AAU-ETD :: Browsing by Author "Robel Yirgu"

Browsing by Author "Robel Yirgu"

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Acute Respiratory Tract Infections and Infant and Young Child Feeding Practices among 6 TO 23 Months Old Children In Addis Ababa, Ethiopia, 2023
(Addis Ababa University, 2024-01) Selamawit Minwyelet; Jemal Haidar ; Robel Yirgu
Background: Suboptimal child feeding practice may lead to malnutrition which in turn is associated with an increased risk of morbidity and mortality from respiratory tract infections among under two children. In Ethiopia, an encouraging progress in the reduction of ARI was observed until 2010; however, since then the national prevalence is unchanged. Therefore, the need to uncover the role of infant and young child feeding practice is to provide information for interventions aiming to reduce under-five children morbidity and mortality due to childhood infections. Objective: The aim of this study is to determine the association between acute respiratory tract infections and infant and young child feeding practices among 6 to 23 months old children attending public health centers in Addis Ababa, Ethiopia, 2023. Methods: Facility based analytical cross-sectional design was conducted from August to September, 2023 among 342 children aged 6- to 23-months paired with their mothers in public health centers located in Addis Ababa. Multistage sampling technique was used to recruit the study participants. Data was collected from mothers of the infants and children using electronic method. Data was entered and analyzed using the statistical package for social sciences (SPSS) version 26. The association between IYCF practices and ARI were investigated using Chi-square test and binary logistic regression model. Result: The overall proportion of infants and children with acute respiratory tract infection was 31%. Early initiation of breastfeeding (AOR 0.57; 95% CI: 0.39, 0.82) and Exclusively Breastfed for the first two days after birth (AOR 0.64; 95% CI: 0.45, 0.91) were associated with lower risk of ARI. Infants and children who were frequently fed (AOR 0.54; 95% CI: 0.38, 0.76) and who consumed fruits and vegetables (AOR 0.37; 95% CI: 0.23, 0.61) were also less likely to experience ARI compared to their counterparts. Conclusion: The findings of the study indicate that the magnitude of acute respiratory tract infection is high among under two years children as upper respiratory tract infection being commonest cause and the recommended IYCF practices to reduce the occurrence of ARI in infants and children are early initiation of breastfeeding, exclusive breastfeeding in the first two days after delivery, consumption of vegetables or fruits and frequent feeding of infants and children.
Assessment of Association Between Parental Feeding Practice and Children Eating Behavior among Preschool Children in Addis Ababa.
(Addis Ababa University, 2019-10) Nardos Wondafrash; Robel Yirgu; Seifu Hagos
Background: Low and middle-income countries are facing both extremes of public health nutrition problems. Despite the well-established risk factors of mal-nutrition, individual differences in eating behaviors may contribute to the existing variation in nutritional status. Eating behaviors are biological and behavioral processes directed towards meeting bodily requirements; and these behaviors develop during the first years of life. Eating behaviors can be categorized as food approach and food avoidant. Some of the food approach behaviors are enjoyment of food (EF), food responsiveness (FR), emotional overeating (EOE), desire to drink (DD), and food avoidant behaviors are satiety responsiveness (SR), slowness in eating (SE), emotional under eating (EUE) and food fussiness (FF). Parents and caregivers influence their children’s eating behavior through communicating their attitudes and beliefs about food and feeding. Objective: To assess the different eating behaviors of preschool children and to determine its association with parental feeding practice in Addis Ababa. Method: A school based cross-sectional study was conducted among preschool children in randomly selected schools. A stratified multi-stage sampling procedure was followed. Eating behavior was measured using a children eating behavior questionnaire and for the parental feeding practice together with parents perception and concern about child weight and perceived feeding responsibility the child feeding questionnaire was used. For parent depression status and child psychological status patient health questionnaire and strength and difficulties questionnaire were used respectively. All the questionnaires were pre-tested interview-based tools that have been translated to the local language and tested for face validity. Internal consistency was estimated using