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Background: Menstrual hygiene is vital to the health, well-being, dignity and productivity of women and girls. However, there is a problem on menstrual hygiene management especially among communities in which discussing about menstrual hygiene is taboo in their culture. Objective: The study was aimed to assess menstrual hygiene management practice and associated factors among secondary school girls in Finot Selam town, Ethiopia 2019. Method: A cross-sectional study was conducted among randomly selected school girls in Finot Selam town from March 20 to 30, 2019. Descriptive summary was done as a mean, frequency and proportion. In bivariate analysis variables with a p-value

Background Sharps injuries are a serious public health problem that healthcare providers face and constitute a major risk for the transmission of blood-borne infections. Prevention of sharps injuries in hospitals requires that healthcare providers comply with universal precautions. Objectives The aim of this study was to assess and improve the compliance of healthcare providers with protocols based on best available evidence for prevention of sharps injuries in medical, surgical and pediatric wards of the hospital. Methods A three-phase clinical audit was carried out using the online JBI Practical Application of Clinical Evidence System and Getting Research into Practice Program. Six audit criteria based on available evidence were used. Phase 1 of the project was the baseline audit, phase 2 the implementation of the best practice, and phase 3 the follow-up audit. Data were collected through observation, interview and resource inventory. Results The postintervention compliance report showed maximum improvement in compliance in criterion 1 (sharps containers are not filled above the mark that indicates the bin is full) and criterion 2 (sharps containers are positioned out of the reach of children at a height that enables safe disposal by staff). Between the baseline and postintervention audits, the compliance rate for these criteria improved by more than half (criterion 1) and by nine-fold (criterion 2) (from 38 to 100% and 0 to 93%, respectively). During baseline, two nurses reported experiencing sharps injuries, noting that they think it is not important to report the injury if the patient is negative for HIV, and when they do not know where to report it, regardless. At the postintervention audit no injuries were reported. Conclusion The best practice recommendations using a clinical audit process was an effective intervention for improving knowledge and compliance of healthcare workers with protocols for the prevention of sharps injuries in low-resource settings.

Background Cervical cancer is the second most common gynecologic cancer affecting the lives of women. It causes hundreds of thousands of death among women annually worldwide. When a woman is screened for cervical cancer at least once in her life between the ages of 30 and 40, the risk of getting cervical cancer can be decreased by 25–36%. Despite this advantage, the coverage of cervical cancer screening is limited in low and middle-income countries including Ethiopia. Objective To assess cervical cancer screening service utilization and associated factors among age-eligible women in Jimma town, South West Ethiopia, 2017. Methods Community based cross-sectional study was used. Seven hundred thirty-seven women were selected using systematic random sampling. Data were collected using a structured interview administered questionnaire. Data were collected on socio-demographic, reproductive factors, knowledge of cervical cancer as well as constructs of Health belief model and practice related variables. Logistic regression analysis was performed, and variables with a p-value of less than 0.05 in the multivariable analysis were taken as statistically significant predictors of cervical cancer screening service utilization. Results Of the 737 women, only 15.5% were screened for cervical cancer. The independent predictors of cervical cancer screening utilization were: being government employee [AOR = 3.00, 95% CI: 1.49–6.01], knowing someone who has ever screened [AOR = 3.61, 95% CI: 2.07–6.29], having history of gynecologic examination for any reason (having previous examination that expose women genitalia for physician like examination during child birth, abortion procedure and examination for STI) [AOR =2.84, 95% CI: 1.48–5.45], not preferring gender of physician for gynecological examination [AOR = 3.57, 95% CI: 1.98–6.45], getting advice from health care providers [AOR = 4.45, 95% CI: 2.57–7.70], having good knowledge of cervical cancer screening [AOR = 3.46, 95% CI: 1.47–8.21] and having perceived susceptible for cervical cancer [AOR = 3.03, 95% CI: 1.64–5.56]. Conclusions The utilization of cervical cancer screening services was low in Jimma town. Strengthening the screening service is important through raising the awareness of the community towards cervical cancer and screening services.

