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Background Although food cravings, aversions, and pica behaviors are practiced globally, they are more common in African countries. No clear evidence indicated on malpractices during pregnancy. Therefore, this study aims to investigate pica, food aversion, and craving practices and their associated factors in the study area. Objectives To assess the prevalence of pica practice, food aversion, craving and its associated factors among pregnant women attending antenatal care in Nifas Silk sub-city health facilities, Addis Ababa Ethiopia, 2021 Methods An institution-based cross-sectional study was conducted among 502 pregnant mothers from July 15 to August 15, 2021. Data were enterd to EpiData version 3.1 and analyzed by SPSS version 21.The binary logistic regression model was fitted to identify factors associated with pica, food aversion and craving. Results The prevalence of pica practices,food aversion and craving were 22%,40.8% and 85% respectively. Maternal education level status [AOR, 2.95(1.14,7.62)], using family planning[AOR, 2.35 (1.34, 4.12)], Iron/folate supplementation [AOR, 2.45 (1.47,4.05)] and having pregnancy related complication[AOR, 2.45 (1.47, 4.05)] were significantly associated with pica practice. Maternal age 19–24 and 25–29 years[AOR, 0.17 (0.06,0.44)] and [AOR, 0.56 (0.34,0.89] respectively, ANC visit [AOR, 0.14(0.08, 0.34], Nutritional status[AOR, 2.25 (1.06, 4.78)], IFA supplementation [AOR, 0.20 (0.10, 0.38)], Pregnancy related complication were factors associated with food craving. Additionally, maternal income[AOR,0.44(0.24,0.81)],family planning user[AOR,3.45(2.21,5.40)], IFA supplementation[AOR, 2.47(1.59, 3.85)] were factors associated with food aversion. Conclusion Pica, food aversion and food craving during were prevalent. Maternal educational level, family planning users, iron folate supplementation and pregnancy complications were significantly influenced pica practice. Maternal age, ANC and IFA supplementation were decreases the food craving practices while maternal undernutrition increases food craving. Additionally, family planning users, IFA supplementation and income were factors associated with food aversion. Therefore, those malpractices should be decreased by working on identified factors. Increases the maternal health services during pregnancy should strengthen to alleviate these malpractices.

Rahel Dereje,1,2 Kalkidan Hassen,1 Getu Gizaw1 1Department of Nutrition and Dietetics, Institute of Health Science, Faculty of Public Health, Jimma University, Jimma, Ethiopia; 2School of Public Health, College of Medicine and Health Science, Mizan Tepi University, Mizan Aman, EthiopiaCorrespondence: Rahel Dereje Email raheldereje3@gmail.comBackground: Globally, hypertension is becoming a serious problem affecting the health and wellbeing of the adult population. Anthropometric indices like body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) have long been utilized to screen hypertension; in contrast, other evidence indicates the superior utility of waist-to-height ratio (WHtR) to screen hypertension. There are inconclusive results from different studies done in different settings regarding the best screening index for hypertension. In addition, there is a paucity of information on the evaluation of anthropometric indices for screening hypertension in the study area. Therefore, this study evaluates the utility of anthropometric indices for screening hypertension among Mizan Tepi University employees, southwestern Ethiopia.Methods: An institution-based cross-sectional study was conducted among Mizan Tepi University employees. A gender-based stratified simple random sampling technique was used to select 585 employees. Logistic regression analysis was conducted to assess the association between anthropometric indices and hypertension. Receiver operating characteristic curve (ROC) was employed to evaluate anthropometric indices for screening hypertension, and optimal cutoff points were also developed based on Youden index (sensitivity + specificity – 1) and presented with sensitivity, specificity, positive predictive value (PPV), and negative predictive values (NPV).Results: The overall prevalence of hypertension was 20.9%, which was 22.5% in males and 18.7% in females. Among males, WHtR, WHR, and BMI were significantly associated with hypertension, while, in females, only BMI was associated with hypertension. WHtR had a higher screening ability for hypertension followed by WC in both sexes. For males, the cutoff point for WHR, WC, BMI, and WHtR for screening hypertension was 0.897, 85.17cm, 24.6kg/m2, and 0.51, respectively. In females, the cutoff point developed for screening hypertension for WHR, WC, BMI, and WHtR were 0.92, 85.67cm, 24.8kg/m2, and 0.52, respectively.Conclusion: The waist-to-height ratio was found to be the best obesity index to screen hypertension than BMI, WC, and WHR. The finding supports the use of WHtR for screening hypertension in resource-limited settings.Keywords: obesity, WHtR, BMI, WHR, WC

