Prevalence and associated factors of adolescent undernutrition in Ethiopia: a systematic review and meta-analysis

Springer Science and Business Media LLC - Tập 5 Số 1 - 2019
Kidanemaryam Berhe1, Abadi Kidanemariam Berhe2, Gebrehiwot Gebremariam3, Alem Gebremariam3
1Department of Nutrition and Dietetics, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
2Department of Nursing, College of Medicine and Health Sciences, Adigrat University, Adigrat, Ethiopia
3Department of Public Health, College of Medicine and Health Sciences, Adigrat University, Adigrat, Ethiopia

Tóm tắt

AbstractBackgroundIn Ethiopia, there are different pocket studies that assessed adolescent undernutrition which came up with inconsistent and inconclusive findings. Therefore, estimating the pooled prevalence and associated factors of the adolescent undernutrition using meta-analysis is crucial in Ethiopia.MethodsA systematic review of eligible articles was conducted using preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines. A comprehensive searching of the literature was made in Pub Med, Scopus, Google, Google Scholar, Cochrane Library and CINAHL. The quality of the articles included in the review was assessed using the Newcastle-Ottawa Scale (NOS) for non-randomized studies in meta-analyses. The pooled prevalence and odds ratio of the associated factors with their 95% confidence interval was computed using STATA version 14 software.ResultsTwenty-two studies were included in the meta-analysis with a total of 17,854 adolescents. Using the random-effects model analysis, the pooled prevalence of stunting and underweight was 20.7% (95% CI: 16.08, 25.33) and 27.5% (95% CI: 17.9, 57.14), respectively. Rural residence, having family size≥5, households with an unprotected water source for drinking and food-insecure household were significant associated factors for adolescent stunting. Early adolescent age (10–14 years), family size≥5, food-insecure household, lack of latrine, WHO diet diversity score < 4, mother educational status (with no formal education) were significant associated factors for adolescent underweight.ConclusionAdolescent undernutrition remains one of the most important public health problems in Ethiopia. Almost a quarter of Ethiopian adolescents were affected by stunting and underweight. Large family size, rural residence and unprotected source of drinking water were the associated factors for adolescent stunting. Similarly, large family size, early age of adolescent, lack of latrine, low dietary diversity score, mother illiteracy, and food insecure household were the associated factors for adolescent underweight. It would be good to give high emphasis on adolescent undernutrition and it is important to address the above mentioned associated factors during adolescent nutritional interventions in Ethiopia.

Từ khóa


Tài liệu tham khảo

World Health Organization. Nutrition in adolescence-issues and challenges for the Health Sector; 2005. p. 1–123.

Afework M. Multiple micronutrient deficiencies in adolescent school girls from Tigray, Northern Ethiopia; 2009.

Robert E, Cesar G, Susan P, Zulfi QARA, Parul C, de Onis M, Maternal and Child Nutrition Study Group, et al. Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet. 2013;382:472–51.

Manyanga T, El-Sayed H, Doku DT, Randall JR. The prevalence of underweight, overweight, obesity and associated risk factors among school-going adolescents in seven African countries. BMC Public Health. 2014;14(887):1–12.

Public Health at Glance. Adolescent nutrition. 2003.

Central Statistical Agency (Ethiopia) and ORC Macro. Demographic and health survey. Addis Ababa and Calverton: Central Statistical Agency and ORC Macro; 2005.

Central Statistical Agency (Ethiopia) and ICF International. Ethiopia demographic and health survey. Addis Ababa and Calverton: Central Statistical Agency and ICF International; 2012.

World Health Organization. Nutrition for health and development (NHD): a global agenda for combating malnutrition. 2000.

USAID and SPRING. Review of programmatic responses to adolescent and Women’s nutritional needs in low and middle-income countries. 2015.

UNICEF, Open University, AMREF and Federal Democratic Republic of Ethiopia Ministry of Health. Adolescent and youth reproductive health: blended learning module for the health extension program; 2008. p. 1–150.

Rukhsana H, Suman B. Adolescent nutrition: a review of the situation in selected southeast Asian countries; 2006.