Background. A preterm birth is the leading cause of death in both neonatal and children under five years of age every year throughout the world, particularly in Sub-Saharan Africa. The causes of a preterm birth are complex and multifactorial; many risk factors that contribute it are not fully understood. The aim of this study was to identify predictors of a preterm birth among mothers who gave birth in Silte Zone Public Hospitals, Southern Ethiopia (2019/20). Methods and Materials. A hospital-based unmatched case-control study design was carried out from July 15th to October 30th, 2019, by assigning mothers who gave preterm births as cases and those with term births as controls. A total of 365 respondents (91 cases and 274 controls) were selected by a consecutive simple random sampling until the required sample size was achieved. For each case, three consecutive controls were included. Data were collected using a structured interview questionnaire complement with record reviewing. The data were entered into Epi Info 7 and exported into SPSS 25 for analysis. Descriptive analysis was computed to obtain summary values for cases and controls separately. All candidate variables in bivariate analysis were entered into the multivariable logistic regression model by using the backward likelihood ratio selection methods. Finally, variables with p value ≤ 0.05 were considered as potential determinants of a preterm birth and reported in the form of adjusted odds ratio with 95% confidence interval. Results. Among a total of 365 mothers who gave live birth, 91 (24.9%) were cases compared to 274 (75.1%) which were controls. The final multivariable logistic regression analysis results showed that having history of a previous preterm birth ( AOR = 3.51 ; 95 % CI = 1.40 − 8.81 ), having shorter interpregnancy interval ( AOR = 4.46 ; 95 % CI = 1.95 − 10.21 ), experiencing obstetric complication ( AOR = 3.82 ; 95 % CI = 1.62 − 9.00 ), and having infant born with low birth weight ( AOR = 5.58 ; 95 % CI = 2.39 − 13.03 ) were found to be independent predictors of a preterm birth. Conclusions. According to this finding, mothers having previous history of a preterm birth, experiencing obstetric complication, having shorter interpregnancy interval, and having infant born with low birth weight were reported as the independent predictors of a preterm birth. Improving the quality of antepartum and intrapartum, counseling on birth space, creating awareness on family planning, and early screening of preterm determinants are mandatory.

Background Pneumonia is the leading cause of mortality and morbidity in under-five children. Regardless of this fact, efforts to identify determinants of pneumonia have been limited in the study area. The aim of this study was to identify determinants of community-acquired pneumonia among 2–59 months of age children in Northeast Ethiopia. Methods Facility-based unmatched case-control study was conducted from February to April, 2019 among 444 (148 cases and 296 controls) 2–59 months of age children in Northeast Ethiopia. Cases were children with pneumonia, while controls were non-pneumonia children. Data were collected using a structured and pre-tested questionnaire by integrated management of neonatal and childhood illness trained nurses. The data were entered into Epi Data and then transferred to SPSS version 23 for analysis. Binary logistic regression analysis was used to test associations between the independent and the dependent variables. Variables with P-value ≤ 0.05 in the multivariable logistic regression model were declared as significant variables. Results Children having older age mother (AOR = 0.03, 95% CI; 0.01,0.14), having mothers who are housewife (AOR = 0.19, 95% CI; 0.07,0.54), not having separate kitchen (AOR = 5.37; 95% CI: 1.65,17.43), having a history of diarrhea in the last 2 weeks (AOR = 10.2; 95% CI: 5.13, 20.18), having a history of acute lower respiratory infection in the last 2 weeks (AOR = 8.3, 95% CI: 3.32, 20.55) and having a history of parental asthma in the family (AOR = 4.9, 95% CI: 2.42, 10.18) were found to be determinants of community-acquired pneumonia. Conclusions Children having older age mother, having mothers who are housewife, not having separate kitchen, having a history of diarrhea in the last 2 weeks, having a history of acute lower respiratory infection in the last 2 weeks and having a history of parental asthma in the family were found to be determinants of community-acquired pneumonia. Therefore, all health institutions should promote early treatments and prevention of diarrhea and acute lower respiratory infections of under-five children at the health facility and household level.

Additional file 1. Questionaire (English Version).docx.

BACKGROUND: Both impaired and accelerated postnatal growth have been associated with adult risks of obesity and cardiometabolic diseases, like type 2 diabetes and cardiovascular disease. However, the timing of the onset of cardiometabolic changes and the specific growth trajectories linking early growth with later disease risks are not well understood.OBJECTIVES: The aim of this study was to identify distinct trajectories of BMI growth from 0 to 5 y and examine their associations with body composition and markers of cardiometabolic risk at age 5 y.METHODS: In a prospective birth cohort study of 453 healthy and term Ethiopian children with BMIs assessed a median of 9 times during follow-up, we identified subgroups of distinct BMI trajectories in early childhood using latent class trajectory modeling. Associations of the identified growth trajectories with cardiometabolic markers and body composition at 5 y were analyzed using multiple linear regression analyses in 4 adjustment models for each outcome.RESULTS: We identified 4 heterogeneous BMI growth trajectories: stable low BMI (19.2%), normal BMI (48.8%), rapid catch-up to high BMI (17.9%), and slow catch-up to high BMI (14.1%). Compared with the normal BMI trajectory, children in the rapid catch-up to high BMI trajectory had higher triglycerides (TGs) (range of β-coefficients in Models 1-4: 19-21%), C-peptides (23-25%), fat masses (0.48-0.60 kg), and fat-free masses (0.50-0.77 kg) across the 4 adjustment models. Children in the stable low BMI trajectory had lower LDL cholesterol concentrations (0.14-0.17 mmol/L), HDL cholesterol concentrations (0.05-0.09 mmol/L), fat masses (0.60-0.64 kg), and fat-free masses (0.35-0.49 kg), but higher TGs (11-13%).CONCLUSIONS: The development of obesity and cardiometabolic risks may be established already in early childhood; thus, our data provide a further basis for timely interventions targeted at young children from low-income countries with unfavorable growth patterns. The birth cohort was registered at ISRCTN as ISRCTN46718296.

