Pooled prevalence and associated factors of chronic undernutrition among under-five children in East Africa: A multilevel analysis

Background Childhood undernutrition is the leading cause of under-five mortality and morbidity in the world particularly in East African countries. Although there are studies on child undernutrition in different East African countries, our search of the literature revealed that there is limited evidence of a pooled analysis of these studies. Therefore, this study aimed to investigate the pooled prevalence and associated factors of chronic undernutrition (i.e. stunting) among under-five children in East Africa. Methods A pooled analysis of the Demographic and Health Surveys (DHSs) in 12 East African countries was conducted. A total weighted sample of 79744 under-five children was included in the study. Mixed-effect logistic regression analysis was used to identify significant factors associated with chronic undernutrition since the DHS data has a hierarchical structure. The intra-class correlation coefficient (ICC), Median Odds Ratio (MOR), Likelihood Ratio (LR)-test, and deviance was used for model comparison. Variables with p-value <0.2 in the bivariable mixed-effect logistic regression analysis were considered for the multivariable analysis. In the multivariable multilevel analysis model, the Adjusted Odds Ratio (AOR) with the 95% Confidence Interval (CI) were reported for significant factors. Results The pooled prevalence of chronic undernutrition among underfive children in East Africa was 33.3% (95% CI: 32.9%, 35.6%) ranging from 21.9% in Kenya to 53% in Burundi. Children whose mothers lived in rural area (AOR = 1.11, 95% CI: 1.06, 1.16), born to mother who had no formal education (AOR = 1.42, 95% CI: 1.34, 1.50) and primary education (AOR = 1.37, 95% CI: 1.31, 1.44), being in poor household (AOR = 1.66, 95% CI: 1.58, 1.74), and middle household (AOR = 1.42, 95% CI: 1.35, 1.49), child aged 36–48 months (AOR = 1.09, 95% CI: 1.04, 1.14), being male (AOR = 1.19, 95% CI: 1.15, 1.23), 2nd - 4th birth order (AOR = 1.08, 95% CI: 1.03, 1.13), and above 4th 1.27 (AOR = 1.27, 95% CI: 1.19, 1.35), home delivery 1.09 (AOR = 1.09, 95% CI: 1.05, 1.13), small size at birth (AOR = 1.35, 95% CI: 1.29, 1.40) and being multiple births (AOR = 1.98, 95% CI: 1.81, 2.17) were associated with increased odds of stunting. While, antenatal care visit (AOR = 0.89, 95% CI: 0.86, 0.93), mothers aged 25–34 (AOR = 0.83, 95% CI: 0.79, 0.86) and ≥ 35 years (AOR = 0.76, 95% CI: 0.72, 0.81), large size at birth (AOR = 0.85, 95% CI: 0.81, 0.88), and family size >8 (AOR = 0.92, 95% CI: 0.87, 0.98) were associated with decreased odds of stunting. Conclusion The study revealed that stunting among under-five children remains a major public health problem in East Africa. Therefore, to improve child nutrition status the governmental and non-governmental organizations should design public health interventions targeting rural residents, and the poorest households. Furthermore, enhancing health facility delivery, ANC visit, and maternal health education is vital for reducing child chronic undernutrition.

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Pooled prevalence and associated factors of health facility delivery in East Africa: Mixed-effect logistic regression analysis

PLoS ONE ◽

10.1371/journal.pone.0250447 ◽

2021 ◽

Vol 16 (4) ◽

pp. e0250447

Author(s):

Getayeneh Antehunegn Tesema ◽

Zemenu Tadesse Tessema

Keyword(s):

