency anemia in children sustainably.

When pregnancy occur among teenagers; there is a competition for nutrients between the still-growing adolescent mother and her fetus. Pregnant adolescents' nutrition issues are not addressed well and changes are too slow in Ethiopia. This study aimed to study, nutrition knowledge, nutritional status and associated factors among pregnant adolescents in West Arsi , central Ethiopia. We conducted a cross-sectional study of 426 pregnant adolescents between January 1 and January 25, 2023. Data were collected using kobo collect and analyzed using SPSS version 25. We performed linear regression to identify independent predictors of nutritional status and multivariable logistic regression analyses to identify nutritional knowledge. Odds ratios (ORs) with 95% confidence intervals were estimated to show the strength of the association. Magnitude of good nutrition knowledge was 23.7%, 95% CI (21.4-25.3%), and the odds of having good nutrition knowledge was 7.5 times higher among participants whose education level was above college compared with illiterate participants [(AOR = 7.5, 95% CI = (5.27-9.38)],the odds of having good nutrition knowledge was 8 times higher among adolescent who had ANC visits, [(AOR = 8, 95% CI = (3.63-13.85)], and the odds of having good nutrition knowledge was 5 times higher among adolescents who received nutrition education [(AOR = 5, 95% CI = (3.67- 13.53)]. Receiving nutrition education (β = 0.25, P = 0.002) and good nutrition knowledge (β = 0.08, P < 0.001) were positively associated with nutritional status; however, food insecurity (β = - 0.93, P < 0.001) was negatively associated with nutritional status. The nutrition knowledge of pregnant adolescents was suboptimal; educational status, ANC visits and nutrition education were associated with good nutrition knowledge, whereas food insecurity, low nutrition knowledge, and not receiving nutrition education were predictors of poor nutritional status. Nutritional education interventions, increasing utilization of ANC, and interventions for improving food security are strongly recommended., (© 2024. The Author(s).)

When pregnancy occurs in adolescence, the growth and development of the mother and fetus may be impaired due to strong competition for nutrients between the still-growing adolescent and the fetus. Pregnant adolescents constitute an underserved population; they lack adequate nutritional knowledge. Therefore, this study investigated the effect of nutritional behavior change communication (NBCC) through alliance for development (AFD) on the nutritional status and gestational weight gain (GWG) of pregnant adolescents. A two-arm parallel cluster randomized controlled community trial was conducted in the West Arsi Zone, central Ethiopia, from August 2022 to July 2023. The nutritional status of the pregnant adolescent was assessed using mid-upper arm circumference. Weight was measured at baseline and at the end of the intervention. A total of 207 and 219 pregnant adolescents participated in the intervention and control clusters, respectively. The intervention started before 16 weeks of gestation, and the intervention group attended four NBCC sessions. The NBCC was based on the health belief model (HBM) and was given at the participants' homes with their husbands. The NBCC intervention was delivered by AFDs and community-level health actors. Pregnant adolescents in the control group received routine nutrition education from the health care system. A linear mixed-effects model and difference in difference (DID) were used to measure the intervention effect after adjusting for potential confounders. After the implementation of the trial, the mean mid-upper arm circumference (MUAC) in the intervention arm significantly increased from baseline (p ≤ 0.001), 23.19 ± 2.1 to 25.06 ± 2.9 among intervention group and 23.49 ± 2.1 to 23.56 ± 2.0 among control group and the mean difference in the MUAC (DID) was 1.89 ± 2 cm (p ≤ 0.001); the mean GWG in the intervention arm significantly increased from baseline; 51.54 ± 4.7 to 60.98 ± 4.6 among intervention group and 52.86 ± 5.27 to 58 ± 5.3 among control group; the mean GWG in the intervention group was 9.4 kg, and that in the control group was 5.14 kg, and the difference in difference was 4.23 kg and this was statically significant p ≤ 0.001). This study demonstrated that the use of the HBM for NBCC delivered through the AFD was effective at improving the nutritional status and GWG of pregnant adolescents. These results imply the need for the design of model-based nutritional counseling guidelines.Clinical trial registration: PACTR202203696996305, Pan African Clinical Trials Registry, date of first registration: 16/03/2022., (© 2024. The Author(s).)