Background Outpatient therapeutic program (OTP) brings the services for the management of Severe Acute Malnutrition (SAM) closer to the community by making services available at decentralized treatment points within the primary health care setting. Despite the available interventions to tackle nutritional problems, there is scarce information on time to recovery and its predictors. Therefore, the aim of this study was to estimate time to recovery and identify its predictors among children aged 6–59 month with SAM admitted to OTP in Bench Sheko zone Southwest Ethiopia. Methods A retrospective cohort study was conducted on 588 children who had been managed for SAM under OTP, from September 01, 2018, to August 30, 2019, in 4 public health centers in Bench Sheko zone. A total of 1301 children’s card were eligible from them 588 children’s cards were selected by simple random sampling methods. Data was entered into EPI- data version 4.4.2 and exported to SPSS version 20 for analysis. Kaplan Meir estimate median time to recovery and survival curve was used to compare the time to recovery using a log-rank test among different characteristics. Cox Proportional Hazard Model was used to identify significant predictors of time to recovery. Association was summarized by using adjusted hazard ratio (AHR) and statistical significance was declared at 95% CI, and P-value Result Recovery rate was 54.4% with the median recovery time 49 days with an Interquartile range of 21 days. The independent predictors of nutritional recovery time were: newly admitted (AHR = 1.52, 95% CI: 1.17, 2.98),had no diarrhea (AHR = 1.9, 95% CI: 1.52, 2.42), had no cough (AHR = 1.4, 95% CI: 1.13, 1.74) had no blood stool (AHR = 1.55, 95% CI: 1.14, 2.10) had no malaria (AHR = 1.75, 95% CI: 1.32, 2.32), and took deworming (AHR = 1.4, 95% CI: 1.01–1.61). Conclusion and recommendation In the current study recovery rate and the median time of recovery is by far below the standard. Cough, diarrhea, malaria, deworming and admission status were independently associated with recovery time. Health professionals should give attention for early detection and management of co-morbidities. Minster of health should give refreshment community based management of acute malnutrition training for health workers to follow the national guideline strictly.

Background: Sub-Saharan Africa shares a disproportionately large ratio of the global acute disease burden, however epidemiological data specific to the burden of emergency conditions are lacking. This study aimed to determine the morbidity burden of emergency conditions in Jimma city, Southwest Ethiopia. Methods: A cross-sectional study was conducted using emergency case registries of three years from 2014 to 2017, at Jimma Medical Center and Shenen Gibe Hospital. 39,537 emergency visits were included in the study. The data were exported to SPSS V.23.0 for statistical analysis, descriptive analysis was used to summarize demographic characteristics, causes of visit, and morbidity rates. Findings were integrated with population-based health demographic reports quantifying the morbidity burden. Outcome measures were overall number of emergency visits and morbidity rates for the population groups. Results: From a total of 39,537 visits, those between 15 and 29 years of age accounted for 42.1% (n = 16615), and 50.6% (n = 20004) were females. Communicable, Maternal, Neonatal and Nutritional (CMNNs) conditions accounted for 57.2%(n = 22597), followed by injuries (22.9%, n = 9055). Top five conditions were non-specific trauma (2.3%, n = 4861), complicated labor (8.4%, n = 3320), lower respiratory infections (8.1%, n = 3213), acute febrile illness (6.6%, n = 2600), and neonatal infections (3.7%, n = 1444). Conclusion: The burden of acute conditions presented to public hospitals in Jimma city is high. Traumatic injuries, obstetric emergencies, lower respiratory infections, and neonatal emergencies were the most frequent causes of acute visits. An appropriate emergency care system that addresses this high burden of acute emergencies should be established in the study area usc Refereed/Peer-reviewed