Logistic Regression ◽

East Africa ◽

Health Facility ◽

Associated Factors ◽

Facility Delivery ◽

Health Facility Delivery ◽

East African ◽

African Countries ◽

Mixed Effect ◽

Pooled Prevalence

Background Many mothers still give birth outside a health facility in Sub-Saharan Africa particularly in East African countries. Though there are studies on the prevalence and associated factors of health facility delivery, as to our search of literature there is limited evidence on the pooled prevalence and associated factors of health facility delivery in East Africa. This study aims to examine the pooled prevalence and associated factors of health facility delivery in East Africa based on evidence from Demographic and Health Surveys. Methods A secondary data analysis was conducted based on the most recent Demographic and Health Surveys (DHSs) conducted in the 12 East African countries. A total weighted sample of 141,483 reproductive-age women who gave birth within five years preceding the survey was included. All analyses presented in this paper were weighted for the sampling probabilities and non-response using sampling weight (V005), primary sampling unit (V023), and strata (V021). The analysis was done using STATA version 14 statistical software, and the pooled prevalence of health facility delivery with a 95% Confidence Interval (CI) was presented using a forest plot. For associated factors, the Generalized Linear Mixed Model (GLMM) was fitted to consider the hierarchical nature of the DHS data. The Intra-class Correlation Coefficient (ICC), Median Odds Ratio (MOR), and Likelihood Ratio (LR)-test were done to assess the presence of a significant clustering effect. Besides, deviance (-2LLR) was used for model comparison since the models were nested models. Variables with a p-value of less than 0.2 in the bivariable mixed-effect binary logistic regression analysis were considered for the multivariable analysis. In the multivariable mixed-effect analysis, the Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) were reported to declare the strength and significance of the association between the independent variable and health facility delivery. Results The proportion of health facility delivery in East Africa was 87.49% [95% CI: 87.34%, 87.64%], ranged from 29% in Ethiopia to 97% in Mozambique. In the Mixed-effect logistic regression model; country, urban residence [AOR = 2.08, 95% CI: 1.96, 2.17], primary women education [AOR = 1.61, 95% CI: 1.55, 1.67], secondary education and higher [AOR = 2.96, 95% CI: 2.79, 3.13], primary husband education [AOR = 1.19, 95% CI: 1.14, 1.24], secondary husband education [AOR = 1.38, 95% CI: 1.31, 1.45], being in union [AOR = 1.23, 95% CI: 1.18, 1.27], having occupation [AOR = 1.11, 95% CI: 1.07, 1.15], being rich [AOR = 1.36, 95% CI: 1.30, 1.41], and middle [AOR = 2.14, 95% CI: 2.04, 2.23], health care access problem [AOR = 0.76, 95% CI: 0.74, 0.79], having ANC visit [AOR = 1.54, 95% CI: 1.49, 1.59], parity [AOR = 0.56, 95% CI: 0.55, 0.61], multiple gestation [AOR = 1.83, 95% CI: 1.67, 2.01] and wanted pregnancy [AOR = 1.19, 95% CI: 1.13, 1.25] were significantly associated with health facility delivery. Conclusion This study showed that the proportion of health facility delivery in East African countries is low. Thus, improved access and utilization of antenatal care can be an effective strategy to increase health facility deliveries. Moreover, encouraging women through education is recommended to increase health facility delivery service utilization.

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Incidence and predictors of under-five mortality in East Africa using multilevel Weibull regression modeling

Archives of Public Health ◽

10.1186/s13690-021-00727-9 ◽

2021 ◽

Vol 79 (1) ◽

Author(s):

Getayeneh Antehunegn Tesema ◽

Achamyeleh Birhanu Teshale ◽

Zemenu Tadesse Tessema

Keyword(s):