Early nutrition and growth have been found to be important early exposures for later development. Studies of crude growth in terms of weight and length/height, however, cannot elucidate how body composition (BC) might mediate associations between nutrition and later development. In this study, we aimed to examine the relation between fat mass (FM) or fat-free mass (FFM) tissues at birth and their accretion during early infancy, and later developmental progression. In a birth cohort from Ethiopia, 455 children who have BC measurement at birth and 416 who have standardised rate of BC growth during infancy were followed up for outcome variable, and were included in the statistical analysis. The study sample was restricted to mothers living in Jimma town who gave birth to a term baby with a birth weight ≥1500 g and no evident congenital anomalies. The relationship between the exposure and outcome variables was examined using linear-mixed regression model. The finding revealed that FFM at birth was positively associated with global developmental progression from 1 to 5 years (β=1·75; 95 % CI 0·11, 3·39) and from 4 to 5 years (β=1·34; 95 % CI 0·23, 2·44) in the adjusted model. Furthermore, the rate of postnatal FFM tissue accretion was positively associated with development at 1 year of age (β=0·50; 95 % CI 0·01, 0·99). Neither fetal nor postnatal FM showed a significant association. In conclusion, fetal, rather than postnatal, FFM tissue accretion was associated with developmental progression. Intervention studies are needed to assess whether nutrition interventions increasing FFM also increase cognitive development.

Background Accelerated growth in early childhood is an established risk factor for later obesity and cardiometabolic disease, but the relative importance of fat mass (FM) and fat-free mass (FFM) accretion is not well understood. We aimed to study how FM and FFM at birth and their accretion during infancy were associated with body composition and cardiometabolic risk markers at 5 years. Methods and findings Healthy children born at term were enrolled in the Infant Anthropometry and Body Composition (iABC) birth cohort between December 2008 and October 2012 at Jimma University Specialized Hospital in the city of Jimma, Ethiopia. FM and FFM were assessed using air displacement plethysmography a median of 6 times between birth and 6 months of age. In 507 children, we estimated individual FM and FFM at birth and their accretion over 0–3 and 3–6 months of age using linear-spline mixed-effects modelling. We analysed associations of FM and FFM at birth and their accretion in infancy with height, waist circumference, FM, FFM, and cardiometabolic risk markers at 5 years using multiple linear regression analysis. A total of 340 children were studied at the 5-year follow-up (mean age: 60.0 months; girls: 50.3%; mean wealth index: 45.5 out of 100; breastfeeding status at 4.5 to 6 months post-partum: 12.5% exclusive, 21.4% almost exclusive, 60.6% predominant, 5.5% partial/none). Higher FM accretion in infancy was associated with higher FM and waist circumference at 5 years. For instance, 100-g/month higher FM accretion in the periods 0–3 and 3–6 months was associated with 339 g (95% CI: 243–435 g, p < 0.001) and 367 g (95% CI: 250–484 g, p < 0.001) greater FM at 5 years, respectively. Higher FM at birth and FM accretion from 0 to 3 months were associated with higher FFM and cholesterol concentrations at 5 years. Associations for cholesterol were strongest for low-density lipoprotein (LDL)–cholesterol, and remained significant after adjusting for current FM. A 100-g higher FM at birth and 100-g/month higher FM accretion from 0 to 3 months were associated with 0.16 mmol/l (95% CI: 0.05–0.26 mmol/l, p = 0.005) and 0.06 mmol/l (95% CI: 0.01–0.12 mmol/l, p = 0.016) higher LDL-cholesterol at 5 years, respectively. Higher FFM at birth and FFM accretion in infancy were associated with higher FM, FFM, waist circumference, and height at 5 years. For instance, 100-g/month higher FFM accretion in the periods 0–3 and 3–6 months was associated with 1,002 g (95% CI: 815–1,189 g, p < 0.001) and 624 g (95% CI: 419–829 g, p < 0.001) greater FFM at 5 years, respectively. We found no associations of FM and FFM growth with any of the other studied cardiometabolic markers including glucose, HbA1c, insulin, C-peptide, HOMA-IR, triglycerides, and blood pressure. Non-attendance at the 5-year follow-up visit was the main limitation of this study, which may have introduced selection bias and limited the power of the regression analyses. Conclusions FM accretion in early life was positively associated with markers of adiposity and lipid metabolism, but not with blood pressure and cardiometabolic markers related to glucose homeostasis. FFM accretion was primarily related to linear growth and FFM at 5 years., Rasmus Wibaek and colleagues reveal associations between fat mass and fat free mass in the first 6 months of life and cardiometabolic markers and growth later in childhood., Author summary Why was this study done? Suboptimal growth in fetal life and early childhood are important risk factors for later obesity, diabetes, and heart disease. Progression towards disease may start early in life, demonstrated by studies linking early growth with changes in fat mass, lean mass, and cardiometabolic risk markers in children as young as 4 years of age. In populations from low-income countries, currently experiencing a rapidly growing chronic disease burden, knowledge about these relationships is lacking. What did the researchers do and find? We followed a cohort of healthy preschool children from the city of Jimma, Ethiopia, for 5 years starting from birth. Using advanced statistical growth modelling and accurate assessment of body composition, we estimated individual fat and lean mass accretion in the periods 0–3 and 3–6 months of age in 507 children. We conducted regression analyses to test for associations of fat and lean mass growth in early infancy with body composition and cardiometabolic risk markers measured at 5 years of age. These analyses showed that children who gained more fat mass in early infancy had greater fat mass and waist circumference and higher concentrations of risk markers related to cholesterol metabolism at 5 years. Children who gained more lean mass in early infancy were taller and had more lean mass at 5 years. Fat and lean mass growth in early infancy were not associated with blood pressure and cardiometabolic markers related to glucose homeostasis at 5 years. What do these findings mean? This study showed that early infancy is an important developmental window for a child’s later body composition. This contemporary cohort of preschool children from a sub-Saharan African urban setting had markedly higher fat mass than similar-aged children from the UK and India, which may be a result of excess fat mass accretion during the first 6 months of life. Variable patterns of fat and lean mass growth did not appear to be consistently associated with markers of cardiometabolic risk, other than markers of cholesterol metabolism at 5 years.