Yoseph G, Solomon S, Balem D, Gessessew B. Nutritional status of adolescents in selected government and private secondary schools of Addis Ababa, Ethiopia. Int J Nutr Food Sci. 2014;3(6):504.

Herrador Z, Sordo L, Gadisa E, Moreno J, Nieto J, Benito A, et al. Cross-sectional study of malnutrition and associated factors among school-aged children in rural and urban settings of Fogera and Libo Kemkem districts, Ethiopia. PLoS One. 2014;9(9):e105880 PubMed PMID: 25265481. Pubmed Central PMCID: 4179248.

Huruy A, Tefera B, Legesse N. Socio-demographic factors associated with underweight and stunting among adolescents in Ethiopia. Pan Afr Med J. 2015;20:252 Pub Med PMID: 26161175. Pub Med Central PMCID: 4484194.

Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med. 2009;151(5):393–5.

World Health Organization. Multicentre Growth Reference Study Group. WHO child growth standard’s: length/height-for-age, weight-for-age, weight for length, weight-for-height and body mass index-for-age: methods development. Geneva: World Health Organization; 2006.

Wells G, Shea B, O'Connell D, Peterson J, Welch V, Losos M, et al. The Newcastle-Ottawa scale (NOS) for assessing the quality of nonrandomized studies in meta-analyses: Ottawa Hospital Research Institute; 2000. http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp.

Egger M, Smith GD, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997;315(7109):629–34.

Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analysis. BMJ. 2003;327(7414):557.

Abdulkadir A, Tefera B, Habtemu J. Nutritional status and associated factors among primary school adolescents of pastoral and agropastoral communities, Mieso Woreda, Somali region, Ethiopia: a comparative cross-sectional study. J Public Health Epidemiol. 2016;8(11):297–310.

Afework M, Fitsum H, Barbara S, Gideon K, Vincent L, Zenebe A, Mekonen Y, Girmay G. Nutritional status of adolescent girls from rural communities of Tigray, Northern Ethiopia. Ethiop J Health Dev. 2009;23(1):5–11.

Ahmed Y, Tomas B. Nutritional status and associated risk factors among adolescent girls in Agarfa High School, Bale Zone, Oromia region, south East Ethiopia. Int J Nutr Food Sci. 2015;4(4):445–52.

Tolessa D, Mektie W, Aderajew N. Nutritional status and associated factors among school adolescent in Chiro Town, West Hararge, Ethiopia. Gazi Med J. 2015;21(1):32.

Dessalegn A, Jemal H, Gebrekiros G, Desta H. Magnitude of a double burden of malnutrition and its associated factors among selected in-school adolescents: evidence from South Ethiopia. Int J Nutr Metab. 2017;9(4):30–7.

Gebregyorgis T, Tadesse T, Atenafu A. Prevalence of thinness and stunting and associated factors among adolescent school girls in Adwa town, North Ethiopia. Int J Food Sci. 2016;2016:1–8.

Hadush G, Omer S, Huruy A. Assessment of nutritional status and associated factors among school-going adolescents of Mekelle city, northern Ethiopia. Int J Nutr Food Sci. 2015;4(1):118–24.

Roba KT, Abdo M, Wakayo T. Nutritional status and associated factors among school adolescent girls in Adama city, Central Ethiopia. J Nutr Food Sci. 2016;06(03):1–8.

Hunegnaw M, Takele T, Teresa K. Malnutrition and its correlates among rural primary school children of Fogera District, Northwest Ethiopia. J Nutr Disord Ther. 2013;03(02):1–7.

Mekonnen T, Semere S, Tesfaye A, Abdurrahman K. Nutritional status and associated factors of adolescent school girls, Goba town, Southeast Ethiopia. Global J Med Res. 2016;16:1):1–9.

Melaku YA, Zello GA, Gill TK, Adams RJ, Shi Z. Prevalence and factors associated with stunting and thinness among adolescent students in northern Ethiopia: a comparison to World Health Organization standards. Arch Public Health. 2015;73:44 Pub Med PMID: 26516456. Pub Med Central PMCID: 4624644.

Mesert Y, Jemal H, Hailu K, Fleming Fallon L Jr. Socioeconomic and demographic factors affecting body mass index of adolescents students aged 10-19 in ambo (a rural town) in Ethiopia. Int J Biomed Sci. 2010;6(4):321–6.