East Africa ◽

Health Facility ◽

Media Exposure ◽

Facility Delivery ◽

Health Facility Delivery ◽

East African ◽

African Countries ◽

Wealth Status ◽

Under Five ◽

Size At Birth

Abstract Background In 2017, an estimated 5.3 million under-five children died annually in Sub-Saharan African countries, more than half of those deaths occurred in East Africa. Though East African countries share the huge burden of global under-five mortality, there is limited evidence on the incidence and predictors of under-five mortality. Therefore, this study investigated the incidence and predictors of under-five mortality in East Africa. Methods A community-based cross-sectional study was done based on the Demographic and Health Survey (DHS) data of 12 East African countries conducted from 2008 to 2019. A total weighted sample of 138,803 live births within 5 years preceding the survey were included for analysis. The Kaplan-Meier curve and Log-rank test were done to assess the children’s survival experience across variable categories. The Global Schoenfeld residual test was employed for checking Proportional Hazard (PH) assumptions and it was violated (p-value< 0.05). Considering the hierarchical nature of DHS data, multilevel parametric survival models were fitted. Model comparison was made by AIC, deviance, and shape of the hazard function. Variables with a p-value of less than 0.2 in the bi-variable analysis were considered for the multivariable analysis. In the multilevel Weibull regression analysis, the Adjusted Hazard Ratio (AHR) with 95% Confidence Interval (CI) was reported to declare the significant predictors of under-five mortality. Results Under-five mortality rate in East Africa was 51.318 (95% CI: 51.311, 51.323) per 1000 live births. Babies born to mothers attained secondary education and above (AHR = 0.83, 95% CI: 0.75, 0.91), being 2nd - 4th birth order (AHR = 0.62, 95% CI: 0.56, 0.67), ≥ 5th birth order (AHR = 0.68, 95% CI: 0.61, 0.76), health facility delivery (AHR = 0.87, 95% CI: 0.82, 0.93), 1–3 ANC visit (AHR = 0.61, 95% CI: 0.54, 0.68), births interval of 24–48 months (AHR = 0.53, 95% CI: 0.50, 0.57), wanted pregnancy (AHR = 0.72, 95% CI: 0.68, 0.76), middle wealth status (AHR = 0.90, 95% CI: 0.83, 0.97), and richest wealth status (AHR = 0.81, 95% CI:0.73, 0.90) were significantly associated with lower hazards of under-five mortality. Whereas, advanced maternal age (≥35 years) (AHR = 1.13, 95% CI: 1.04, 1.24),, babies born to household who did not have media exposure (AHR = 1.13, 95% CI: 1.07, 1.20), twin births (AHR = 3.81, 95% CI: 3.52, 4.12), being male child (AHR = 1.27, 95%CI: 1.21, 1.33), small birth size at birth (AHR = 1.73, 95% CI: 1.63, 1.84), and large size at birth (AHR = 1.11, 95% CI: 1.04, 1.11) were significantly associated with higher hazards of under-five mortality. Conclusion Under-five mortality is a major public health concern in East African countries. Health facility delivery, ANC visit, higher wealth status, adequate birth spacing, wanted pregnancy, and maternal education were significantly correlated with a lower risk of under-5 mortality. Whereas, higher birth order, small or large size at birth, male birth, twin birth, advanced maternal age and mothers who didn’t have media exposure were significantly correlated with a higher risk of under-five mortality. This study highlights that public health programs should enhance health facility delivery, ANC visit, media exposure, maternal education, and adequate birth spacing to decrease the incidence of under-five mortality in East Africa.

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Zinc utilization and associated factors among under-five children with diarrhea in East Africa: A generalized linear mixed modeling

PLoS ONE ◽

10.1371/journal.pone.0243245 ◽

2020 ◽

Vol 15 (12) ◽

pp. e0243245

Author(s):

Yigizie Yeshaw ◽

Misganaw Gebrie Worku ◽

Zemenu Tadesse Tessema ◽

Achamyeleh Birhanu Teshale ◽

Getayeneh Antehunegn Tesema

Keyword(s):