Introduction: The role of infant fat growth in childhood obesity and adult type 2 diabetes is not clear. We have previously used latent class analysis (LCA) to identify four distinct fat mass (FM) growth patterns in early infancy. Here we examine their associations with adiposity and cardiometabolic outcomes at 5 years (y) of age. Methods: Air Displacement Plethysmography (ADP) was used to repeatedly measure FM from 0-6 months of age in a cohort of 314 healthy urban-living Ethiopian infants and LCA was used to identify FM growth patterns (catch-up, accelerated, average and delayed) (Figure 1). At 5y of age, cardiometabolic outcomes were obtained from ADP and blood samples. Multiple linear regression was used to examine associations between infant FM growth patterns and cardiometabolic outcomes at 5y, adjusted for gender, birthweight, breastfeeding, maternal age and education and SES. Results: Overall mean (SD) BMI at 5y was 14.98 (1.19) kg/m2. Compared to children with an “average fat” growth pattern, children with a "catch-up fat" pattern had significantly higher BMI (0.79 kg/m2 [95% CI, 0.04; 1.54]) and FMI (0.69 kg/m2 [95% CI, 0.06; 1.37]), but not FFMI (0.05 kg/m2 [-0.51; 0.62]) at 5y of age (Figure 1). There were no differences in any other cardiometabolic outcomes. Conclusions: Fat catch-up growth in early infancy was associated with a higher BMI in childhood, which was almost entirely fueled by increased adipose tissue. Disclosure G.S. Andersen: Stock/Shareholder; Self; Novo Nordisk Inc. R. Wibaek: None. B. Admassu: None. D. Vistisen: Stock/Shareholder; Self; Novo Nordisk A/S. M.E. Jørgensen: Research Support; Self; Amgen Inc., AstraZeneca, Danish Diabetes Association, Sanofi-Aventis. Stock/Shareholder; Self; Novo Nordisk A/S. K.F. Michaelsen: None. J.C. Wells: None. H. Friis: Research Support; Self; Arla Food for Health. Funding Danish Council for Strategic Research; Danida (104.Dan.8-1207); Danish Diabetes Academy; Innovation Fund, Denmark