Cronbach’s alpha. We used EpiData version 4.4.1.0 for data entry and the statistical software package Stata version 15.0 for data cleaning and analysis. A separate multiple linear regression was run for each scale of children eating behavior and the association with parental feeding practice was explored. Result: Most of mean scores of the children eating behaviors scales. were close to the scale midpoint (2.5). Parental feeding practice monitoring practice had the highest mean score 4.13(SD:1.02) while restriction had the lowest score 3.47(SD:0.91). The internal reliability (Cronbach’s alpha) for both questionnaires ranged from 0.50 to 0.89. There was a significant relationship between children eating behavior and parental feeding practice. Parents food restriction practice had positive association with food approach behaviors which are enjoyment of food(b= 0.23, p= 0.000) , food responsiveness (b=0.23, p=0.000), emotional overeating(b=0.09, p= 0.001) and desire to drink(b=0.24, p=0.000) while parents practice of pressure to eat had a negative association with enjoyment of food (b= -0.11, p=<0.001), food responsiveness (b= -0.08, p= <0.001) and emotional overeating (b=-0.11, p=<.001) .Meanwhile, of the food avoidant behaviors such as food fussiness (b=0.09,p<0.001), satiety responsiveness(b=0.13,p<0.001) and slowness in eating (b=0.10,p=0.005) had a positive association with parents practice of pressure to eat. After adjusting for factors such as socio demographic characteristics, parent’s perception and concern about child weight, parental depression status and child psychological status. Conclusion: Parents that practiced food restriction had children that were more food responsive, tend to emotionally overeat, tend to enjoy food more and had more desire to drink. While Parents that practice pressure to eat had children that were more food fussier, satiety responsive and tend to eat slower. The above findings might help parents to understand eating behaviors in young children and to practice appropriate feeding practice to overcome eating problems. Health care providers should provide better support for parents in managing eating behaviors in young children and it is better incorporate appropriate eating behavior and feeding practice as an important component of child feeding strategies.
Could Self-Report a Valid Method to Measure Adherence to Iron Folic Acid Supplementation among Pregnant Women Attending Antenatal Care Service in Addis Ababa, Ethiopia
(Addis Abeba University, 2019-10) Feleke Milkiyas; Robel Yirgu; Seifus Hagos
Background: Iron folic acid supplementation during pregnancy is one of the major intervention given for pregnant women to alleviate the risk of anemia. According to WHO 2012 report anemia prevalence among pregnant women is highest in Africa including Ethiopia. The major problem with increased prevalence of anemia during pregnancy is noncompliance as the women fails to take their pills properly. Objective: Aimed to validate self report to measure adherence to iron folic acid supplementation among ante-natal care attending pregnant women in Addis Ababa Ethiopia. Methods: Longitudinal was employed among 361 pregnant women in Addis Ababa from March to July 2019. A multi-stage random sampling procedure was employed. The study participants was prospectively observed over three months using pill count and self report methods. Data were entered using Epi-Info version 7 and analyzed using STATA SE Version 14.1. Estimation of the prevalence of adherence was done using both methods. Sensitivity, specificity and positive predictive value was computed to check the validity on the performance of self report in estimating Adherence. McNemar test was done to assess if there was significant difference in adherence rate between the methods. P-value of <0.05 was considered to indicate a significant difference in prevalence. Result: The prevalence of iron folic acid supplementation of 82.8% (at 95% CI, 78.5 – 86.6) was obtained by self report where as adherence rate of 58.2% (95% CI of 52.9 - 63.3) was observed using pill count method. Discrepancies of 24.6 % difference was observed between both methods of adherence measurement. The sensitivity, specificity and RUC curve of self report was showed 97.7%, 37.7% and 0.68% respectively at a P-Vvalue of < 0.05. Conclusion: Valid measurment is extremely important in assessing adherence rate. Self report adherence estimation to IFA supplementation continues to be problematic and difficult in determining how pregnant women are using their supplement. Self-report adherence measurement had poor validity in measuring those who were correctly adhered as compared to pill count. There was a statistically significant difference in estimation of adherence between the self report and pill count methods.