Background: Stunting in children is the term for reduced linear growth and development, which is frequently brought on by a persistently inadequate diet, recurrent infections and chronic diseases or poor health conditions. Apart from the classic covariates of stunting, which include diet and illness, the relative contribution of household air pollution to chronic nutrition conditions is least studied. Hence, this study is conducted to investigate the impact of household air pollution on the linear growth of under-five children in Jimma town, Ethiopia., Methods: A prospective cohort study was employed to collect data from 280 under-five children who lived in households using solid fuel (exposed group, n = 140) and clean fuel (unexposed group, n = 140). Height-for-age Z scores were compared in both groups over a 12-month follow-up period. The difference in differences estimators were used for comparison of changes in the height-for-age Z scores from baseline to end line in exposed and non-exposed groups. The independent effect of the use of solid fuels on height-for-age Z scores was analyzed through a multivariable linear regression model. Statistical Significances were declared at P < 0.05 and 95% CI level., Results: In an unadjusted model (Model 1), compared with the clean fuel type, the mean difference in the height-for-age Z score of children in households using solid fuel was lower by 0.54 (-0.54, 95% CI -0.97, -0.12, P = 0.011). The beta coefficient remained negative after adjusting for age and sex (Model 2 -0.543, 95% CI -1.373, -0.563) and sociodemographic variables (Model 3: -0.543, 95% CI -1.362, -0.575). In the final model (Model 4), which adjusted for wealth quantile, dietary practice, water, sanitation and hygiene status and household food insecurity access scale, the beta coefficient held the same and significant (beta: -0.543, 95% CI -1.357, -0.579, P < 0.001). Higher HAZ scores were observed among female child (β: = 0.48, 95%CI: 0.28, 0.69), Child with father attended higher education (β: = 0.304 95%CI: 0.304, 95% CI 0.19, 0.41) as compared to male gender and those who did not attend a formal education, respectively. In contrast, child living in households with poor hygiene practices had lower HAZ score (β: -0.226, 95% CI: -0.449, -0.003), P < 0.001., Conclusions: Exposure to indoor air pollution was inversely related to linear growth. Furthermore, sex, educational status and hygiene were found relevant predictors of linear growth. In such a setting, there is a need to step up efforts to design and implement public education campaigns regarding the health risks associated with exposure to household air pollution. Promoting improvements to kitchen ventilation and the use of improved cooking stoves, which will help to mitigate the detrimental effects of indoor air pollution on child growth impairment and its long-term effects., (© 2024. The Author(s).)

The aftermath of dietary modifications made during pregnancy has the most substantial effects on nutritional status and birth results, despite the important influence of nutritional reserves. Numerous studies have been conducted on dietary practices and their determinants among pregnant women; however, there is a gap in evidence among pregnant adolescents. Therefore, this study sought to close this gap by examining dietary practices and associated factors among pregnant adolescents in the West Arsi Zone, Central Ethiopia. This community-based cross-sectional study was conducted among 459 pregnant adolescents between February and March 2023. Cluster sampling was used for selecting pregnant adolescents. Structured questionnaires were used for data collection. The data were entered into the Kobo toolbox and exported to SPSS version 25 software for analysis. Dietary diversity was assessed using the 24-h dietary recall method. Binary and multivariable logistic regression analyses were used to identify independent predictors of dietary practices. Odds ratios (ORs) with 95% confidence intervals (CIs) were estimated to identify the factors associated with the outcome variables. A p value ≤ 0.05 indicated statistical significance. The prevalence of inadequate dietary practices among the pregnant adolescents was 78.4% (95% CI 74.3%, 82.8%), and a level of nutritional knowledge [AOR = 2.4, 95% CI (1.82-4.74]; an unfavorable attitude toward dietary diversity [AOR = 4.3, 95% CI 2.9-5.83]; a food insecurity status [AOR = 8.7, 95% CI 2.37-10.24]; and a low perceived severity of poor dietary practices [AOR = 4.7, 95% CI 3.26-5.47]. These factors were significantly associated with inadequate dietary practices among pregnant adolescents. The most frequently consumed foods were starchy foods (81.3%) and pulses (79%), and the least consumed foods were meat (2.8%) and fruits (3.48%). The magnitude of inadequate dietary practices was high, and it was significantly associated with educational, behavioral, and economic status. Nutritional interventions focused on communicating nutritional behavioral changes and strengthening sustainable income-generating strategies are recommended to improve the dietary practices of pregnant adolescents., (© 2024. The Author(s).)