Background: Fetal and early life growth is associated with adult risk of obesity and cardiometabolic disease. However, little is known about the relative importance of birth weight and successive periods of weight gain on markers of cardiometabolic risk in childhood in low-income populations.Objectives: The objective was to study associations of birth weight and weight gain velocities in selected age intervals from birth to 60 mo with height, fat-free mass (FFM), and markers of adiposity and cardiometabolic risk at 60 mo.Methods: In a prospective cohort study of 375 Ethiopian children aged 60 mo, we estimated individual weight gain velocities in the periods between birth and 3, 6, 24, 48, and 60 mo using linear-spline mixed-effects modeling. Subsequently, we analyzed associations of birth weight, weight gain velocities, and current weight with height, FFM, and markers of adiposity and cardiometabolic risk.Results: Weight gain from 48 to 60 mo and weight at 60 mo rather than birth weight were the strongest correlates of insulin, C-peptide, HOMA-IR, blood pressure, height, FFM, waist circumference, and fat mass at 60 mo. For instance, 1 SD higher (1 SD = 50 g/mo) weight accretion from 48 to 60 mo was associated with a higher insulin of 23.3% (95% CI: 9.6%, 38.8%), C-peptide of 11.4% (2.7%, 20.8%), systolic blood pressure of 1.4 mm Hg (0.6, 2.3 mm Hg), fat mass of 0.72 kg (0.59, 0.85 kg), and FFM of 0.70 kg (0.56, 0.85 kg). Weight gain from 0 to 3 mo was positively associated with LDL cholesterol, systolic blood pressure, height, and the body composition indices, and weight gain from 24 to 48 mo was inversely associated with blood glucose.Conclusions: In 60-mo-old Ethiopian urban children, weight gain and weight after 48 mo rather than weight at birth may represent a sensitive period for variations in markers of adiposity and glucose metabolism. The birth cohort is registered at https://www.isrctn.com/ as ISRCTN46718296.

Background: Increasing legal access to abortion is associated with improvement in sexual and reproductive health. Conversely, unsafe abortion and related mortality are both highest in countries with narrow grounds for legal abortion. The objective of this study was to determine the prevalence and reasons for terminations of pregnancy at Jimma university teaching hospital. Methods: A retrospective cross sectional study was conducted at JUTH from June15-28, 2015, a total of 194 cards of women who came for abortion services from January 2012-January 2014 were included by systematic random sampling with inclusion and exclusion criteria. Chi square (x2) test calculated to analyze the statistical association between abortion types and other variables, p-value less than 0.05 was considered statistically significant. Result: According to this study, of the total calculated 194 sample size from clients admitted for both spontaneous and induced abortion 125(64.4%) were spontaneous and 69(35.6%) were induced abortion. 28(14.4%) of incomplete spontaneous abortion occurs between age of 25-years.one of the most common complication in this study was sepsis 23(11.9%). This study revealed that the main reason for induced abortion was due to rape and economic problem which holds 30(15.5%) and 16(8.2%) respectively Occupation and marital status are strongly associated with types of abortion with p-value of P

Background: Cervical cancer is one of the common causes of premature death and disability in women worldwide. It is preventable through vaccination, and screening for precancerous lesions and early treatment. However, screening service uptake and treatment for cervical cancer face significant challenges in low-income countries due to poor information systems. The aim of this study was to assess knowledge of cervical cancer and its determinants among women aged 30-49 years living in Jimma Town, Southwest Ethiopia. Methods: A community-based cross-sectional study was undertaken from March 20 to April 15, 2017. The data were collected using a structured interviewer-administered questionnaire and analyzed by SPSS version 21. Multivariable logistic regression anaysis was done and variables with a p-value < 0.05 were considered statistically significant. Results: Of the interviewed women, only 321(43.6%) had adequate knowledge about cervical cancer and screening. Attending secondary school or above (AOR = 2.42, 95% CI: 1.24-4.74), using modern contraceptives (AOR = 6.31, 95% CI: 2.86-13.89), knowing somebody with cervical cancer (AOR = 2.24, 95% CI: 1.35-3.71) and knowing someone screened for cervical cancer (AOR = 2.23, 95% CI: 1.30-3.80) were associated with knowledge of cervical cancer. Conclusion: Knowledge of cervical cancer is low in the current study area even if appropriate knowledge regarding the disease is important in decreasing the incidence and prevalence of cervical cancer through screening and human pappiloma virus vaccination. Increasing awereness regarding the disease and prevention strategies are the key issue.

