High manifestations of food insecurity and hunger among pregnant and lactating women during post-conflict in Tigray, Ethiopia: a community-based study.

BACKGROUND: Food insecurity is a state or condition in which people have limited or uncertain physical, social, and economic access to safe, sufficient, and nutritious food to meet their dietary needs. Since no thorough evaluation was carried out to determine the degree of household food insecurity in Tigrayan communities in the aftermath of the conflict. This study aims to describe household-level food insecurity status among pregnant and lactating women during the post-armed conflict in Tigray, Ethiopia. METHOD: Descriptive research was designed to assess household food insecurity. A multi-stage sampling technique was used for this study. One thousand two hundred forty-nine households were selected systematically following a list of food insecure households. Descriptive statistical values, including frequency counts, percentages, minimum values, maximum values, and averages, were calculated to quantify the indicators under study. Household food insecurity and hunger Scale measurement using the standardized Food and Agriculture Organization standard. RESULTS: The mean age (± SD) of the mothers was 28.35 ± 5.91 years. More than three fourth of the participants 1010(80.93%) were rural residents. The survey result showed that 88.8% of the pregnant and lactating were food insecure. Half (50.1%) of the households were hungry,one month before the study, 78.5% of the families expressed concern about running out of food and 6.4% had severe hunger. CONCLUSIONS: The food insecurity levels and hunger prestige of the study communities were excessively high. This is in the context of a region affected by intense armed conflict. It is commended that the study communities need to be safeguarded from the direct and long-term consequences of armed conflict-caused household food insecurity.

Patient-centered nutrition education improved the eating behavior of persons with uncontrolled type 2 diabetes mellitus in North Ethiopia: a quasi-experimental study.

Background: Improving the clinical outcome of people with type 2 diabetes mellitus by modifying their eating behavior through nutrition education is an important element of diabetes self-management. Significant data from the literature supports this idea, however in the Ethiopian setting, there is a practice gap. Therefore, the purpose of this study was to assess how patient-centered nutrition education affected the eating behavior and clinical outcomes of people with uncontrolled type 2 diabetes mellitus. Method: In this quasi-experimental trial, 178 people with uncontrolled type 2 diabetes were purposely assigned to the intervention (n = 89) or control (n = 89) arm. The intervention arm was given patient-centered nutrition education, whereas the control arm received the routine care. Eating behavior and clinical outcome indicators such as HbAc, lipid profile, anthropometric indices, and blood pressure were assessed in both groups at the start and completion of the intervention. All scale variables were tested for normality and log transformed when appropriate. The baseline characteristics of the intervention and control groups were compared using the t-test for continuous variables and the chi-square test for categorical variables. The effect of nutrition education was determined using a difference in differences (DID) approach. P < 0.05 was established as the criterion of significance. Result: Food selection (DID = 15.84, P < 0.001), meal planning (DID = 31.11, P < 0.001), and calorie needs (DID = 37.65, P < 0.001) scores were statistically higher in the nutrition education arm. Furthermore, their overall eating behavior score (DID = 27.06, P < 0.001) was statistically greater than the controls. In terms of clinical outcomes, the overall picture reveals that the intervention did not outperform over the routine care. However, in comparison to the controls, the intervention arm showed clinically significant improvement in HbA1c (DID = -0.258, P = 0.485). Conclusion: Patient-centered nutrition education has resulted in positive adjustments in the eating behavior of people with uncontrolled type 2 diabetes mellitus. Furthermore, it has shown a great potential for improving their glycemic control.

Correction: High atherogenic risk concomitant with elevated HbA1c among persons with type 2 diabetes mellitus in North Ethiopia.

[This corrects the article DOI: 10.1371/journal.pone.0262610.].

High atherogenic risk concomitant with elevated HbA1c among persons with type 2 diabetes mellitus in North Ethiopia.