Background and Purposes: Appropriate healthy dietary practices are essential for well-being. Adopting of healthy lifestyle remains challenging worldwide. Ethiopia has an unacceptably high burden of malnutrition like other least developed countries. However, healthy dietary practices and their associated factors were not conducted in Nekemte town. Hence, the study was designed to assess healthy dietary practices and associated factors among middle-aged adults in Nekemte town from January 15 to February 30, 2019., Methods: A community-based cross-sectional study design was applied in Nekemte town. Primary data were gathered using a questionnaire from 266 adults and checked for normality. In both bivariate and multivariate logistic regression analyses the association and significance were determined at P < 0.05., Results: The Magnitude of dieting practice was 73.31% (unhealthy) and 26.69% (healthy), respectively. Being low-income households ( P = 0.001), not married ( p = 0.001), had a daily meal frequency [AOR: 1.91, 95% CI: (1.04, 2.71), and had poor knowledge of healthy diet AOR: 3.87, 95% CI: (3.23, 5.65)] were associated with unhealthy diets., Conclusion: The researchers identified unhealthy diet practices were widespread in the study samples of Nekemte populations. Hereafter, community-based lifestyle and Nutrition education through intensive participation of community leaders is highly recommended., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Adeba, Tamiru and Belachew.)

The response of a mixed system is determined by the proportions of the various ingredients that add up to one, not by the combination's total amount. This research aimed at examining the effects of blending ratio variation on the macro-composition and sensory acceptability of dabi teff-field pea-based novel composite complementary flours. Standard methods (AOAC, 2016, Official Methods of Analysis of the Association of Official Analytical Chemists ) were used to determine macronutrients. The sensory attributes were evaluated using a 5-point hedonic scale. The ingredients were constrained at 0%-30% for field pea, 20%-35% for dabi teff, and 5%-20% for maize, while the remaining were set constant at 5% linseed, 15% oats, and 25% barley. D-optimal was used to examine the effects of blending ratio variation on the responses. All the responses were significantly different ( p  < .05) among the blends except for fat content, ranging from 14.58% to 17.21% for protein, 4.22% to 5.59% fat, 2.01% to 2.60% ash, 2.68% to 3.96% fiber, 68.08% to 70.76% utilizable carbohydrate, and 378.82 to 386.9 kcal/100 g gross energy. The sensory acceptability score ranged from 3.4 to 4.4. The linear model was significant ( p  < .05) and adequate to describe variation in moisture, protein, and ash contents. An increase in the ratio of field pea significantly increased ( p  < .05) protein, ash, fiber, and energy. The interactive effect between dabi teff and field pea significantly increased the sensory acceptability of the blends. These findings showed that varied proportions of the ingredients had a significant effect on the responses, and were used to develop a wholesome product to combat protein-energy malnutrition among children., Competing Interests: The authors declare no conflict of interest., (© 2023 The Authors. Food Science & Nutrition published by Wiley Periodicals LLC.)

Background: The two most physically active stages of life, pregnancy and adolescence, put the pregnant adolescent under a lot of stress. Adolescence is a crucial era in women's nutrition that is frequently overlooked., Objective: This study aimed to explore dietary perceptions, beliefs and practices among pregnant Adolescents in West Arsi, Central Ethiopia., Design: A qualitative method, specifically, a phenomenological research design, was carried out from February to March 2023., Settings: This study was conducted in the West Arsi zone, Oromia, Ethiopia, in four randomly selected districts., Participants: Thirty participants, 12 pregnant adolescents, 8 husbands of pregnant adolescents and 10 healthcare providers were purposefully selected and participated., Methods: In-depth and key informant interviews were conducted. To create relevant codes, subthemes and themes, ATLAS.ti V.7.1 software was used. An inductive qualitative data analysis approach was used. The results were presented using respondents' clear verbatim and thematic analysis., Results: The findings were organised into four major themes: (1) low nutritional awareness, (2) poor dietary practice, (3) barriers to good dietary practice and (4) facilitators for good dietary practice. A low perceived severity (one's belief of the seriousness) of undernutrition and low perceived benefits (one's belief of the benefits) of balanced nutrition have been reported. A monotonous diet (one type food usually cereal based), no change in dietary practices during pregnancy, and low intake of animal food sources (meat, egg and milk) were found under dietary practices. One of the most striking findings to emerge from this study is the Alliance for Development (AFD), the former Women Development Army, which can be a great facilitator of good dietary practice. Husbands' involvement in nutrition education and specific nutrition training for healthcare providers are the other facilitators identified in this study. The lack of nutrition education, misconceptions and economic problems are barriers to dietary practices., Conclusion: This study found a low nutritional awareness and poor dietary practices. Further experimental studies are recommended to assess whether AFD is capable of delivering effective nutrition interventions that improve dietary practice of pregnant., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Undernutrition in childhood is a crucial public health issue in Ethiopia. Yet, more than an assessment of undernutrition using conventional index is needed to conclude the overall prevalence of undernutrition among children aged 6-23 months. Therefore, this study aimed to assess the prevalence of undernutrition using composite index of anthropometric failure and its associated factors among children aged 6-23 months in Southwest Ethiopia. A community-based cross-sectional study was employed among 440 mother-child pairs selected using a two-stage cluster sampling method in the rural Kersa district, Jimma Zone, Southwest Ethiopia. A pretested structured questionnaire was used to collect data. Multivariable logistic regression analysis was employed to identify factors associated with undernutrition. Variables with a p -value of <.05 were considered statistically significant. The proportion of undernutrition using composite indexes of anthropometric failure was 57.3% among children aged 6-23 months. Children being male [AOR = 1.55; 95% CI (1.013, 2.373)], not met minimum acceptable diet (MAD) [AOR = 2.104; 95% CI (1.05, 4.214)], larger family size [AOR = 1.699; 95% CI (1.0791, 2.675)], having comorbidity [AOR = 3.31; 95% CI (2.068, 5.327)], and being in food insecurity household [AOR = 3.12; 95% CI (2.0, 4.868)] were more likely to be in anthropometric failure, whereas children from the mother who attended higher and above schooling [AOR = 0.244; 95% CI (0.093, 0.641)] were less likely to be in anthropometric failure. More than half of children aged 6-23 months were experienced anthropometric failure. Male children, those who have not received the MAD, come from larger families, have comorbidities, live in food-insecure households, and have mothers with higher education levels were found to be at higher risk of anthropometric failure., Competing Interests: The authors declare no conflicts of interest., (© 2023 The Authors. Food Science & Nutrition published by Wiley Periodicals LLC.)