Teji K, Dessie Y, Assebe T, Abdo M. Anaemia and nutritional status of adolescent girls in Babile District, eastern Ethiopia. Pan Afr Med J. 2016;24:62 Pub Med PMID: 27642403. PubMed Central PMCID: 5012790.

Berheto TM, Mikitie WK, Argaw A. Urban-rural disparities in the nutritional status of school adolescent girls in the Mizan district, southwestern Ethiopia. Int Electron J Rural Remote Health Res Educ Pract Policy. 2015:1–10.

Wassie M, Gete A, Yesuf M, Alene G, Belay A. Predictors of nutritional status of Ethiopian adolescent girls: a community-based cross-sectional study. BMC Nutrition. 2015;1(1):1–7.

Wolde M, Berhan Y, Chala A. Determinants of underweight, stunting and wasting among school children. BMC Public Health. 2015;15:8 PubMed PMID: 25595201. Pubmed Central PMCID: 4308904.

Yayehyirad Y, Abel G, Wondessen N, Dejene H, Tadesse A, Frehiwot M, et al. Undernutrition and its associated factors among adolescent girls in the rural community of Aseko district, eastern Arsi zone, Oromia region, eastern Ethiopia, 2017. Int J Clin Obstet Gynecol. 2017;1(2):17–26.

Yebyo H, Weres ZG, Gesesew H, Miruts KB. Assessment of adolescents’ under nutrition level among school students in eastern Tigray, Ethiopia: a cross-sectional study. J Nutr Food Sci. 2015;05(05):1–6.

Tesfalem T, Pragya S, Debebe M. Prevalence and associated factors of overweight and obesity among high school adolescents in urban communities of Hawassa, southern Ethiopia. Curr Res Nutr Food Sci Jour. 2012;1(1):23–36.

World Health Organization. Adolescent nutrition: a review of the situation in selected south-east Asian countries. 2006.

Amitava P, Amal K, Arunangshu S, Prakash C. Prevalence of undernutrition and associated factors: a cross-sectional study among rural adolescents in West Bengal, India. Int J Pediatr Adolesc Med. 2017;4:9e18.

Sitti P, Andi I, Ida R, Abdul R. Low socioeconomic status among adolescent schoolgirls with stunting in Maros district, South Sulawesi in Indonesia. Int Proc Chem Biol Environ Eng. 2016;95. https://doi.org/10.7763/IPCBEE.2016.V95.13.

Pan American Health Organization. Underweight, short stature and overweight in adolescents and young women in Latin America and the Caribbean. 2008.

Government of the Federal Democratic Republic of Ethiopia, National Nutrition Program two. 2016.

Bupe B. Nutritional status among female adolescents aged (15 – 19 years) in Zambia: why it matters. Horizon journal of medicine and medical. Sciences. 2015;1(1):001–7.

Chukwuma B, Anthony C, Kenechi A, Kevin C, Chinomnso C, Irene A, et al. Prevalence and determinants of adolescent malnutrition in Owerri, Imo state, Nigeria. Int J Sci Healthc Res. 2016;1(3):53–63.

Lorraine S, Parke E, Helen S, F. James L. Household Food Security Is Inversely associated with undernutrition among adolescents from Kilosa (Tanzania). J Nutr. 2012;142(9):1741–7.

Taru M, Hesham E, David T, Jason R. The prevalence of underweight, overweight, obesity and associated risk factors among school-going adolescents in seven African countries. BMC Public Health. 2014;14:887. https://doi.org/10.1186/1471-2458-14-887.

Susan K, Guy P, Grace E, Bart V. Determinants of stunting and overweight among young children and adolescents in sub-Saharan Africa. Food Nutr Bull. 2014;35(2):167–78.

James E. Adolescent health and development (AHD): a resource guide for World Bank operations staff and government counterparts; 2004.

Allen LH. Interventions for micronutrient deficiency control in developing countries: past, present, and future. J Nutr. 2003;133:3875S–8S.

Thông tin
Thông tin xuất bản

Springer Science and Business Media LLC

Tập 5 Số 1

Thông tin tác giả