Evaluating the Association Between Duration of Breastfeeding and Fine Motor Development among Children Aged 20 to 24 Months in Butajira, Ethiopia
(Addis Ababa University, 2019-10) Rediate Shiferaw; Robel Yirgu; Yalemwork Getnet
Background: In child development, the first two years have critical importance. At this stage breast milk is an important source of nutrition but the breastfeeding practice is poor and it is decreasing. The effect of developmental delay is pronounced in developing countries due to limited access to other resources that complement breast milk for mental development. The roles of nutritional and environmental factors on child development need to be studied for possible intervention. Objective: To assess the association between duration of breastfeeding and fine motor delay among children aged 20 to 24 months living in Butajira, southern Ethiopia. Method: This study was conducted among 20 to 24 months old children employing community-based case-control study design. Cases and controls were identified by conducting screening among children from 20 to 24 months living in Butajira. Fine motor was assessed using Denver developmental screening test. Independent variables were assessed using interviewer-administered questionnaire. Data were entered on to Epi-data version 4.4.2.1 computer software and exported into STATA version 14 for data cleaning and analysis. Descriptive statistics was determined and binary logistic regression was used for the association. Variables with p-value <0.2 on bivariable test and variables that have important clinical significance were added to multivariable logistic regression model and checked for significant association, which was declared at a 95% confidence level. Result: The study has a sample size of 332 with 83 cases and 249 controls of children aged 20 to 24 months. We didn’t find significant protective effect of breastfeeding for fine motor delay for children who were breastfed from 18 to 20 months [AOR: 0.42, 95% CI :( 0.12, 1.42)] and for children who were breastfed from 21 to 24 months [AOR: 0.77, 95% CI :( 0.33, 1.81)] compared to breastfed less than 18 months. Children who were stunted were 2 times more likely to have fine motor delay than children who were not [AOR: 2.04, 95% CI :( 1.11, 3.74)]. Females were 2 times more likely to have fine motor delay than males [AOR: 2.15, 95% CI :( 1.18, 3.89)]. Children who had mothers in the primary school were 71% less likely [AOR: 0.12, 95% CI :( 0.14, 0.70)] and children who had mothers in the secondary school were 80% less likely [AOR: 0.20, 95% CI: (0.06, 0.70)] to have fine motor delay than mothers who didn’t have formal education. Conclusion: Duration of breastfeeding was not associated with fine motor delay for children aged 20 to 24 months old. Stunting, being a female and educational status of the mother were identified to have significant association with fine motor delay. Malnutrition should be prevented and all children should get access to adequate care and nutrition
Malnutrition among HIV-Positive Pregnant Women; Magnitude and Determinants, in Health Centers of Addis Ababa Ethiopia
(Addis Ababa Universty, 2018-11) Zinet Behailu; Robel Yirgu
Introduction: Good nutrition increases resistance to infection and disease, improves energy, and this makes a person generally stronger and more productive. Healthy nutrition is important throughout life but particularly so when a woman is pregnant. As pregnancy affects the metabolism of nutrients, maternal diet must provide sufficient energy and nutrients to meet the mother’s usual requirements as well as the needs of the growing fetus. When an HIV-positive woman becomes pregnant, additional nutritional considerations are warrant. Though in Addis Ababa there is lack study of HIV positive pregnant mothers on the prevalence of malnutrition, which is, depend on them. Objective: The objective of this study was to assess the prevalence and determinants of under nutrition among HIV positive pregnant women attending prevention of Mother-to-Child transmission of HIV clinics in health centers of Addis Ababa, Ethiopia. Methodology: Cross-sectional study was conducted from 1Nov 2017-Jun 2018 on prevention of Mother-to-Child transmission of HIV clients in Addis Ababa, a capital city of Ethiopia. Simple random sampling technique was used to get 342 prevention of Mother-to-Child transmission of HIV clients as a study