Dietary Diversity and Associated Factors among Children 6-23 Months Old in Ethiopia: Systematic Review and Meta-Analysis.

BACKGROUND: Feeding diversified food for children is the major indicator of nutritional quality and adequacy that is crucial during the complementary feeding period for infants and young children aged 6-23 months. Ensuring diversified food is highly essential for the normal growth and development of the infant and young children. In Ethiopia, malnutrition and food insecurity remain prevalent, underscoring the need to understand and improve dietary diversity among children. The primary objective of this review was to determine the pooled prevalence of dietary diversity and its associated factors among children aged 6-23 months in Ethiopia. METHODS: We thoroughly searched some electronic databases, including Pub Med, Africa Index Medicus, Science Direct, Hinari, and Google Scholar, to perform a meta-analysis. Excel was used to extract and combine the data, while Stata 17 was used for statistical analysis. To estimate pooled prevalence rates and related associated factors, we used a random-effect model and the Der Simonian-Laird technique. The I2-test was utilized to examine heterogeneity, and funnel plots, in conjunction with Egger's and Begg's tests, were employed to investigate publication bias. RESULT: This review analyzed 42 full-text studies, finding a pooled prevalence of 26.78% (95% confidence interval (CI): 23.35-30.21) with significant heterogeneity (I2 = 98.95%). Maternal education levels-college & above Adjusted Odds Ratio (AOR: 5.377, 95% CI: 3.116-9.279), secondary and above (AOR: 3.324, 95% CI: 1.939-5.700), primary (AOR: 3.065, 95% CI: 2.275-3.129), and formal education (AOR: 2.484, 95% CI: 1.722-3.583)-showed higher odds than counterparts. Similarly, fathers' education-secondary and above (AOR: 2.837, 95% CI: 1.981-4.065) and primary (AOR: 2.082, 95% CI: 1.016-4.266)-and father's occupation as merchant (AOR: 2.739, 95% CI: 1.355-5.539), and mother's occupation as housewife (AOR: 3.636, 95% CI: 2.457-5.381) showed higher odds. Additionally, male child sex (AOR: 1.877, 95% CI: 1.185-2.972), child age 18-23 months (AOR: 2.470, 95% CI: 1.568-3.987), and 12-17 months (AOR: 2.460, 95% CI: 1.914-3.163) indicated higher odds than counterparts. Having Postnatal Care (PNC) follow-up, counseling on infant and young child feeding (IYCF) practices, and no history of child illness were associated with higher odds (AOR: 3.155, 95% CI: 2.104-4.732), (AOR: 2.960, 95% CI: 2.288-3.829), and (AOR: 2.420, 95% CI: 1.765-3.318), respectively. Maternal knowledge of dietary diversity, urban residency, Antenatal Care (ANC) follow-up, child growth monitoring, and media exposure also showed higher odds. Similarly, maternal age groups 25-34 years and 35-44 years had higher odds compared to those aged 15-24 years. Other factors associated with higher odds included home grading, food security, institutional delivery, availability of cow milk, and household wealth index. CONCLUSION: Among Ethiopian children aged 6-23 months, the prevalence of recommended dietary diversity feeding practices was remarkably low, with only about 25% meeting the minimum recommended diversified food. The scientific predictors factor affecting dietary diversity included maternal media exposure, place of delivery, food security, urban residency, availability of cow milk, child growth monitoring, age, and knowledge of IYCF practices; paternal factors like education and occupation; child-related variables like age, sex, and history of illness; and history of ANC and PNC.

Magnitude and associated factors of postoperative mortality among patients who underwent surgery in Ethiopia: systematic review and meta-analysis.

Background: Postoperative mortality is one of the six surgical indicators identified by the Lancet Commission on Global Surgery for monitoring access to high-quality surgical care. This study aimed to assess the magnitude and associated factors of postoperative mortality among patients who underwent surgery in Ethiopia. Methods: This systematic review and meta-analysis were conducted based on the Preferred Reporting Items for Systematic Review and Meta-analysis guidelines. Ten studies were included in this Systematic review and meta-analysis. The risk of bias for each study was assessed using the Joanna Briggs Institute quality appraisal scale. Publication bias was checked using a funnel plot and Egger's regression test. Heterogeneity across studies was assessed by I2 statistics. STATA version 17 software was used for analysis. A random effect model and the DerSimonian-Laird method of estimation was used to estimate the pooled magnitude of postoperative mortality. Odds ratios with 95% CIs were calculated to determine the associations of the identified factors with postoperative mortality. Results: The results revealed that the pooled magnitude of postoperative mortality among patients who underwent surgery in Ethiopia was 4.53% (95% CI :3.70-5.37). An American Society of Anesthesiologists score greater than or equal to III [adjusted odds ratio (AOR): 2.45, 95% CI: 2.02, 2.96], age older than or equal to 65 years (AOR: 3.03, 95% CI: 2.78, 3.31), and comorbidity (AOR: 3.28, 95% CI: 1.91, 5.63) were significantly associated with postoperative mortality. Conclusion and recommendations: The pooled magnitude of postoperative mortality among patients who underwent surgery in Ethiopia was high. The presence of comorbidities, age older than 65 years, and ASA physical status greater than III were significantly associated with postoperative mortality. Therefore, the Ministry of Health and other concerned bodies should consider quality improvement processes.

Clinical Pattern and Outcome of Burn Injury in Children in AaBet Trauma Center Addis Ababa Ethiopia: Prospective Study.

Introduction: Burn injuries are among the most prevalent health conditions worldwide that happen mainly in children, military, and victims of fire accidents. The previous literature had general limitations in that it focused on the retrospective study design, which can be prone to incomplete data or lack the full evidence of the problem, however, this study is a prospective study that gives a clue to the possible determinant factors of burn injury in pediatrics. Objectives: The purpose of this study was to assess the clinical pattern and outcome of burn injury in children at the AaBet trauma center in Addis Ababa, Ethiopia, between July 2016 and July 2020. Methods: An institutional-based prospective study was conducted in an AaBet trauma center. The study participants were chosen using a systematic random sampling method and followed for 4 years to determine their clinical outcomes after burn injury. A pretested observational check list was used to collect the data. The collected data were coded, entered Epi-data version 4.6, and exported to SPSS version 26 for descriptive and inferential analysis. A binary logistic regression model was used to identify factors associated with burn injury on the adjusted odd ratio with a 95% confidence interval at a p-value of < .05. Results: A total of 256 patients were recruited for this study. Scald burns accounted for 50.8% of the injury mechanisms, with 93.8% of the incidents occurring in private residences. Second-degree burns were the most common presentation of the victims (83%). Lower limbs were the most frequently burned body part (47%). Over 70% of the victims had 20% of their body surface area burned. Intentional burns accounted for 1.2% of all burn victims. The length of the hospital stay ranged from 1 day to 164 days with a mean stay of 24.73 days. Eight patients (3.1%) died during the study period. Conclusion and recommendation: Pediatric burn incidences showed no significant discrepancies between males and females. Scald and open flame are the common causes of burn injury. Most incidents occurred in indoor settings, and most of the victims had not received first aid at home. Most patients left the hospital with no or minimal complications. Only 3.1% of the patients died. Patients who had burn-associated injuries were 98.8% less likely to be alive than those who had no associated injuries at all. For all governmental and non-governmental bodies, it is highly recommended to give priority to preventive measures and education on the need for appropriate prehospital care.