Showing papers by "Kalkidan Hassen Abate published in 2021"

Prevalence and outcomes of malnutrition among hospitalized COVID-19 patients: A systematic review and meta-analysis.

Abstract: Summary Background Malnutrition is inevitable in patients with Coronavirus Disease 2019 (COVID-19) due to its effect on the gastrointestinal system, immune system, and high metabolic activity. However, the prevalence of malnutrition and its outcomes is uncertain. This study aimed to investigate the prevalence and outcome of malnutrition among patients with COVID-19. Method A comprehensive search was conducted in PubMed/Medline; Science direct and LILACS from December 29, 2019 to September, 2020 without language restriction. All observational studies reporting the prevalence of malnutrition were included while case reports and reviews were excluded. The data were extracted with two independent authors with a customized format and the disagreements were resolved by the other authors. The methodological quality of included studies was evaluated using a standardized critical appraisal tool. Results A total of 511 articles were identified from different databases and 27 articles were selected for evaluation after the successive screening. Fourteen articles with 4187 participants were included. The pooled prevalence of malnutrition among hospitalized patients with COVID-19 was 49.11% (95% CI: 31.67 to 66.54). The odd of mortality among patients COVID-19 with malnutrition was 10 times more likely as compared to those who were well-nourished. Conclusion The prevalence of malnutrition and mortality associated with malnutrition among COVID-19 hospitalized patients was very high which entails a mitigating strategy by different stakeholders to prevent and manage malnutrition and its outcomes. Registration This systematic review was registered in Prospero's international prospective register of systematic reviews (CRD42020215396).

Impact of early life famine exposure on adulthood anthropometry among survivors of the 1983-1985 Ethiopian Great famine: a historical cohort study.

Abstract: Nutritional insult in early life brings adaptive changes in body structure and functioning that could remain throughout the affected individual’s life course. The long term impact of early life famine exposure on adulthood anthropometric measurements has been recorded in previous studies. However, the results were contradictory. Hence, we extend this study to examine the impact of famine exposure during early life on adulthood’s anthropometry among survivors of the 1983–85 Ethiopian great famine. A total of 1384 adult men and women survived from 1983 to 85 Ethiopian great famine were included in the study. Famine exposure status was classified into five groups: early life-exposed, prenatal-exposed, postnatal-exposed, adolescence-exposed, and non-exposed based on self-reported age and birthdate of the participants. Prenatal, post-natal, and adolescence exposed groups were considered as early life exposed. Following a standard procedure, anthropometric measurements were taken. A linear regression analysis was used to analyze the impact of famine exposure on adult anthropometric measurements adjusted for all possible covariates. The effect of famine exposure on overweight, general obesity, and abdominal obesity was examined using multinomial and binary logistic regression analysis. Compared to non-exposed groups, adult height was lower by 1.83 cm (β = − 1.83; 95% CI: − 3.05, − 0.58), 1.35 cm (β = − 1.35; 95% CI: − 2.56, − 0.14) and 2.07 cm (β = − 2.07 cm; 95% CI: − 3.31, − 0.80) among early life, prenatal and post-natal exposed groups, respectively. Likewise, famine exposure during early life (β = 0.02; 95% CI: 0.01, 0.03), prenatal (β = 0.03; 95% CI: 0.02, 0.03) and post-natal life (β = 0.02; 95% CI: 0.02, 0.03) was positively associated with increased waist to height ratio. However, none of the above exposures resulted in a significant association with body mass index (P > 0. 05). Additionally, exposure to famine during early stage of life was not associated with increased risk of overweight, general obesity and abdominal obesity in adults. Decreased adult height and increased waist-to-height ratio were associated with early life exposure to famine, particularly prenatal and post-natal exposure. These results therefore underscore the significance of avoiding undernutrition in early life, which tends to be important for achieving once potential adult height and to minimize the increased risk of anthropometric markers of abdominal obesity such as waist to height ratio in later life.

Central Obesity and Associated Factors among Adult Patients on Antiretroviral Therapy (ART) in Armed Force Comprehensive and Specialized Hospital, Addis Ababa, Ethiopia.