population. Data was collected using pretested, structured, and semi-structured questionnaire, anthropometry measure, dietary assessment method and the data was analyzed using Epi.data version 3.1 and SPSS version 22. The study was provided information on Prevalence of under nutrition and its determinants in health centers was been measured. Result: The overall prevalence of under nutrition among the study participant was found to be 34.2%, of those 33.6% was moderate malnutrition. Those who have experiance for last one month of less than three frequency of serving including snacks were 3.2 times more likely to be undernourished than those more than and equal to three frequency of serving including snacks (AOR=3.2; 95% CI: 1.14-8.88). In addition, 350 cells/μl or below CD4 T-cell level of HIV positive pregnant mother were almost 3 times (AOR=2.50; 95% CI: 1.27-4.94) more likely to be undernourished than those who had above 350 cells/μl CD4 T-cell level. Conclusion and Recommendation: There was high prevalence of undernutrition among HIV positive pregnant mother. The finding indicates that higher level of CD4 count is associated with better nutritional status, while improved eating habit were associated with lower proportion of undernutrition during pregnancy. Thus, the factors associated with under nutrition are potentially modifiable through interventions targeting improved frequency of food serving and increasing ART clinical care and promotion of improved eating habit through prenatal dietary advice. To overcome this nutritional problem the government should ratify need to give special attention of economical and nutritional support HIV positive pregnant mothers and health professionals also give them special care and when they get under nutritious mother they have to put them in immediate nutritional therapy programme.
Perinatal Mortality Magnitude, Determinants and Causes in WestGojam: Population-Based Nested Case-Control Study
(Addis Ababa University, 2012-12) Robel Yirgu; Mitike Molla
Introduction: The millennium development goal was set to achieve a reduction of child mortality by two thirds by the end of 2015. In Ethiopia even if a significant reduction in mortality was seen among the post neonatal age children yet the death of newborns in the perinatal age category is still high. This study estimated the perinatal mortality rate and identified its determinant factors and causes of death in West Gojam zone ,Amhara region. Methods and materials:Outofthe4158pregnant mothers who were followed in the cohort of this nested case control study,73 cases and 146 controls were identified and interviewed in three districts of the West Gojam zone, from Feb 2011 to Mar 2012.Wealthindexwas used to estimate the wealth difference among the studied families. Factors such as birth spacing, history of abortion and history of perinatal mortality were included in a multiple binary logistic regression model to identify risk factors. Physician review method was used to identify the causes of death from the verbal autopsy data. Result: The perinatal mortality rate was 27.04per 1000 live and still births (95%CI,15.1,38.9).Perinatal mortality was significantly associated with household wealth and family size, those with 2-5 and greater than three family members had a lesser risk for perinatal mortality as compared to those with a family size of only two (AOR=0.04,95%CI 0.01-0.38)and (AOR=0.03,95%CI 0.01-0.27)respectively. Primiparous mothers indicated a greater risk for perinatal mortality as compared to those who gave birth to five or more children(AOR=7.89,95%CI 1.46-42.77). In addition women with a previous history of perinatal death and abortion showed a higher risk for perinatal mortality than those who had no history of perinatal mortality or abortion(AOR=14.29,95%CI 5.28 38.67)and (AOR=0.24,95%CI0.1,0.58) respectively. Preterm newborns were more at risk (AOR=17.49,95%CI 1.51,202.78) than the term babies. Twins were also at higher risk for perinatal mortality than the singletons(AOR=5.09,95%CI1.21,21.4). Home delivery was found to protect against perinatal death (AOR=0.05 95%CI0.01,0.26)in comparison to the births that took place in health facilities. Conclusion: Findings of this study indicated a high perinatal mortality rate and the increased risk that was associated with selected socio-economic and health service related factors some of which are amenable to change.