East Africa ◽

Associated Factors ◽

Maternal Education ◽

Media Exposure ◽

Wealth Index ◽

East African ◽

African Countries ◽

Under Five ◽

Under Five Children ◽

Zinc Utilization

Introduction Diarrhea is the leading cause of illness and death among under-five children in low and middle income countries. Through the provision of zinc supplements has been shown to reduce the severity and duration of diarrhea, as well as the risk of mortality, the use of zinc for the treatment of diarrhea is still very low in low-income countries. Therefore, this study was conducted to determine the prevalence and associated factors of zinc utilization among under-five children with diarrhea in East Africa. Methods A secondary data analysis of the recent Demographic and Health Surveys (DHS) of East African countries were used to determine the prevalence and associated factors of zinc utilization among under-five children with diarrhea in East Africa. A total weighted samples of 16,875 under-five children with diarrhea were included in the study. A generalized linear mixed model (using Poisson regression with robust error variance) was used. Prevalence Ratios (PR) with their 95% confidence interval (CI) were calculated for those variables included in the final model. Results The overall prevalence of zinc utilization among under-five children with diarrhea in this study was 21.54% (95% CI = 20.92–22.16). Of East African countries, Uganda had the highest prevalence of zinc utilization (40.51%) whereas Comoros had the lowest (0.44%). Maternal primary education (Adjusted Prevalence Ratio(aPR) = 1.29, 95% CI: 1.16–1.44), secondary education (aPR = 1.36, 95% CI = 1.19–1.55) and higher education (aPR = 1.91, 95% CI = 1.52–2.40), high community women education (aPR = 1.12, 95% CI = 1.02–1.24), high wealth index (aPR = 1.12, 95% CI = 1.01–1.24), high community media exposure (aPR = 1.17, 95% CI = 1.06–1.29) were associated with a higher prevalence of zinc utilization. Conclusion The prevalence of zinc utilization among under-five children was found to be low in East Africa. Maternal education, wealth index, community women education, and community media exposure were significantly associated with zinc utilization. Increased mass media exposure, maternal education and wealth index is recommended to improve zinc utilization among under-five children with diarrhea.

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Prevalence of stillbirth and its associated factors in East Africa: generalized linear mixed modeling

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-03883-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Getayeneh Antehunegn Tesema ◽

Zemenu Tadesse Tessema ◽

Koku Sisay Tamirat ◽

Achamyeleh Birhanu Teshale

Keyword(s):

Public Health ◽

East Africa ◽

Birth Interval ◽

Associated Factors ◽

Maternal Education ◽

Public Health Problem ◽

Household Wealth ◽

East African ◽

African Countries ◽

Mixed Effect

Abstract Background Stillbirth is the most frequently reported adverse pregnancy outcome worldwide, which imposes significant psychological and economic consequences to mothers and affected families. East African countries account for one-third of the 2.6 million stillbirths globally. Though stillbirth is a common public health problem in East African countries, there is limited evidence on the pooled prevalence and associated factors of stillbirth in East Africa. Therefore, this study aimed to investigate the prevalence of stillbirth and its associated factors in East Africa. Methods This study was based on the most recent Demographic and Health Surveys (DHSs) of 12 East African countries. A total weighted sample of 138,800 reproductive-age women who gave birth during the study period were included in this study. The prevalence of stillbirth with the 95% Confidence Interval (CI) was reported using a forest plot. A mixed-effect binary logistic regression analysis was done to identify significantly associated factors of stillbirth. Since the DHS data has hierarchical nature, the presence of clustering effect was assessed using the Likelihood Ratio (LR) test, and Intra-cluster Correlation Coefficient (ICC), and deviance were used for model comparison. Variables with a p-value of less than 0.2 in the bi-variable analysis were considered for the multivariable analysis. In the multivariable mixed-effect binary logistic regression analysis, the Adjusted Odds Ratio (AOR) with 95% CI were reported to declare the strength and significance of the association. Results The prevalence of stillbirth in East Africa was 0.86% (95% CI: 0.82, 0.91) ranged from 0.39% in Kenya to 2.28% in Burundi. In the mixed-effect analysis; country, women aged 25–34 years (AOR = 1.27, 95% CI: 1.11, 1.45), women aged ≥ 35 years (AOR = 1.19, 95% CI: 1.01, 1.44), poor household wealth (AOR = 1.07, 95% CI: 1.02, 1.23), women who didn’t have media exposure (AOR = 1.11, 95% CI: 1.01, 1.25), divorced/widowed/separated marital status (AOR = 2.99, 95% CI: 2.04, 4.39), caesarean delivery (AOR = 1.81, 95% CI: 1.52, 2.15), preceding birth interval < 24 months (AOR = 1.15, 95% CI: 1.06, 1.24), women attained secondary education or above (AOR = 0.68, 95% CI: 0.56, 0.81) and preceding birth interval ≥ 49 months (AOR = 1.45, 95% CI: 1.28, 1.65) were significantly associated with stillbirth. Conclusions Stillbirth remains a major public health problem in East Africa, which varied significantly across countries. These findings highlight the weak health care system of East African countries. Preceding birth interval, county, maternal education media exposure, household wealth status, marital status, and mode of delivery were significantly associated with stillbirth. Therefore, public health programs enhancing maternal education, media access, and optimizing birth spacing should be designed to reduce the incidence of stillbirth.