Abstract: Background. Similar to the general population, the prevalence of central obesity is increasing among HIV-infected persons. There are little data on the burden of abdominal obesity using the waist-to-hip ratio measurement in HIV-infected patients in resource-limited settings, including Ethiopia. Therefore, this study aimed to assess the prevalence and associated factors of central obesity among HIV patients taking ART in an armed force comprehensive and specialized hospital, Addis Ababa, Ethiopia. Methods. A cross-sectional study was conducted from March to April 2018. A systematic sampling method was used to select 353 study participants. Pretested World Health Organization stepwise questionnaire, document review, and anthropometric and biochemical measurements were used to collect data on different variables under the study. The collected data were entered into EpiData version 3 and analyzed by SPSS version 21. An adjusted odds ratio with 95% CI was considered to declare a statistically significant association. Results. The prevalence of central obesity in this study was 71.7% (95% CI: 67%–76.4%). Besides, the odds of central obesity were associated with being female (AOR: 85.6; 95% CI: 20.09, 364.6), among merchants (AOR: 18.8; 95% CI: 1.39, 255.7), CD4 count <200 cells/mm3 (AOR: 0.03; 95% CI: 0.007, 0.160), among respondents taking AZT + 3TC + EFV-based ART regimen (AOR: 8.73; 95% CI: 1.33, 57.17), ABC + 3TC + ATV/r-based regimen (AOR: 0.18; 95% CI: 0.03, 0.94), increased BMI (AOR: 3.50; 95% CI: 1.36, 3.89), and abnormal blood pressure (AOR: 2.53; 95%: 1.13, 5.67). Conclusion. It is possible to conclude that central obesity is a huge public health problem among the HIV-infected population in the study area. Being female, increased BMI, low CD4 count, AZT + 3TC + EFV, ABC + 3TC + ATV/r-based regimen, and abnormal blood pressure were associated with central obesity. Therefore, adequate attention must be paid to primary and secondary control of these factors to reduce the prevalence of abdominal obesity among HIV-infected patients.

Malnutrition in School-Going Adolescents in Dessie Town, South Wollo, Ethiopia.

Abstract: Background. Malnutrition among adolescents is a global public health problem. Nutrient intake is a proxy measure of nutritional status, but studies in developing countries describing the actual nutrient intake condition associated with nutrition in the adolescents are limited. On top of this, there is inconsistent finding on the extent of malnutrition among adolescents. Hence, the aim of this study was to assess malnutrition and the associated factors among adolescents at Dessie high school. Methods. A school-based cross-sectional study was conducted among 365 randomly selected high school adolescents. The data were collected using a structured questionnaire adapted from previous literature studies. Nutrient intakes were estimated by ESHA food processor software from a 24-hour recall, and anthropometric indices were calculated from weight, height, age, and sex. The data analysis was managed by SPSS version 23. Binary logistic regression and multinomial logistic regression were used to report the associated factors of malnutrition. Adjusted odds ratio with 95% CI was used to reveal the presence of statistical association. Results. The percentage of being stunted, underweight, and overweight/obese was 15.7%, 6.3%, and 8.2%, respectively. Snack consumption (AOR = 0.38, 95% CI: 0.20, 0.71) was negatively associated with stunting, while MAR <1 (AOR = 3.36, 95% CI: 1.15, 7.82) was positively associated with stunting. Being a male (AOR = 2.76, 95% CI: 1.03, 7.44) and meal consumption <3 times per day (AOR = 4.21, 95% CI: 1.35, 13.11) were factors positively associated with being underweight/thin. Dietary diversity score <5 (AOR = 0.35, 95% CI: 0.13, 0.89) was negatively associated with overweight/obesity, while MAR < 1 (AOR = 3.14, 95% CI: 1.09, 9.09) was positively associated with overweight/obesity. Conclusion. The percent of overweight/obesity among adolescents in the study area was higher compared with the national and regional prevalence, and this was found to be a public health concern. Therefore, increasing snack consumption, sex consideration, increasing meal consumption, and intake of diversified foods should be included in the prevention strategies of malnutrition among adolescents.