Background: Vitamin A deficiency (VAD) during pregnancy is a public health challenge in low-income countries. There are inconsistent findings that can affect policy in planning appropriate intervention. This systematic review and meta-analysis were conducted to summarize the evidence in order to identify existing gaps and propose strategies to reduce VAD during pregnancy in Ethiopia., Methods: This study included published and unpublished observational studies searched from different databases (PubMed, CINHAL [EBSCO], Embase, Google Scholar, Directory of Open Access Journals, Web of Sciences, MEDLINE, Cochrane Library, Scopus, Google Search and MedNar). Statistical analysis was conducted using Stata version 14 software. Heterogeneity and publication bias were assessed. Forest plots were used to present the pooled prevalence using the random effects model., Results: A total of 37 618 pregnant women from 15 studies were included. The overall pooled prevalence of VAD was 29% (95% confidence interval 21 to 36) with I2=99.67% and p<0.001. Socio-economic and sociodemographic factors were identified as affecting vitamin A deficiencies among pregnant women., Conclusions: Nearly one-third of pregnant women in Ethiopia had VAD. Strengthening intervention modalities that aimed to increase the uptake of vitamin A-rich foods can avert VAD among pregnant women in Ethiopia., (© The Author(s) 2023. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.)

Background: Functional Gastrointestinal Disorders (FGIDs) and their risk factors vary from region to region. Therefore, this study aimed to determine the prevalence of abdominal pain of FGIDs in different dietary diversity score (DDS) and its determinant factors among adults in Jimma City, Southwest Ethiopia., Methods: A community-based cross-sectional study was conducted from July 17 to October 27, 2019. The study included systematically selected healthy adults aged ≥ 18years. Data were collected on gastrointestinal symptoms (Rome III), and DDS (24-dietary recall)., Results: Of 865 healthy adults, the prevalence of abdominal pain symptoms co-occurrence was 168(19.4%), dyspepsia, 152(17.6%) and IBS, 133(15.4). Similarly, the co-occurrence was distributed as 81(9.4%) in middle, 64(7.4%) in high and 23(2.6%) in low DDS groups. Although this distribution was different in the DDS groups, it is not significantly associated. With potential confounders adjusted, the behavioral factors associated with the co-occurrence with an AOR (95% CI) were khat chewing: 7.37 (1.76 - 30.87), drinking alcohol: 3.24 (1.15 - 9.18), sedentary life: 12.28 (3.19 - 48.40) and less physical activity: 4.44 (1.43-13.75). Moreover, elevated TAG: 5.44 (2.78 - 8.10), elevated LDL: 4.26 (1.61-11.29), central obesity: 2.78 (1.08 -7), low HDL 5.89 (2.22-15.60), positive H.pylori stool test: 2.7 (1.86 -7.72), being diabetic: 2.7 (1.79 -7.79) and hypertensive: 2.79 (1.08 - 7.14) were associated with the co-occurrence., Conclusion: Abdominal pain and FGIDs had significant distribution among adults in Jimma City. Therefore, early screening and managing FGIDs in the community is recommendable., (© 2023 Zawdie, et al.)