Robel Hussen Kabthymer,1 Getu Gizaw,2 Tefera Belachew2 1Human Nutrition Unit, School of Public Health, Dilla University, Dilla, Ethiopia; 2Department of Population and Family Health, College of Health Sciences, Jimma University, Jimma, EthiopiaCorrespondence: Robel Hussen Kabthymer Tel +251913575702Email robelhussen@rocketmail.comPurpose: Treatment at a stabilization center is an important intervention to avert the huge burden of mortality for children with complicated severe acute malnutrition (SAM). Despite the improvement in hospital coverage and the development of standardized WHO treatment guidelines, recent reviews indicated a wide range in recovery rate (34– 88%) due to several context-specific factors. This study aimed to estimate time to recovery and to determine predictors of time to recovery among children aged 6– 59 months with severe acute malnutrition.Patients and Methods: An institution-based retrospective cohort study design was used among 375 children aged 6– 59 months admitted to Jimma University Medical Center, Jimma, Ethiopia from September 2015 to September 2017. All eligible children were enrolled and assessed using a pretested questionnaire. Kaplan–Meir estimates and survival curves were used to compare the time to recovery using log rank test among different characteristics. Cox proportional hazard model was used to identify significant predictors of time to recovery. A p-value less than 0.05 was declared statistically significant.Results: The rate of recovery was 4.06 per 100 person days. Median time of recovery for our cohort of SAM children’s was 19 days (95% CI: 17.95– 20.05). Independent predictors of time to recovery were play stimulation (AHR=1.93, 95% CI: 1.23– 3.03), vaccination status (AHR=2.26, 95% CI: 1.12– 4.57), tuberculosis (AHR= 0.48, 95% CI: 0.27– 0.87), malaria (AHR=0.34,95% CI:0.13– 0.88), use of amoxicillin (AHR=1.54, 95% CI: 0.008– 2.34), deworming (AHR=1.8, 95% CI: 1.18– 2.73), and shock (AHR=0.18, 95% CI: 0.05– 0.59).Conclusion: The findings of this study showed that the average length of stay on treatment and median time for recovery are within the sphere standard. Psychosocial stimulation, appropriate provision of routine medication and management of medical co-morbidity are needed to promote fast recovery.Keywords: retrospective cohort, predictors, recovery, severe acute malnutrition, Jimma

OBJECTIVES: Both body fat and lean body mass have important roles in health and wellbeing. It is crucial that researchers and clinicians can accurately measure them, especially in nutritionally vulnerable populations such as people living in rural areas of Ethiopia. Skinfold thickness measurements are one of the few methods to measure % body fat outside of a clinical setting. The validity of the measurements is dependent upon age, sex, and ethnicity. The existing skinfold thickness equations are derived from populations of European descent. This study will demonstrate that existing equations are not valid for Ethiopian adults and create new, sex-specific equations for this population. METHODS: Skinfold thickness will be measured on 250 adults recruited from Jimma City, Ethiopia. Percent body fat will be calculated using several existing skinfold thickness equations. For women, the equations are the Sloan; Jackson, Pollock, & Ward; and Durnin and Wormsley. The equations for men are Sloan; Jackson and Pollock; and Durnin and Wormsley. The results of these equations will then be compared against % body fat measured by a BodPod. Pearson's correlation coefficient and Bland-Altman plots will be used to assess the validity of each calculation. Stepwise forward regression will be used to determine new sex-specific equations. RESULTS: In women, the Sloan equation had moderate correlation (0.59) while Jackson, Pollack, and Ward and the Durnin and Wormsley equations had near-perfect correlation (0.81 and 0.88 respectively). In men, the Sloan equation had substantial correlation (0.79) while the Jackson and Pollack and the Durnin and Wormsley had near-perfect correlation (0.89 and 0.85 respectively). Scatter and Bland Altman plots showed that all equations underestimated the % body fat measured compared to a BodPod requiring new equations. For women: body density = 1.068892 − 0.00088 x −0.0005412 y − 0.0012765 z. Where x is the skinfold thickness at the suprailiac crest, y is thigh, and x is subscapular. For men: body density = 1.08899 −0.0014585 m −0.0008318 n. Where m is abdominal skinfold thickness and n is thigh skinfold thickness. CONCLUSIONS: The current most commonly used skinfold thickness equations are not valid for use in Ethiopian adults. The equations put forth in this analysis should be used for this population. FUNDING SOURCES: H.E. Babcock Fund, NIDDK/NIH.

