A Single 24 hour Recall is inaccurate in Assessing Exclusive Breast Feeding among Infants under six months of age, Butajira, Ethiopia.
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Date
2016-06
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Addis Abeba Universty
Abstract
Background:Indicators are developed to measure the feeding practice of a child. WHO has
developed an indicator to asses exclusive breast feeding which is obtained by using single 24
hour recall. Single 24 hour recall only captures the current status. A single day dietary history
may be misleading in determining a usual intake of an infant if there is a day to day variation in
the feeding pattern, and this might lead to an over estimation and misclassification.
Objective:To assess how accurate a single 24 hour dietary recall, multiple 24 hours recall and
recall since birth is as compared to 7 repeated 24 hour recall in assessing exclusive breastfeeding
among infants less than 6 months, Butajira, Ethiopia.
Method:Community based cross sectional study was conducted from March to April 2016. A
total of 422infant mother pairsless than 6 months who resides in Butajira were selected by simple
random sampling method. Data on duration of EBF was collected by using a single 24 hour
recall, multiple 24 hour recall and recall since birth.Mcnemar’s test was done to asses if there
was a significant difference in rate of EBF. P-value less than 0.05 was considered to indicate a
statistically significant difference in proportion. Sensitivity, specificity, positive predictive value
and negative predictive value were computed by using 7 repeated 24 hour recall as a reference.
Result: exclusive breast feeding rate varied across different methods.The highest prevalence
76.7% was obtained by single 24 hour recall. 7 repeated 24 hour recall and recall since birth
resulted in EBF rate of 53.2% and 50.2% respectively. Single 24 hour recall overestimates EBF
prevalence by 23.54%;by increasing the number of recall we can decrease the degree of
overestimation significantly. Taking seven repeated 24 hour recall as a gold standard, single 24
hour recall was observed to have the lowest specificity of 49.7% and positive predictive value of
69.3%. An increase in specificity as high as 94.8% was observed by increasing the number of
observation days. Recall since birth was found to have a high specificity 93.8% and positive
predictive value 94.2.
Conclusion:Single 24 hour recall overestimated EBF prevalence and had the lowest specificity.
By increasing observation days we can improve accuracy of estimates of EBF. Recall since birth
presented estimates of EBF that is close to reality. The use of recall since birth could be a
feasible alternative to assess EBF practice.
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A Single 24 hour Recall is inaccurate in Assessing Exclusive