4 results on '"Tadesse, Amare Worku"'
Search Results
2. Identification and Community Management of Severe Acute Malnutrition : Empirical evidence in rural Southern Ethiopia
- Author
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Tadesse, Amare Worku
- Subjects
recovery ,Medicin och hälsovetenskap ,anthropometric indicators ,children ,Severe acute malnutrition ,integrated outpatient therapeutic programme ,Ethiopia ,Medical and Health Sciences - Abstract
The current recommended standard management for all children with severe acute malnutrition (SAM) is Community-based Management of Acute Malnutrition (CMAM). CMAM has a community-based outpatient therapeutic program (OTP) to treat uncomplicated SAM and has been scaled-up and integrated with government health services in low-resource settings. How-ever, the context in which such large-scale programs are implemented modifies their effective-ness. This study aims at assessing factors of importance for the effectiveness of management of SAM in the community. A population-based survey of households with children aged under five years and a longitu-dinal study among children admitted to the integrated OTPs of rural Southern Ethiopia was undertaken. For Study I, children aged 6-59 months (n=4,297) from randomly selected house-holds were examined for differences between children identified as SAM by MUAC and WHZ. For Study II, subsets of 1,048 children admitted to OTPs were analyzed for program outcome and nutritional status at discharge (n=759) and 14 weeks after admission (n=991). For Study III, non-oedematous children (n=661) admitted to OTPs were analyzed for gains in anthropo-metric measures after 4 weeks of treatment. For Study IV, children with SAM (n=788) were studied in terms of factors of importance for their recovery. Home-visits were used to collect data and anthropometry was measured following standardized World Health Organization (WHO) techniques. The degree of agreement between the two anthropometric indicators of severe wasting dif-fered depending on the sex and age of the children. The indicators’ response to treatment varied according to the indicator used to define SAM at admission. While 32.7% achieved the program’s recovery criteria at discharge, 29.6% had SAM at discharge and 72.1% of children were acutely malnourished at the end of 14 weeks of follow-up. Despite low recovery rate, children of caregivers with the highest decision-making autonomy recovered faster from SAM than children of caregivers with lower autonomy. The poor agreement between MUAC and WHZ in diagnosing SAM within different groups of children indicates each anthropometric indicator may select different set of children for treatment. Our study provided empirical evidence that supports the current recommendation to use MUAC and WHZ independently for the management of SAM. Linking CMAM to other com-plementary programmes may improve the effectiveness of integrated large-scale nutrition programmes.
- Published
- 2018
3. Choosing Anthropometric Indicators to Monitor the Response to Treatment for Severe Acute Malnutrition in Rural Southern Ethiopia--Empirical Evidence.
- Author
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Tadesse, Amare Worku, Tadesse, Elazar, Berhane, Yemane, and Ekström, Eva-Charlotte
- Abstract
The World Health Organization (WHO) recommends the assessment of nutritional recovery using the same anthropometric indicator that was used to diagnose severe acute malnutrition (SAM) in children. However, related empirical evidence from low-income countries is lacking. Non-oedematous children (n = 661) aged 6-59 months admitted to a community-based outpatient therapeutic program for SAM in rural southern Ethiopia were studied. The response to treatment in children admitted to the program based on the mid-upper arm circumference (MUAC) measurement was defined by calculating the gains in average MUAC and weight during the first four weeks of treatment. The children showed significant anthropometric changes only when assessed with the same anthropometric indicator used to define SAM at admission. Children with the lowest MUAC at admission showed a significant gain in MUAC but not weight, and children with the lowest weight-for-height/length (WHZ) showed a significant gain in weight but not MUAC. The response to treatment was largest for children with the lowest anthropometric status at admission in either measurement. MUAC and weight gain are two independent anthropometric measures that can be used to monitor sufficient recovery in children treated for SAM. This study provides empirical evidence from a low-income country to support the recent World Health Organization recommendation. [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
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4. Hair, serum and urine chromium levels in children with cognitive defects: A systematic review and meta-analysis of case control studies.
- Author
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Islam, G.M. Rabiul, Rahman, Mohammad Meshbahur, Hasan, Mohammed Imrul, Tadesse, Amare Worku, Hamadani, Jena Derakhshani, and Hamer, Davidson H.
- Subjects
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META-analysis , *URINE , *CHROMIUM , *HAIR , *CHILD development , *COGNITIVE development - Abstract
Environmental chromium exposure may cause impaired development of children. We conducted a systematic review and meta-analysis. Electronic databases including PubMed, Embase, Web of Science and CINAHL were searched to identify case-control studies that reported childhood Cr exposure and cognitive development. The Newcastle-Ottawa Scale (NOS) was used to ensure the quality of the included studies. Cr levels were compared in cases and controls, and a random effect meta-analysis was performed using Stata version 16. Twelve of 61 studies identified in the literature search were eligible for this analysis. Hair, serum and urine Cr measurements were reported by seven, two and one studies, respectively. In addition, one study reported both serum and hair Cr exposure and another reported urine and hair Cr exposure. The pooled standard mean differences (SMD) showed that hair Cr levels were non-significantly lower among children with cognitive defects (−0.01 μg/g, 95% CI: −0.04, 00, p = 0.27). In serum and urine, the pooled SMD was higher in children with cognitive deficits compared with healthy control children (0.32 μg/g, 95% CI: −0.78, 1.42, p = 0.56 and 0.64 μg/g, CI: −0.07,1.36, p = 0.08; respectively). In summary, this systematic review found no significant differences in hair, serum and urine Cr levels between children with cognitive deficits and healthy control children when all study data were pooled in the meta-analysis. Larger studies using standardized criteria and longitudinal assessment of cognitive development are needed to determine whether there is a dose response effect of childhood Cr exposure on cognitive development of children. [Display omitted] • Aim of this study to evaluate the relationship among hair serum and urine chromium levels and child cognitive defects. • The pooled standardized mean difference (SMD) of hair Cr levels was lower in cases (N = 326) than controls (N = 486). • The pooled SMD of serum Cr levels was higher in cases (N = 123) vs. controls (N = 123). • The pooled SMD of urine Cr levels was higher in cases (N = 55) than controls (N = 45). • No consistent variation was observed for different age group and region. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
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