ABSTRACT
Background: Ethiopia is one of the four low income countries in achieving MDG4, however, minimizing child undernutrition became critical undertaking thus far. This review aimed at identifying the predictors of under-5 children nutrition in Ethiopia. Methods: Databases searched were Med Line, HINARY, MedNar and Embase. Furthermore, gray literatures were also sought. All papers selected for inclusion in the review were subjected to a rigorous critical appraisal using standardized critical appraisal instruments from the Joanna Briggs Institute. Quantitative papers were pooled for statistical analysis and narrative synthesis. Odds ratios and their 95% confidence intervals were calculated for analysis. Papers of optimal quality but without optimal data set for meta-analysis were subjected for narrative synthesis. Results: Nonadherence towards Optimal feeding recommendations was the most reported predictor of stunting and wasting, while, maternal education and 'Water, Sanitation and Hygiene' factors were the second. The findings of the Meta-analysis showed no evidence of association between household income/wealth and stunting of children in Ethiopia (OR=1.14, 95% CI= 0.97, 1.34), heterogeneity test:i2 = 92%, df = 20, (P < 0.00001). On the other hand, children in low income/wealth group were 1.73 times more likely to have wasting compared to children of the higher income/wealth households (OR=1.73, 95% C I= 1.51, 1.97) heterogeneity test: i2 = 71%, df = 20, (P < 0.00001). Conclusion: An over-reliance on macroeconomic growth as a solitary factor towards undernutrition should not be the way forward. Supplementary and more focused nutrition specific and sensitive interventions are needed in Ethiopia
Subject(s)
Child , MalnutritionABSTRACT
Objectives: Vitamin D deficiency is a public health problem world wide, even in countries with enough sunshine year round to promote adequate skin synthesis. There are few studies that look at vitamin D status in children living in sunny climates as it is assumed that they receive adequate vitamin D from sun exposure. But, no study has been done among children living in Ethiopia. This study is aimed to determine vitamin D status and its predictors among school children aged 11-18 years living in Ethiopia. Methods: An institution based comparative cross-sectional study was conducted in Adama Town and rural kebeles of Adama Woreda on a total sample of 174 (89 urban, 85 rural) during May-June 2013. Children were randomly selected using multi-stage stratified sampling method. Results: Vitamin D deficiency (serum 25(OH)D<50nmol/L) was noted in 42% of children. The proportion of deficiency was significantly higher among children in urban setting as compared to those in rural setting (61.8% and 21.2%, respectively; p <0.001). The significant predictors of vitamin D were study setting, maternal education, triceps skinfold thickness, sun exposure, body surface area exposed, having television/computer in the home and socioeconomic status [Adjusted OR (2.74-19.57): 95%CI(1.23, 69.21)]. Conclusions: Vitamin D deficiency was prevalent among school children living in a tropical country like Ethiopia both in urban and rural settings, with the prevalence being significantly higher among urban school children.
ABSTRACT
BACKGROUND: Surgical Site infections are the second most frequently reported infections of all nosocomial infections among hospital patients. Among surgical patients in obstetrics, Surgical Site Infections were the most common nosocomial infections and the rate is higher in sub-Saharan Africa. There has not been a study which documented the extent of the problem in the study area; hence the objective of this study was to determine the surgical site infection rate among women having surgery for delivery in obstetrics of Jimma University Specialized Hospital (JUSH) from April 1, 2009 to March 31, 2010. METHODS: A prospective descriptive study design was conducted with the aim of determining the surgical site infection rate on all 770 women who had surgery for delivery from April 1, 2009 to March 31, 2010 in obstetric ward of the Hospital. Data on history of the patient, patient specific demographic information on potential risk factors and the occurrence of Surgical Site infections in the first 30 days following surgery were collected using pretested data collection form. In addition, relevant data were also abstracted from the operation logbook of the cases. Then data were cleaned, edited and fed to computer and analyzed using SPSS for window version 16.0. Finally Statistical test for significance was employed using chi-squared (X 2) where appropriate at 5% level of significance. RESULTS: The mean (±SD) of the subjects' age was 26(±7) years and the majority of the women were from the rural areas (72.7%). The overall surgical site infection rate was 11.4%. Of those who had surgical site infections, 64.8% had clean-contaminated wound and 35.2% had contaminated /dirty wounds. Wound class at time of surgery has a statistically significant association with Surgical Site infections (p <0.001).The Surgical Site infections rate was similar for cesarean section and abdominal hysterectomy but higher for destructive delivery under direct vision. Majority of the operations were made for emergency Obstetric conditions (96.6%) and the Surgical Site Infections rate was two times higher compared to that of elective surgery. Chorioamnionitis, presence of meconium, large intraoperative blood loss and Perioperative blood transfusion were associated with increased severity of SSIs with p < 0.001. Absence of antenatal care follow up was also associated with increased severity of Surgical Site Infections. CONCLUSION: it has been revealed that Surgical Site Infections rates are higher than acceptable standards indicating the need for improving Antenatal care, increasing the number of skilled birth attendants at the local clinics, increasing basic and comprehensive emergency obstetric care services, applying improved surgical techniques and improving infection prevention practices to decrease infection rate to acceptable standard