BACKGROUND: Type 2 diabetes mellitus (T2DM) is a chronic disease associated with worse clinical presentation. However, the current investigation practices in Ethiopia have limitations to demonstrate the scope of the clinical burden. Hence, this study was aimed at assessing the glycemic status and coronary heart disease (CHD) risk of persons with T2DM using HbA1c and atherogenic index of plasma (AIP). METHOD: This institution-based cross-sectional study was conducted among 421 adults with T2DM from September to November 2019. Demographic, socioeconomic, and lifestyle data were collected through a face-to-face interview. Clinical information was retrieved from medical records whereas anthropometric and biochemical measurements were performed using the WHO protocols. Glycemic status was determined using HbA1c and CHD risk assessed using an atherogenic index of plasma (AIP). Gaussian variables were expressed using mean and standard deviation (SD), Log-normal variables using geometric mean and 95% CI and non- Gaussian variables using median and interquartile ranges. Categorical variables were summarized using absolute frequencies and percentages. Multivariable logistic regression was used to identify factors associated with glycemic control with a statistical significance set at 5%. RESULT: A total of 195 male and 226 female subjects were involved in this study. The results demonstrated that 77% (324) had HbA1c value ≥7% and 87.2% (367) had high atherogenic risk for CHD. Besides, 57% and 67.9% of persons with T2DM had metabolic syndrome according to International Diabetes Federation (IDF) and the National Cholesterol Education Program-Adult treatment panel III (NCEP-ATP III) criteria, respectively. About 36.8% had one or more comorbidities. Having healthy eating behavior [AOR 1.95; CI 1.11-3.43] and taking metformin [AOR 4.88; CI 1.91-12.44] were associated with better glycemic outcomes. CONCLUSION: High AIP level concomitant with poor glycemic control indicates increased risk for coronary heart disease among persons with T2DM in Northern Ethiopia.

Eating behavior among persons with type 2 diabetes mellitus in North Ethiopia: a cross-sectional study.

BACKGROUND: Diet is central to the management of type 2 diabetes mellitus (T2DM). Depending on the stage of the disease at which the recommended diet is initiated, optimal adherence can reduce HbA1c by about 1 to 2%. However, evidence on eating behavior is generally scarce including in Ethiopia. The present study aimed to assess the eating behavior of adults with T2DM in North Ethiopia. METHODS: This cross-sectional study was conducted among 421 adults with T2DM from September to November 2019. Socio-demographic variables were collected using structured questionnaires; an asset-based wealth index was used to determine socioeconomic status. Three dimensions of eating behavior were assessed using Likert-type items: food selection, meal planning and calorie recognition. Raw Likert scores in each dimension were transformed to percent scales to maximum (%SM). Participants' behavior in each dimension was categorized into healthy and unhealthy taking 66.7% SM score as a cutoff. Overall eating behavior was determined by aggregating ranks scored in the three dimensions. Correlates of overall eating behavior were identified using Chi-square test and multinomial logistic regression with statistical significance set at P-value < 0.05. RESULT: Only 1% of the participants had overall healthy eating behavior. Yet, overall unhealthy eating was apparent in 54.4%. By dimensions, healthy eating behaviors in food selection, meal planning and calorie recognition were seen in 43.5, 7.4 and 2.9% participants, respectively. Factors that were positively associated with having healthy eating behavior in one dimension relative to unhealthy in all were: receiving nutrition education [AOR 1.73; CI 1.09, 2.74], female gender [AOR 1.78; CI 1.03, 3.08] & being in 26-44 age category [AOR 3.7; CI 1.56, 8.85]. But, being in the poor [AOR 0.42; CI 0.16, 1.32] or average [AOR 0.54; CI 0.19, 1.55] socioeconomic strata were negatively associated. However, only receiving nutrition education [AOR 3.65; CI 1.31, 10.18] was significantly associated with having healthy behavior in two eating dimensions over unhealthy in all. CONCLUSION: In North Ethiopia, the overall eating behavior of adults with T2DM is extremely poor. Diverse and integrated approaches including nutrition education during consultation should be implemented to address the gap.

Seroprevalence of hepatitis B virus surface antigen (HBsAg) among clients visiting 'Tefera Hailu' memorial hospital, Sekota, Northern Ethiopia.

BACKGROUND: Hepatitis B virus is one of the most causative agents of human liver disease, including acute and chronic hepatitis, cirrhosis and hepatocellular carcinoma. The disease is a great health problem worldwide, with estimated of 350 million chronically infected people. OBJECTIVE: The aim of this study was to determine the prevalence of hepatitis B virus in Tefera Hailu Memorial Hospital (THMH) for the last three years (2013, 2014, 2015) by using secondary data. METHOD: A three year retrospective record review was conducted from March 01/2015-July 30/2015. All registered data for hepatitis B virus serological screening of the specified period were included. The data were collected by predesigned data collection sheet. The sample size was calculated by simple statistical estimation to be 149 for each year. RESULT: Of 482 subjects, 215 (44.60 %) were females and 267 (55.40 %) were males. The overall prevalence of HBV was 102 (21.16 %). The positivity rate was 69 (14.31 %) in the age group between 15 and 45. There was a decrease in the prevalence of HBV from 2012 up to 2014. CONCLUSION: The seroprevalence of HBsAg was higher in males than in females and the yearly prevalence decreases from 2012-2014. But HBV infection is still a public health problem in Ethiopia. Therefore intensification of health education concerning modes of transmission and prevention of HBV, early case finding and treatment is recommended to reduce the spread of the disease.