Background/Objectives Low and high birth weight and rapid weight gain during infancy are associated with childhood obesity. Associations of birth and infancy body composition (BC) growth with childhood BC remain unknown in low-income countries. We aimed to investigate the associations of fat mass (FM) and fat-free mass (FFM) at birth and its accretion during early infancy with FM and FFM at the age of 4 years. Methods In the infant Anthropometry and Body Composition (iABC) cohort, BC was assessed at six consecutive time points from birth to 6 months and at 4 years of age by air displacement plethysmography. Multiple linear regression models were used to determine the association between FM and FFM at birth and their accretion rates during infancy and FM index (FMI) and FFM index (FFMI) at 4 years in 314 children. Results One kilogram higher FFM at birth was associated with a 1.07 kg/m2 higher FFMI (95% CI 0.60, 1.55) at 4 years while a one SD increment in FFM accretion rate from 0 to 6 months was associated with a 0.24 kg/m2 increment in FFMI (95% CI 0.11, 0.36) and with a 0.20 kg/m2 higher FMI at 4 years (β = 0.20; 95% CI 0.04, 0.37). FFM at birth did not predict FMI at 4 years. FM at birth was associated with 1.17 kg/m2 higher FMI at 4 years (95% CI 0.13, 2.22) whereas FM accretion from 0 to 4 months was associated with an increase in FMI of 0.30 kg/m2 (95% CI 0.12, 0.47). FM at birth did not predict FFMI at 4 years, and neither did FM accretion from 0 to 4 months. Conclusions A higher FFM in early infancy predicted higher FFMI at 4 years while a higher FM accretion during early infancy predicted higher FMI at 4 years. Follow-up studies are merited to explore associations of childhood BC with cardio-metabolic risk later in life.

ObjectiveTo examine the relationship between body composition—specifically fat mass (FM) and fat-free mass (FFM)—in early infancy, and mental health outcomes in early childhood.Study designIn the Infant Anthropometry and Body Composition birth cohort study from Ethiopia, body composition was measured at birth and 1.5, 2.5, 3.5, 4.5, and 6 months of age. Mental health was assessed at 5 years of age using the approved Amharic version of the Strengths and Difficulties Questionnaire (SDQ), a parent report scale covering 4 different domains providing a total difficulties score. The associations of FM or FFM at birth as well as during early infancy, with SDQ score at 5 years of age were examined using multiple linear regression analyses.ResultsAt 5 years of age, the mean ± SD for SDQ score was 10.4 ± 5.8. FM at birth was positively and FFM negatively associated with SDQ score. For each kg increase in FM at birth, the SDQ score at 5 years was 5.7 points higher (β = 5.7; 95% CI, 1.4-10.0). In contrast, for each kilogram increase in FFM at birth, the SDQ score was 3.9 points lower (β = -3.9; 95% CI, -7.0 to -0.8). Neither FM nor FFM accretion rate during early infancy were associated with SDQ score at 5 years of age.ConclusionsFetal rather than infant body composition was associated with SDQ score at 5 years of age. Greater FFM accretion during fetal life may have contributed to more optimal neurobehavioral development during early life. However, the potential mechanisms underlying the observed associations need further investigation.

The objective of this study was to identify subgroups with distinct fat and fat-free growth patterns in the first 6 months of life and describe predictors of these different patterns.A total of 510 apparently healthy Ethiopian infants were followed from birth to 6 months of age. Each infant had at least three and up to six repeated measurements of fat and fat-free mass using air-displacement plethysmography. Latent class trajectory analyses were used to categorize infants in groups with distinct body composition patterns.Four distinct fat mass and two fat-free mass growth patterns were identified. Of the infants measured, 5% presented a delayed fat growth pattern and 3% presented a catch-up fat growth pattern involving low birth weight but a significant fat growth velocity from 2.5 to 6 months. A large class had a high fat level at birth and an accelerated fat growth pattern in early infancy. Fat-free growth was represented by two distinct classes with less variability. Catch-up growth was primarily seen in fat mass.We identified distinct patterns of delayed, catch-up, and accelerated fat growth in early infancy. This variability is not detected in regular anthropometric assessment and could be a mechanism linking early growth with later obesity and cardiometabolic risk.

Background: A midupper arm circumference (MUAC)

Objective. To assess the timing of first antenatal care attendance and associated factors among pregnant women in Arba Minch Town and Arba Minch District, south Ethiopia.Method. Facility based cross-sectional study employing both quantitative and qualitative methods was conducted from February to March, 2014, in Arba Minch Town and Arba Minch District. Data were collected from 409 pregnant women attending antenatal care clinics in nine public health facilities using systematic random sampling. Analysis was done using SPSS version 20. Descriptive statistics and binary and multiple logistic regression analysis were done.Results. The mean (SD±) age of the respondents was 26 ± 5.5 years. The mean gestational age at first antenatal care attendance was 5 ± 1.5 months. This study indicated that pregnant women with low monthly income (AOR = 4.9, CI: 1.71, 14.08), women who did not receive advise on when to start ANC (AOR = 3, CI: 1.48, 6.24), women with household food insecurity (AOR = 4.66, CI: 1.007, 21.59) and women with unplanned pregnancy (AOR = 4.49, CI: 2.16, 9.35) had higher odds of late antenatal care attendance compared with their counterparts.Conclusions. The study showed that majority of the pregnant women attended late for first antenatal care. Hence, providing health education on the timing of antenatal care is important.