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Pooled prevalence and determinants of skilled birth attendant delivery in East Africa countries: a multilevel analysis of Demographic and Health Surveys

Italian Journal of Pediatrics ◽

10.1186/s13052-020-00943-z ◽

2020 ◽

Vol 46 (1) ◽

Author(s):

Zemenu Tadesse Tessema ◽

Getayeneh Antehunegn Tesema

Keyword(s):

East Africa ◽

Odds Ratio ◽

Wealth Index ◽

Skilled Birth Attendant ◽

Skilled Birth Attendance ◽

Demographic And Health Surveys ◽

East African ◽

African Countries ◽

Birth Attendance ◽

Pooled Prevalence

Abstract Introduction Skilled health professional assisted delivery is an effective strategy to reduce maternal and newborn mortality. Skilled assistant delivery can prevent about 16–33% of maternal and newborn mortality. Despite the commitments of the government to assure home free delivery, majority of the births in Sub-Saharan Africa are attended by traditional birth attendants. As to our search of the literature, there is limited evidence on the prevalence and determinants of skilled delivery in East African countries. Therefore, this study aimed to estimate the pooled prevalence and determinants of skilled birth attendant delivery in East Africa Countries. Methods Pooled analysis was done based on Demographic and Health Surveys conducted in the 12 East African countries from 2008 to 2017. A total weighted sample of 141,483 women who gave birth during the study period was included in the study. The pooled prevalence of skilled birth attendance was estimated using STATA version 14. Intra-class Correlation Coefficient, Median Odds Ratio, Proportional Change in Variance, and deviance were used for model fitness and comparison. The multilevel multivariable logistic regression model was fitted to identify determinants of skilled birth attendance in the region. Adjusted Odds Ratio with its 95% Confidence Interval was used to declare significant determinants of skilled birth attendants. Results The pooled prevalence of skilled birth attendant in East African countries were 67.18% (95% CI:66.98, 67.38) with highest skilled birth attendant in Rwanda (90.68%) and the lowest skilled birth attendant in Tanzania (11.91%). In the Multilevel multivariable logistic regression model; age 15–24 (Adjusted Odds Ratio (AOR) = 1.14, 95%CI:1.09, 1.18), age 25–49(AOR = 1.16, 95%CI:1.10,1.23), primary women education (AOR = 1.57, 95%CI:1.51,1.63), secondary and above women education (AOR = 2.85, 95%CI:1.73,3.01), primary husband education (AOR = 1.11, 95%CI = 1.07,1.15), secondary and above husband education (AOR = 1.46, 95%CI = 1.40,1.53), middle wealth index (AOR = 1.43, 95%CI = 1.38,1.49),rich wealth index (AOR = 2.38, 95%CI = 2.28,2.48), had ANC visit (AOR = 1.68, 95%CI = 1.62,1.73),multiple gestation (AOR = 2.06, 95%CI = 1.90,2.25), parity 2–4(AOR = 0.65, 95%CI = 0.61,0.69), parity 5 + (AOR = 0.44, 95%CI = 0.41,0.47), accessing health care not big problem (AOR = 1.32, 95%CI = 1.28,1.36), residence (AOR = 0.43, 95%CI = 0.41,0.45) and being Burundi resident (AOR = 0.77, 95%CI = 0.70,0.85) were significantly associated with skilled assisted delivery. Conclusion Skilled birth attendance at birth in the East Africa countries was low. Maternal age, women and husband education, wealth index, antenatal care visit, multiple gestations, parity, accessing health care, residence, and living countries were major determinants of skilled attendant delivery. Strategies to increase the accessibility and availability of healthcare services, and financial support that targets mothers from poor households and rural residents to use health services will be beneficial. Health education targeting mothers and their partner with no education are vital to increasing their awareness about the importance of skilled birth attendance at birth.

