The association between malaria and malnutrition among under-five children in Shashogo District, Southern Ethiopia: a case-control study.

BACKGROUND: Recent studies have presented conflicting findings about whether malaria is associated with an increased or decreased risk of malnutrition. Therefore, assessing the relationship between these two disastrous diseases in the most vulnerable groups, such as in children aged below 5 years (under-five children), may lead to the discovery of new low-cost and effective aides to current methods of malnutrition prevention in malaria-endemic areas. Therefore, this study was conducted to assess the relationship between malaria and malnutrition among under five children in an area with a high degree of malaria transmission. METHODS: The study involved comparing malnourished children aged 6-59 months and nourished children of the same age for their past exposure to malaria, in Shashogo District, Southern Ethiopia. A validated structured questionnaire was used to collect home to home socioeconomic data and anthropometric instruments for clinical data. The collected data were analysed using descriptive and inferential statistics by means of EpiData entry software and STATA data analysis software. RESULTS: A total of 356 (89 malnourished and 267 nourished) under-five children participated in the study. Previous exposure to Plasmodium infection was found to be a predictor for the manifestation of malnutrition in under-five children (P = 0.02 [OR = 1.87, CI = 1.115-3.138]). Children from a household with a monthly income of less than USD 15 were 4.5 more likely to be malnourished as compared to the other children (P = 0.001 [OR = 0.422, CI = 0.181-0.978]). CONCLUSION: This study found that exposure to Plasmodium has a significant impact on the nutritional status of children. In addition, socio-demographic factors, such as family income, may play a role in determining whether children are malnourished or not and may lead to increased morbidity due to malnourishment in children living in malaria-endemic areas. Therefore, malnutrition control interventions should be consolidated with malaria prevention strategies particularly in high malaria transmission areas.

Prevalence of smear positive pulmonary tuberculosis among outpatients presenting with cough of any duration in Shashogo Woreda, Southern Ethiopia.

BACKGROUND: Excluding patients with cough less than two weeks from screening for TB which is the current practice of TB control program in Ethiopia may result in delayed diagnosis thereby increasing transmission risk to others. The current study aimed to determine the prevalence of smear positive pulmonary tuberculosis among patients presenting with cough to four health centers in Shashogo woreda, Southern Ethiopia. METHODS: A cross sectional study was conducted in four health centers in Shashogo Woreda, between November 2011 and March 2012. Four-hundred and sixty one patients aged five years and above attending the outpatient clinics and reporting cough of any duration were screened for pulmonary TB using smear microscopy. During data analysis, patients were classified by duration of cough with the cut-off of two weeks. Stata version 11 was used for data analysis. RESULTS: A total of 299 patients with cough of two or more weeks and 162 patients with cough less than 2 weeks were recruited. The overall prevalence of smear positive pulmonary TB was 4.6% (95% CI: 2.6% to 7.7%). The prevalence of smear positive pulmonary TB among patients with cough lasting two or more weeks was significantly higher compared to those patients with cough lasting less than two weeks (6.0% versus 1.9%; p = 0.04). CONCLUSION: Although the prevalence of smear positive pulmonary TB among patients with cough less than 2 weeks was low, considering the contribution of delayed diagnosis for continued transmission of TB, screening patients with cough less than 2 weeks might be considered for TB control. A multi-site study with large sample size is needed to substantiate the current findings.