BACKGROUND/OBJECTIVES: Birth weight (BW), independent of socioeconomic status, has been identified as a predictor for childhood cognitive development. However, it is not known whether this relation is related to low BW per se or particularly related to a deficit in fat mass (FM) or fat-free mass (FFM) at birth. This study therefore aimed at investigating the relation between body composition at birth and child development at 2 years of age.SUBJECTS/METHODS: An Ethiopian birth cohort was followed up at 2 years. Body composition was measured within 48 h of birth using infant air-displacement plethysmography. Child development was assessed at 2 years of age using Denver developmental screening test. Associations between body composition at birth and development at 2 years of age were tested using linear regression analysis.RESULTS: FFM but not FM at birth was positively associated with higher global developmental score at 2 years of age (β=2.48, 95% confidence interval (CI) 0.17; 4.79) adjusted for neonatal, postnatal and parental characteristics. This association was attributable to the association with the language developmental domain (β=1.61, 95 CI 0.33; 2.90).CONCLUSIONS: Among Ethiopian children, FFM at birth but not FM predicted better global and language development at 2 years of age. Higher FFM at birth might have exerted a positive effect on the growth and differentiation of the brain and neuronal circuits for better development. This study therefore highlights the need to improve mother's nutritional status during pregnancy in ways that stimulate fetal FFM growth.European Journal of Clinical Nutrition advance online publication, 27 September 2017; doi:10.1038/ejcn.2017.129.

Background We have previously shown that fat-free mass (FFM) at birth is associated with height at 2 y of age in Ethiopian children. However, to our knowledge, the relation between changes in body composition during early infancy and later linear growth has not been studied. Objective This study examined the associations of early infancy fat mass (FM) and FFM accretion with linear growth from 1 to 5 y of age in Ethiopian children. Methods In the infant Anthropometry and Body Composition (iABC) study, a prospective cohort study was carried out in children in Jimma, Ethiopia, followed from birth to 5 y of age. FM and FFM were measured ≤6 times from birth to 6 mo by using air-displacement plethysmography. Linear mixed-effects models were used to identify associations between standardized FM and FFM accretion rates during early infancy and linear growth from 1 to 5 y of age. Standardized accretion rates were obtained by dividing FM and FFM accretion by their respective SD. Results FFM accretion from 0 to 6 mo of age was positively associated with length at 1 y (β = 0.64; 95% CI: 0.19, 1.09; P = 0.005) and linear growth from 1 to 5 y (β = 0.63; 95% CI: 0.19, 1.07; P = 0.005). The strongest association with FFM accretion was observed at 1 y. The association with linear growth from 1 to 5 y was mainly engendered by the 1-y association. FM accretion from 0 to 4 mo was positively associated with linear growth from 1 to 5 y (β = 0.45; 95% CI: 0.02, 0.88; P = 0.038) in the fully adjusted model. Conclusions In Ethiopian children, FFM accretion was associated with linear growth at 1 y and no clear additional longitudinal effect from 1 to 5 y was observed. FM accretion showed a weak association from 1 to 5 y. This trial was registered at www.controlled-trials.com as ISRCTN46718296.

BACKGROUNDLow birth weight is associated with childhood stunting, but equivalent associations for birth body composition (BC) remain unknown. The aim of this study was to assess associations between birth BC and height-for-age z-score (HAZ) at 2 years of age.METHODSIn a prospective cohort study, fat mass (FM) and fat-free mass (FFM) were measured using air-displacement plethysmography within 48 h of birth. Linear regression models were applied to study the relationship between BC at birth and HAZ at 24 ±3 months.RESULTSA total of 268 children with height assessment at 2 years were included. Mean±SD HAZ at 2 years of age was -1.2±1.2, with 25.8% classified as stunted (HAZ-2SD). FFM at birth was positively associated with HAZ at 2 years, independent of length at birth. When adjusted for potential confounders, HAZ at 2 years was 0.73 higher for each additional kg FFM at birth (β=0.73, 95% CI: 0.08, 1.38). FM was not associated with HAZ at 2 years in any model.CONCLUSIONThe FFM component of birth weight, independent of length at birth, explained variability in HAZ at 2 years. Further studies are required to explore how changes in early infant BC are associated with linear growth.

