Browsing by Author "Mohammedsanni, Afrah"

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    Association of Maternal Dietary Pattern and Neural Tube Defects; A Case-control Study in Addis Ababa, Ethiopia
    (Addis Abeba University, 2020-07) Mohammedsanni, Afrah; Dr.Medhin, Girmay(MSc, PhD)
    Background: Neural Tube Defects (NTDs) are significant public health problems with complex etiology. Maternal nutrition is one of the environmental factors to contribute to the etiology of NTDs. This study aims to assess the relationship of diet with NTDs among pregnant women who received antenatal care services in Zewditu Memorial Hospital. Methods: We conducted a matched case-control study from January 1, 2020 to April 30, 2020 in Zewditu Memorial hospital, Addis Ababa. A total of 252 pregnant women (63 cases and 189 controls) were included in the study. Pregnant women were matched on age, gestational age and gravidity. We used a 70-item food frequency questionnaire to assess the dietary intake of pregnant women. Factor analysis was used to identify major dietary patterns. Cases and controls were confirmed by specialist gynecologists. Conditional logistic regression was used to assess the association between dietary patterns and neural tube defects. Result: We identified seven major dietary patterns using factor analysis: prudent pattern, traditional pattern, western pattern, Mediterranean pattern, raw meat and alcohol pattern, refined cereal and vegetable pattern and sugar and caffeine pattern. In the adjusted model, the odds of having a fetus affected with NTDs was 83% lower among women who had high intake of prudent pattern compared to those who had low intake (high vs. low intake: AOR=0.17; CI: 0.05 - 0.52). Likewise, women with high intakes of Mediterranean pattern scores were less likely to have a fetus affected with NTD (high vs. low intake: AOR=0.20; CI: 0.06 - 0.59). The odds of having NTDaffected fetus was 3 times higher among women with high consumption of traditional pattern scores (high vs. low intake: AOR=3.37; CI: 1.23 - 9.19) compared to those who with low consumption. There was no statistically significant association between western pattern adherence before pregnancy and neural tube defect in the adjusted model (high vs. low intake: AOR=1.40; CI: 0.41 - 4.73) Conclusion and recommendations: This study demonstrated that maternal adherence to high intake of prudent and Mediterranean diets a year before pregnancy have protective effects against NTDs. Conversely, pregnant women with high intake of traditional pattern one year prior to pregnancy are more likely to have a fetus affected with NTDs. Promoting healthy diet prior to pregnancy is one possible way to optimize reproductive outcomes. We suggest the application of dietary patterns as an approach to communicate healthy dietary choices to the public and formulate dietary guidelines.
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    Effect of nutrition education and counseling on knowledge and dietary practice of pregnant women: A cluster randomized controlled trial in urban setting of Ethiopia
    (Addis Ababa Universty, 2018-01) Mohammedsanni, Afrah; Hagos, Seifu (BSc, MPH, MSc, PHD)
    Background: The first 1,000 days of life, from the first day of pregnancy until the child is 24 months old is a critical window of opportunity for health and development. It is essential for pregnant women to have adequate knowledge in order to achieve optimal nutritional status during pregnancy. Antenatal care is a key unit for provision of nutrition information for pregnant women. It is critical for health care providers to have adequate knowledge and skill necessary to be able to provide sufficient nutritional information for pregnant women. However, studies show lack of adequate knowledge and skill among health care providers. Objective: To evaluate the effectiveness of nutrition education and counseling in improving knowledge and dietary behavior of pregnant women. Method: We conducted a cluster randomized controlled trial in Addis Ababa, Ethiopia. Health centers were allocated to intervention and control arms using a matched-pair randomization scheme. 40 health care providers from intervention arm were trained on pregnancy nutrition and counseling skills. 683 pregnant women (347 from intervention and 336 from control) were included from 20 health centers. We estimated deference in deference (DID) impact of intervention using mixed-effect linear regression with health center catchment area as random effect. Result: Pregnant women’s knowledge on food groups, use of iron folic acid supplement, benefits of balanced diet and consequence of under nutrition showed a significant improvement (P <0.001) Pregnant women of intervention arm were observed to have a significantly higher knowledge on using iodized salt (difference in proportion (DP) 24.3% vs 1.7; DID 23%), duration of iron folic acid supplementation (DP 70.9% vs 3.4; DID 68%) and having one additional meal (DP 54.3% vs 4.3; DID 49.9%). Significant improvement was also observed on dietary diversity (DP 39.0% vs 4.5; DID 32.3%) and having one additional meal to the diet (DP 36.7% vs 24.7; DID 12.8%). Pregnant women of intervention arm improved their consumption of dairy per week (DID 1.2). Intake of iron folic acid supplement has shown an improvement of 3 more days per week (D 4.9 vs 1.6; DID 3.2). However, effect of knowledge on initiation of breast feeding (P = 0.089) and dietary frequency of grains (P = 0.067) appears to be statistically insignificant. Conclusion: Nutrition education and counseling improves pregnant women’s nutritional knowledge and dietary behavior in urban settings.