There are wide ranges of factors that determine individual food insecurity within households. In cash crop area products are for market rather than for agricultural households that can cause food accessibility to a severe challenge. There is, however, a dearth of information about the food security status of adolescent living inside coffee farming households. The aim of this study is to investigate the prevalence of adolescent food insecurity and determine its factors among coffee producing districts in Jimma Zone, South west Ethiopia. Community based cross-sectional study was employed in coffee producing district in Jimma zone, from April-May 2016. A total of 550 households having adolescents were included. Data were entered into EpiData and the analyses were made by SPSS version 20. Bi-variate and multivariable logistic regression was done and p-value < 0.05 considered as a cut-off point to determine statistical significance. Sixty percent of adolescents (60%) were found to be food insecure. Female adolescents [AOR=2.18, 95%CI (1.4-3.48)], household food insecurity [AOR=9.4, 95%CI (5.49-16.19)], male of household heads [AOR=2.77, 95%CI (1.44-5.33)], high dependency ratio [AOR=2.53, 95%CI (1.447-4.446)], not formally educated household head [AOR=4.925, 95%CI (2.636-9.201)] and have no own land for farm [AOR=2.484, 95%CI (1.24-4.96)] were positively independent predictors of adolescent food insecurity. This study highlighted the problem of food insecurity in coffee producing farmers. Sex of adolescent, dependency ratio, sex of household head, household heads’ educational status, food security status of household and farm land owner ship are predictors of adolescent food insecurity. This pushes us to advance direct nutrition interventions focusing on adolescents to endorse catch-up growth and break the intergenerational cycle of malnutrition. Key words: Adolescent, food insecurity, coffee farmer.

Background:Substantial evidence is emerging on the coexistence of double burden of malnutrition on adolescents of low-income countries, shaping the health challenges of the upcoming adult generation for the worst. Whether nutritional status markers of adolescents in the cash crop setting are on par with economic gains remains uncertain. Thus, we investigated the nutritional outcomes of adolescents and their determinants in coffee farming households.Methods:The survey was carried out in 3 top coffee-producing districts of Jimma Zone, Ethiopia. Five hundred fifty mothers/caregivers and their respective adolescents were selected using multistage random sampling. Anthropometric data were converted into height-for-age and body-mass-index-for-age Z scores using WHO Anthroplus software and analyzed by SPSS for windows.Results:Prevalence of thinness, stunting, and overweight/obesity were 11.6%, 15.6%, and 7.1%, respectively. The odds of stunting among adolescents in households in the lowest wealth tertile was nearly 6-fold higher compared to the highest tertile (adjusted odds ratio [AOR] = 5.6 [2.6-12]). Conversely, the odds of overweight/obesity was higher among adolescents in the households in the middle wealth tertile (AOR = 2.72 [1.08-6.86]) compared to the highest tertile. Adolescents living in households with low-dependent age-groups were more than twice likely to be overweight/obese (AOR = 2.58 [1.06-6.24]).Conclusion:The current study revealed the presence of substantial dual burden of malnutrition. In such a setting, it is critical to draw a fine line and trade-off for eliminating morbidity and mortality of undernutrition, without triggering the risk of overweight/obesity.

Appropriate complementary feeding Practice is essential in the first two years of life for satisfactory growth and development of children and for prevention of childhood illness. Insufficient quantities, frequency and inadequate quality of complementary foods have a detrimental effect on health and growth in this critical period. The aim of this study was to assess minimum dietary diversity and meal frequency practice and determinants among infant and young children age between 6 and 23 months in Shoa, Oromia Region, Ethiopia. Institution-based cross-sectional study was carried out to select 200 mothers/caregivers with 6–23 months of children reside in Sheno health center from July 25 to August 25, 2017. An interviewer-administered questionnaire was used to gather information on socio-demographic, child feeding practices and health-related characteristics. Data were entered to Epi-Data version 3.02 and transported to SPSS version 21 for further analysis. Binary logistic regression was used to see the association between the outcome variables and explanatory variables, and multivariable logistic regression was performed to identify independent predictors of minimum acceptable diet. The study revealed that the percentage of 6–23 months of children who meet the recommended level of minimum dietary diversity and meal frequency were 45 and 33%, respectively. Proportion of children who received composite indictor minimum acceptable diet was only 13.3%. Mothers/caregivers who had postnatal care visit, having good knowledge about child feeding practice, getting media exposure and mothers who had growth monitoring follow up were positively associated with minimum acceptable diet. Even though the study showed better progress as compared to the national prevalence of complementary feeding practices, child feeding practices in the study area were inadequate and not achieving national and WHO infant and young child feeding recommendations. Strengthening the available strategies and creating new intervention measures to improve maternal and child health services and giving behavioral change communication on child feeding practice using local media are compulsory actions for the government and policymakers.