Despite increased emphasis on antiretroviral therapy for HIV infected individuals, issues of fertility and childbearing have received relatively little attention in Ethiopia. This study was conducted to assess socio-demographic, reproductive and HIV related characteristics of fertility intention among women living with HIV in Western Ethiopia. Cross sectional study was conducted from May I to May 26, 2012 using structured questionnaire on a sample of 456 women living with HIV who are on follow up care in anti-retroviral therapy clinics. Bivariate and multivariable logistic regression models were fitted to identify significant predictors of fertility desire at 95 CL. Out of 456 respondents 42.1% expressed intention to have children in the future. Educational attainment [AOR (95% CI) = 0.041(0.008-0.220)], partner fertility desire [AOR (95% CI) = 0.012 (0.004-0.034)], number of live children [AOR (95% CI) = 0.344 (0.125-0.950)] and partner sero-status [AOR (95% CI) = 6.578 (4.072-10.881)] were significantly associated with fertility intention. A large proportion of HIV-positive women in the study desired more children in future. Interventions to address this problem include integrated access to contraception methods, and counselling on reproductive health decision-making.

Review Objectives : The overall objective of this systematic review is to critically appraise, synthesize and present the best available evidence on gender-based determinants of help seeking and treatment seeking behavior of TB patients. More specifically, the objective of this review is: To provide summarized evidence on: • Determinants of Health seeking behavior of male and female adult (18+ years old) TB patients • Perceived causes of tuberculosis among male and female patients • Whether gender differences exist in tuberculosis diagnosis, treatment seeking and perceived causes of TB • To make recommendations to improve utilization of health services by patients with tuberculosis of both sexes. This review will be conducted to ensure the most appropriate research designs and best quality research reports are identified to address the research objectives. Inclusion Criteria: Types of participants: The populations of interests in this review are male and female tuberculosis adult patients in both developed and developing countries. Tuberculosis patients are those that are diagnosed using a sputum smear positive for TB. Specifically, the review will consider studies where the population of interest are male and female tuberculosis patients aged 18 years and above living in either developing or developed countries. Types of Interventions/Phenomenon of interest: The phenomenon of interest is determinant of help seeking and treatment seeking behavior of TB patient‟s potential gender difference. Types of outcome measures: This review will include studies that examine potential gender differences in health and treatment seeking behaviors by TB patients. The main outcome measures include: patterns of distress, perceived causes of TB, delays in diagnosis and treatment adherence. Primary outcomes o Proportion of women and men who have appropriate health seeking behavior in TB o Proportion of women and men who have closely related perceptions on scientific causes of TB o Proportion of women and men who consider stigma related to TB o Proportion of women and men who seek delayed diagnosis to TB o Proportion of women and men who report various patterns of distress related to TB occurrence Secondary outcomes • Tuberculosis related complications • Tuberculosis related morbidity and mortality • Tuberculosis related treatment completion • Tuberculosis related defaulter rate

Background Intimate partner violence during pregnancy is the most common form of violence that harms the health of women and the fetus but practiced commonly in developing countries. There is scarcity of information regarding intimate partner violence during pregnancy in Ethiopia. Thus, this study aimed to assess the prevalence and associated factors of intimate partner violence during recent pregnancy in Abay Chomen district, Western Ethiopia. Methods Community based cross sectional study was conducted among married pregnant women in Abay Chomen district in April, 2014 using a standard WHO multi-country study questionnaire. Two hundred eighty two randomly selected pregnant women aged 15–49 years participated in the study. Logistic regression and multivariate analysis were employed. Results The prevalence of intimate partner violence during recent pregnancy was 44.5 % (95 % CI, 32.6, 56.4). More than half 157 (55.5 %) experienced all three forms of intimate partner violence during recent pregnancy. The joint occurrence of intimate partner physical and psychological violence during recent pregnancy as well as joint occurrence of intimate partner physical and sexual violence was 160 (56.5 %). Pregnant women who were ever lived with their partner’s family were 46 % less likely to experience recent intimate partner violence. Dowry payment decreases intimate partner violence during recent pregnancy (AOR 0.09, 95 % CI 0.04, 0.2) and pregnant women who didn’t undergo marriage ceremony during their marriage were 79 % are less likely to experience violence (AOR 0.21, 95 % CI 0.1, 0.44). Conclusion Nearly half of interviewed pregnant women experienced intimate partner violence during pregnancy implying the prevalence of such practice in the study site. To that end, increasing community awareness about the consequences of the practice could be important. Moreover, as health extension workers works closely with households, they could be crucial players to increase community awareness about intimate partner violence on pregnant mothers and halt it or its risk factors.