Abstract
Background
Undernutrition remains a major public health concern affecting both children and adolescents in Ethiopia. However, little attention has been given to the undernutrition of primary school-aged children, with their exclusion within national surveys. Therefore, this systematic review and meta-analysis was conducted to determine pooled estimate and determinant factors of undernutrition among primary school-aged children (6 to 15 years of age) in Ethiopia.
Method
We systematically retrieved available articles on the prevalence of undernutrition in primary school-aged children in Ethiopia by using a number of computerized databases, including PubMed, Scopus, Cochrane Library, Google Scholar, and Science Direct between September 1 and November 25, 2019. Two authors independently extracted relevant data using a standardized data extraction form. Heterogeneity among included studies was assessed with the Cochrane Q test statistics and Higgins I2 tests. The pooled estimates and determinant factors of school-aged undernutrition were assessed with random-effects model using Stata/se Version 14.
Result
We have retrieved 30 eligible articles with pooled sample size of 16,642 primary school- aged children to determine the prevalence of undernutrition in Ethiopia. Hence, the pooled prevalence of stunting, underweight, and wasting were found to be 21.3% (95% CI: 17.0, 25.5), 18.2% (95% CI: 14.4, 22.0) and 17.7% (95% CI, 13.5, 21.8) respectively. Heterogeneity was assessed by doing subgroup analysis for study province/region. Thus, the highest prevalence of stunting was 27.6% (95% CI, 20.7, 34.5) and underweight 22.7% (95% CI, 19.2, 26.3) in Amhara Region while, in the instance of wasting, it was 19.3%(95% CI: 5.1, 33.4) in Southern Nations, Nationalities and People’s Region. Maternal educational status (OR = 1.91, 95% CI: 1.33, 2.73), age of school-aged child (OR = 0.56, 95% CI: 0.44, 0.72) and sex of school-aged child (OR = 0.73, 95% CI: 0.62, 0.85) were found to be significantly associated with stunting. Maternal educational status (OR = 0.6, 95% CI: 0.36, 0.9) and age of school-aged child (OR = 2.74, 95% CI: 1.81, 4.14) were associated with thinness/wasting. Parasitic infection (OR = 2.02, 95% CI: 1.10, 3.73) were associated with underweight of school age children.
Conclusion
The prevalence of stunting and underweight among primary school-aged children are moderately high while acute undernutrition (wasting) is more critical than under-five national average as reported in the 2016 Ethiopian Demography and Health Survey. Therefore, this finding warrants the need to design a school-aged children nutrition survey and expand school feeding programs to improve the nutritional status of primary school-aged children in the country. In addition, emphasis should be given to female school-aged children in the early school years, creating awareness for those mothers who lack formal education, and preventing and treating/deworming parasitic infection. Moreover, researchers must conduct research in province/regions which have not yet studied school aged children’s nutritional status to date.
Trends and prevalence of overweight and obesity in primary school aged children in the Republic of Ireland from 2002-2012: a systematic review