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Overweight and/or obesity and its determinants among under-five children in East African countries: A multilevel analysis using Bayesian approach

Heliyon ◽

10.1016/j.heliyon.2021.e08643 ◽

2021 ◽

pp. e08643

Author(s):

Sofonyas Abebaw Tiruneh ◽

Alemayehu Digssie Gebremariam ◽

Melaku Tadege Engidaw ◽

Desalegn Tesfa Asnakew ◽

Fentaw Teshome Dagnaw ◽

...

Keyword(s):

Multilevel Analysis ◽

Bayesian Approach ◽

East African ◽

African Countries ◽

Under Five ◽

Under Five Children

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Prevalence of Alcohol use during pregnancy and its association with partner alcohol use in East Africa: systematic review and meta-analysis

10.1101/687467 ◽

2019 ◽

Author(s):

Abate Dargie ◽

Yossef Eshetie ◽

Yared Asmare ◽

Wendimeneh Shibabaw ◽

Kefyalew Dagne

Keyword(s):

Alcohol Use ◽

East Africa ◽

Meta Analysis ◽

National Level ◽

Total Sample ◽

East African ◽

African Countries ◽

Major Health ◽

Pooled Prevalence ◽

Pregnant Mothers

AbstractIntroductionmaternal alcohol beverages consumption (any amount) during pregnancy can result in multiple major health and social problems both for the mother and fetus; including miscarriage, stillbirth, low birth weight, and prematurity. At the regional and national level, alcohol use prevalence data is a use full indicator for maternal and child health.Methodsthe researchers were searched for studies using a computerized search engine, main electronic databases, and other applicable sources. Observational studies (case-control, crosssectional and cohort) which assess the prevalence of alcohol use and associated factors among pregnant mothers in East Africa were eligible. Data was extracted thoroughly by two authors independently and screened for eligibility. The Pooled prevalence of alcohol use during pregnancy and its association with partner alcohol use was determined by using Epi data version 14 statistical software.Resultsthe study included eighteen studies with the total sample size of 41,022 and The overall pooled prevalence of alcohol use during pregnancy from the random effects method was found to be 18.85% (95% CI; 11.26, 26.44). The overall weighted odds ration revealed that pregnant women partners’ alcohol use did not have a significant association with study subjects alcohol use during pregnancy; i.e. OR=0.32 (95% CI: −0.39, 1.03).ConclusionsThe overall alcohol use (any amount) during pregnancy is higher in magnitude and pregnant mothers who had alcohol user partner had no association with their use of alcohol beverages. The prevalence of alcohol use during pregnancy may be underestimated in the current study due to social desirability bias. Since related study articles were found only in four East African countries, the region may be under-represented due to the limited number of studies included.

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Defamation in East Africa

Journal of African Law ◽

10.1017/s0021855300013036 ◽

1973 ◽

Vol 17 (1) ◽

pp. 66-93 ◽

Cited By ~ 1

Author(s):

R. W. Hodgin

Keyword(s):

East Africa ◽

East African ◽

African Countries ◽

English Law

The purpose of this article is to review the application of the English law of defamation in the East African countries (Uganda, Kenya, Tanzania) and to assess the possible contribution of the Kenya Defamation Act, 1970.

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Prevalence of pneumonia and its associated factors among under five children in East Africa. Meta-analysis and systemic review

10.21203/rs.2.23015/v1 ◽

2020 ◽

Author(s):

Biruk Beletew Abate ◽

Melaku Getahun Bimrew ◽

Ayelign Mengesha Kasie ◽

Mesfin Kassaw Wudu ◽

Molla Azmeraw

Keyword(s):