Consequences of exposure to prenatal famine on estimated glomerular filtration rate and risk of chronic kidney disease among survivors of the great Ethiopian famine (1983–85): a historical cohort study

Abstract: The impact of an adverse prenatal environment such as famine exposure on the development of adulthood non-communicable chronic illnesses, including diabetes and hypertension has been well articulated in the recent past and supported by evidence. However, there exist few longitudinal studies conducted on the long term consequences of prenatal famine exposure on adulthood kidney function. Hence, we set out to examine whether prenatal exposure to the Ethiopian Great Famine (1983–1985) was associated with changes in estimated glomerular filtration rate (eGFR) and the risk of developing chronic kidney disease (CKD) later in adult life. The study was conducted in 219 famine exposed and 222 non exposed cohorts in Raya Kobo district, North Wollo Zone, Northern Ethiopia. Estimated GFR was computed from standardized serum creatinine using the CKD Epidemiology Collaboration (CKD-EPI) equation. The definition of CKD includes those with an eGFR of less than 60 ml/min/1.73 m2 on at least in two occasions of 90 days apart (with or without markers of kidney damage). Linear and logistic regression analyses were employed to examine the independent effect of prenatal famine exposure on eGFR and CKD respectively. The mean (SD) serum creatinine of exposed and non-exposed groups were 0.78 (0.2) and 0.75 (0.2) respectively. The mean (SD) eGFR of exposed groups was 107.95 (27.49) while the non-exposed 114.48 (24.81) ml/min. In linear regression, the unadjusted model to examine the association between famine exposure and eGFR resulted in a significant negative beta coefficient (β = − 0.124: 95% CI: − 11.43, − 1.64). Adjusting the exposure for outstanding covariates of kidney health, including systolic blood pressure, fasting blood sugar and blood glucose did not alter the inverse relationship (β = −.114 95% CI: − 10.84, − 1.17). In the unadjusted bivariate logistic regression model, famine exposure resulted in nearly 2.7 times higher odds of developing CKD (OR: 2.68, 95% CI: 1.16, 6.2). The odds remained equivalent after adjusting for systolic blood pressure, fasting blood glucose and body mass index (OR = 2.61: 95% CI: 1.120, 6.09). In the study setting, prenatal exposure to the Great Ethiopian Famine was associated with decreased eGFR and higher risk of developing CKD among survivors. These findings may imply that famine in early life may play a significant role in the development of kidney dysfunction in adulthood.

Undernutrition and Associated Factors Among Adult Tuberculosis Patients in Jigjiga Public Health Facilities, Somali Region, East, Ethiopia.

Abstract: Background Tuberculosis and undernutrition are the public health concerns of people living in middle and low-income countries. When patient develops TB, undernutrition is not only a risk factor for progression of latent TB infection to active disease, but also intensifies the risk of drug toxicity, relapse and death. Nutritional supplementation in patients with TB is associated with faster sputum conversion, higher cure and treatment completion rates, and body-weight gain. Objective To find out the magnitude of undernutrition and associated factors among adult tuberculosis patients in jigjiga public health facilities. Methods and Materials A facility-based cross-sectional study design was applied. Data were collected using a structured questionnaire while anthropometric measurements were collected in their scale measurements. The data were entered into an Epi-data version 3.1, then were exported and analyzed using SPSS v20. Bivariate logistic regression was done to assess the association between the outcome variable and the independent variables, value <0.25 was considered as a candidate for multivariate logistic regression at 95% CI. In multivariable logistic regression analysis, the level of statistical significance was declared at a p-value less than 0.05. Results The magnitude of undernutrition was 44.3% [95% CI (38.2, 49.7)]. Sex (female) [AOR=1.769, CI=1.035, 3.024], educational status [AOR=3.939, CI=2.285, 6.792] and being Bedridden [AOR=3.718, CI=1.115, 12.394) were predictors of Undernutrition among adult tuberculosis patients. Conclusion The magnitude of undernutrition among adult patients with TB was high in the area. Overall routine appropriate nutrition assessment and support should be given to undernourished patients with TB. The level of education about nutrition should be improved by counseling on a balanced diet to all patients with TB and particularly for female patients. Appropriate nutrition support should be provided to undernourished TB patients, and more focused on those who are bedridden.