Background: Although pro-dietary practices and associated malnutrition are modifiable risk factors, they have a significant effect on maternal and neonatal health outcomes. Therefore, this study aimed to assess the effect of nutritional education and home gardening promotion on feto-maternal outcomes among pregnant women., Methods: A three parallel arms community-based cluster randomized controlled trial was carried out in Jimma Zone, Southwest Ethiopia from August 2020 to January 2021. Eighteen selected clusters were randomly assigned into three arms: husband (pregnant woman with her husband), peers (pregnant woman with her peers), and the controls. A total of 348 pregnant women were recruited in a 1:1:1 allocation ratio to the study arms at the baseline and 336 attended the end-line survey. Three nutrition education sessions and four varieties of vegetable seeds were provided for women in the intervention arms (husband and peers) and only routine nutrition education for the controls. Data were collected using a pretested interviewer-administered structured questionnaire. Generalized estimating equation analysis (GEE) and one-way analysis of variance (ANOVA) and Kruskal Wallis test were used to evaluate the effect of the interventions. The intervention effect estimates were obtained through a difference-in-differences approach., Result: In the final model, neonates born to women in the husband group were 232 g heavier than those in the control groups (β = 232, 95%CI: 228.00, 236.27. Similarly, women in the husband group had a 0.45 g/dl greater hemoglobin level than the control groups (β = 0.45, 95% CI: 36.48, 54.40). Likewise, a minimum diet diversity score was higher in the husband group as compared to the controls (β = 0.87 95% CI: (0.56, 1.18)., Conclusions: Therefore, nutrition education and home gardening interventions resulted in a significant positive effect on the mean birth weight and maternal hemoglobin level among the intervention groups. The findings imply the need for enhancing such interventions to improve feto-maternal outcomes. The trial was registered at Pan African Clinical Trial Registry as PACTR202008624731801., Competing Interests: The authors have declared that no computing interests exist., (Copyright: © 2023 Kuma et al. 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.)

Iron deficiency anemia is one of the major public health problems in children associated with the inadequate intake of bioavailable iron. Thus, this research was aimed at incorporating dabi teff, an underutilized/forgotten crop, into other pre-processed local food crops, viz. , germinated maize, roasted barley, roasted field pea, dehulled oats, and linseed, to develop optimized iron-dense novel composite complementary flour with a reduced phytate/minerals molar ratio. Nutrisurvey software was employed to define ranges, and they were constrained at 20-35% dabi teff, 0-30% field pea, and 5-20% maize, while the remaining were kept constant at 25% barley, 15% oats, and 5% linseed. Eleven experimental runs were generated from the six mixture components using Stat-Ease Design Expert ® software version 11, D-optimal. Inductively coupled plasma-optical emission spectrometry was used to determine micronutrients. 'Scheffe' regression was used to fit and test the model's adequacy, and numerical multi-response optimization was performed using the Design Expert ® to identify the optimal points. Dabi teff had a significantly higher ( p  < 0.05) iron content at 86.5 mg/100 g, iron density at 24.53 mg/100 kcal, and calcium content at 123.59 mg/100 g. The new formulations had a significantly higher iron content (3.31-4.36 times), iron density (3.25-4.27 times), and calcium content (1.49-1.58 times), as compared to the control flour, and fulfilled FAO/WHO recommendations. The optimal formula was identified at 34.66% dabi teff, 25% barley, 15% oats, 15.34% field pea, 5% linseed, and 5% maize flour ratios, with response values at the overall optimization as 32.21 mg/100 g iron, 77.51 mg/100 g calcium, 2.59 mg/100 g zinc, 0.233 phytate/iron molar ratio (Ph:Fe), 0.067 phytate/calcium molar ratio (Ph:Ca), 3.43 phytate/zinc molar ratio (Ph:Zn), and 6.63 phytate by calcium to zinc molar ratio (Ph*Ca:Zn). Furthermore, it contained iron at a level that is 2.01 times higher than the standard and 4.44 times higher than the control, as well as an iron density of 8.47 mg/100 kcal, which was 4.39 times higher than that of the control. These findings showed that the optimized dabi teff-field pea based iron-dense novel composite complementary flour with enhanced bioavailability can be developed and used as a sustainable food-based strategy to combat iron deficiency anemia among children in less developed countries, such as Ethiopia., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Tura, Belachew, Tamiru and Abate.)