East Africa ◽

Associated Factors ◽

Meta Analysis ◽

Eastern Africa ◽

Systemic Review ◽

Cochrane Library ◽

Under Five ◽

Under Five Children ◽

The Impact ◽

National Prevalence

Abstract Introduction Pneumonia is defined as an acute inflammation of the Lungs’ parenchymal structure. It is a major public health problem and the leading cause of morbidity and mortality in under-five children especially in developing countries. In 2015, it was estimated that about 102 million cases of pneumonia occurred in under-five children, of which 0.7 million were end up with death. Different primary studies in Eastern Africa showed the burden of pneumonia. However, inconsistency among those studies was seen and no review has been conducted to report the amalgamated magnitude and associated factors. Therefore, this review aimed to estimate the national prevalence and associated factors of neonatal sepsis in Eastern Africa. Objective The aim of this systematic review and meta-analysis was to assess the magnitude of pneumonia and its associated factors among under-five children in East Africa. Methods Using PRISMA guideline, we systematically reviewed and meta-analyzed studies that examined the prevalence and associated factors of pneumonia from PubMed, Cochrane library, and Google Scholar. Heterogeneity across the studies was evaluated using the Q and the I 2 test. A weighted inverse variance random-effects model was applied to estimate the national prevalence and the effect size of associated factors. The subgroup analysis was conducted by country, study design, and year of publication. A funnel plot and Egger’s regression test were used to see publication bias. Sensitivity analysis was also done to identify the impact of studies. Result A total of 34 studies with 87, 984 participants were used for analysis. The pooled prevalence of hypothermia in East Africa was 34% (95%CI; 23.80–44.21). Use of wood as fuel source (AOR= 1.53; 95%CI:1.30-1.77; I 2 = 0.0% ;P=0.465), cook food in living room (AOR= 1.47;95%CI:1.16-1.79; I 2 = 0.0% ;P=0.58), caring of a child on mother during cooking (AOR= 3.26; 95%CI:1.80-4.72; I 2 = 22.5% ;P=0.26), Being unvaccinated (AOR= 2.41; 95%CI:2.00-2.81; I 2 = 51.4% ;P=0.055), Child history of ARTI(AOR= 2.62; 95%CI:1.68-3.56; I 2 = 11.7% ;P=0.337) were identified factors of pneumonia. Conclusions The prevalence of pneumonia in Eastern Africa remains high. This review will help policy-makers and program officers to design pneumonia preventive interventions.

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Analysis of main risk factors contributing to obesity in the region of East Africa: meta-analysis

African Health Sciences ◽

10.4314/ahs.v20i1.30 ◽

2020 ◽

Vol 20 (1) ◽

pp. 248-256

Author(s):

Lenka Mařincová ◽

Simona Šafaříková ◽

Radka Cahlíková

Keyword(s):

Risk Factors ◽

East Africa ◽

Meta Analysis ◽

Obesity Prevalence ◽

East African ◽

African Region ◽

African Countries ◽

Chi Square ◽

Chi Square Test ◽

Risk Ratios

Background: Over a few decades obesity has become a major global health problem. Its prevalence worldwide has more than doubled since 1980. The situation is expected to worsen in the future, especially in the developing countries that experience nutrition transition due to economic growth. It contributes to reduction in malnutrition which supports an increase in obesity prevalence. Objectives: The aim of this study was to analyse the predictors of obesity in the region of East Africa. Methods: Meta-analysis of existing studies was used in order to find the different risk factors and their significance in obesity development. Data extracted from 16 published academic research articles described the situation in East African countries. The significance of the effect of each variable was tested by means of an asymptotic chi-square test, or Fisher's exact (factorial) test and the risk ratios were calculated. Results: Based on the chi-square test and the risk ratios of the aggregated data, three risk factors were found to be significant in the development of obesity – gender, type of residence and socio-economic status. In East African countries, women are significantly more likely to be obese. Living in an urban area and socioeconomic status are also positively associated with obesity. Because of insufficient data three other risk factors did not prove to be of any significance – alcohol consumption, smoking and education level. Conclusion: Conclusions of this meta-analysis confirm world trends but we also found results that are not in line with them (e.g. education). This meta-analysis confirms the huge existing research gap concerning obesity predictors in the East African region. Keywords: Obesity; meta-analysis; East Africa.

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