Performance of individual dietary diversity score to identify malnutrition among patients living with HIV in Ethiopia.

Abstract: There is a lack of uniformity in developing and validating indicators of nutritional status among People Living with Human Immunodeficiency Virus (PLHIV). Experiences from low and middle-income countries are scant, and differences in methodological and analytical approaches affect the comparability and generalizability of findings. Therefore, this study investigated the performance of individual diversity score (IDDS) as a proxy indicator of nutritional status among PLHIV. We conducted a facility-based cross-sectional study among 423 PLHIV who were under Antiretroviral Treatment (ART) at clinics in Bahir-Dar, Ethiopia. We collected data on sociodemographic, dietary, clinical, and anthropometric measures. Dietary intake was assessed using 24-Hour dietary recall. Body Mass Index (BMI) was calculated to assess the nutritional status of study subjects. The receiver operating characteristic (ROC) curve analysis was used to assess the ability of the IDDS and Minimum Dietary Diversity for Women (MDD-W) to detect poor nutritional status. Furthermore, sensitivity, specificity, Predictive Values (PPs), and Likelihood Ratios (LRs) were calculated at different cut-off points. IDDS showed good reliability with Cronbach’s Alpha of 0.76. The Area Under the Curve (AUC) of IDDS was 78.5 (95%CI 73.9–83.4). At the IDDS cut-off of 4, the sensitivity and specificity of IDDS to indicate nutritional status were 88.0% (95%CI 81.0–93.0) and 71.0% (95%CI 66.0–76.0), respectively. The AUC of MDD-W was 74.1%, and at the cut-off of 4 the sensitivity and specificity of MDD-W to indicate undernutrition were 73.0% and 72.0%, respectively. Both IDDS and MDD-W have good accuracy as a proxy indicator for measuring the nutritional status of PLHIV. In the prevention of undernutrition among PLHIV especially in a resource-limited setting, IDDS and MDD-W can be used to assess nutritional status.

Education can modify the long term impact of early childhood famine exposure on adulthood economic achievement: a historical cohort study among the survivors of the great Ethiopian famine 1983-85.

Abstract: Previous famine studies reported the inverse link between early life nutritional deprivation and adulthood optimal health outcomes. However, there remain sparse data on the impact of early life famine exposure in later life economic achievement. Hence, we set out to examine the association of early life famine exposure on economic achievement among survivors of the 1983–85 great Ethiopian famine. A historical cohort study design was employed among 968 adult men and women in the Raya Kobo district, Northern Ethiopia. Participants were categorized into in utero exposed, postnatal exposed and unexposed groups based on self-reported age and birthdate. Structured questionnaire was used to collect data on socio-demographic and individual assets. Principal component analysis (PCA) was used to determine wealth index as proxy for economic achievement. Multinomial logistic regression analyses were employed to examine the independent effect of early life famine exposure on the outcome. In unadjusted model, compared to unexposed cohorts, in utero and postnatal famine exposed cohorts were nearly twice more likely to fall in the lowest wealth category (OR: 1.93, 95% CI: 1.40, 2.64) and (OR: 2.12, 95%CI: 1.45, 3.08), respectively. However, these associations became non-significant when adjusted for biologic and demographic variables (P > 0.05). Instead, educational status appeared to have significant association with wealth; those who can’t read or write among in utero and postnatal exposed group were three times more likely to fall in low wealth index category than those who achieved secondary and above level of education (OR = 3.00 95% CI: 1.74, 5.18) and (OR = 2.92, 95% CI: 1.48, 5.76), respectively. Similarly, those with primary education among in uero and postnatal famine exposed cohorts were twice more likely to fall in the low wealth index than compared to those secondary and above level of education (OR = 2.04 95% CI: (1.18, 3.54) and (OR = 2.17 95% CI: 1.12, 4.22), respectively. Education appears to be a significant independent factor to determine one’s economic achievement in the studied famine cohort. This may imply, the possible impact of early life famine exposure on economic achievement later in adult life could be modified through better education. Our findings justify the need of expanding education in hunger spots in general and in famine settings in particular.