Risky Sexual Practices and Associated Factors among Daytime and Evening Shift of Polytechnic College Students in Addis Ababa :The Case of Nifas Silk Polytechnic College.
(Addis Abeba University, 2019-05) Wase Wale; Adugnaw Birhane; Robel Yirgu
Introduction: Risky sexual behaviors are any practices that increase the probability of adverse sexual and reproductive health. Most college adolescent and young aged 15–24 years are at particularly high risky sexual practices and often characterized by anew-found sense self government, experimentation with sex and a feeling of invincibility. Objective: To compare the magnitude of risky sexual practices and associated factors among day/regular and evening/extension shift of polytechnic college students in Addis Ababa with the case of Nifassilk polytechnic college. Method and Material: A comparative cross sectional study was conducted from March 27April 15, 2019. A stratified sampling technique was used based on type of schooling (day and evening time) and then, allocation of sample was proportionally distributed to respected study levels based on number of students. Study participants were selected using simple random sampling technique. Two population proportion formulas were used to calculate a total sample size of 486 students (243 day/regular and 243 night/extension students). Data was summarized using descriptive statistics including mean, proportion and standard deviation and inferential statistics such as chi-square test and binomial logistic regression. Ethical clearance was obtained from Addis Ababa University School of Public health. Result: A total of 442 students (227 regular/day time and 215 extension/ evening shift)participated in the study making the response rate 90.9%. The prevalence of risky sexual practice among regular/day and extension/evening shift students were 34(15%)and 75(34.9%), respectively and the overall prevalence for both type schooling was 109(24.7%). The difference between the two categories is statistically significant (p<0.05). In this study, among those students who had practiced premarital first sexual intercourse, 40 (66.6% and 58(61%) of them had not used condom respectively for day and night time shift students. Conclusion: The study depicted that the prevalence of risky sexual practice among night/evening time students is more than twofold of the prevalence among day time students. The schools and other actors need to address both type of schooling with adolescent and youth friendly risk reduction interventions by giving due emphasis to evening/extension students.
What Drives Pregnant Women to Choose Their Food? A Qualitative Study in Butajira Rural Health Programme (BRHP), Ethiopia
(Addis Ababa Universty, 2018-10) Seble Shiferaw; Robel Yirgu
Background: The maternal nutrition during pregnancy is responsible for structural and physiological changes that occur in the fetus as a result of inadequate nutrients or ‘building blocks’ for the growth of specific tissues. The nutrient a mother gets depends on her food choices, signifying the importance food choice during pregnancy. Objective: To explore factors which influence food choice among pregnant women in Butajira Rural Health Programme (BRHP), Ethiopia. Method: Qualitative content analysis using deductive approach was applied to identify factors affecting food choice of pregnant women in rural settings. The study conducted in Health and Demographic Surveillance Site (HDSS) of Addis Ababa University School of Public Health located in Butajira, Gurage zone. A total of 43 pregnant women and 37 husbands of pregnant women participated in the study. A combination of in-depth interview and focus group discussion was applied to collect data from purposively selected participants. The data analyzed deductively, using open code version 4.02 software to code the data. Result: Pregnant women usually ate three times a day that mainly consisted of cereal based food (Kita) and a vegetable, dark green leafy vegetable (Gomen). The study identified several factors which influence pregnant women to choose their food. Agricultural production seems to be a key determinant of consumption and is dependent on the amount of agricultural land they have and agro-ecologic conditions among the study sites. It is also identified that the major determinant of food choice is financial constraint, which determine the ability to produce or purchase the required food. Pregnant women adjust their food choice based on their appetite and gastric symptoms following consumption. The distant market is another factor identified as an obstacle to access healthy food due to high cost of transportation and unstable roads for a pregnant woman. Conclusion: This study identified that the food choice of pregnant women is mainly determined by food availability which is governed by production and financial capacity. Pregnant women also decrease their food intake due to physiological symptoms following consumption.

Browsing by Author "Robel Yirgu"

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