prevalenceandassociatedfactorsofthinnessamongadolescent...

9
Research Article Prevalence and Associated Factors of Thinness among Adolescent Students in Finote Selam Town, Northwest Ethiopia Damitie Kebede Mengesha , 1,2 Reddy P. C. J. Prasad, 1 and Degnet Teferi Asres 1 1 Faculty of Chemical and Food Engineering, Bahir Dar Institute of Technology, Bahir Dar University, P. O. Box 79, Bahir Dar, Ethiopia 2 College of Agriculture and Environmental Sciences, Bahir Dar University, P. O. Box 5501, Bahir Dar, Ethiopia Correspondence should be addressed to Damitie Kebede Mengesha; [email protected] Received 29 January 2020; Revised 16 March 2020; Accepted 19 May 2020; Published 2 June 2020 Academic Editor: Adriano Sfriso Copyright © 2020 Damitie Kebede Mengesha et al. is is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Even if adolescence is a window of opportunity to break the intergenerational cycle of malnutrition, adolescents are the neglected age groups. Hence, information regarding the nutritional status of adolescents is lacking, making creating and implementing intervention programs difficult. is study aimed to assess the prevalence and determinants of thinness among school adolescents in Finote Selam Town, Northwest Ethiopia. A school-based cross-sectional study among adolescent students aged 10–19 in public primary and secondary schools was carried out in Finote Selam Town from February 05 to March 27, 2018. Stratified and simple random sampling techniques were employed to select study subjects. A total of 397 adolescent students were included in the study. Pretested structured questionnaires were used to collect the data. Data were entered using Epi Info version 7 and analyzed using SPSS version 20 and WHO AnthroPlus software. A multivariable binary logistic regression analysis was employed to identify factors associated with thinness. Crude and adjusted odds ratios with 95% level significance were used to measure the strength of association, and statistical significance was declared at p value less than 0.05. e prevalence of thinness among adolescents was 14.9%. Early adolescent stage (AOR 4.81; 95% CI :1.23, 18.51), being male adolescent students (AOR 2.33; 95% CI : 1.60, 3.40), having less than 1000 birr family monthly income (AOR 6.54; 95% CI : 3 : 82, 14.89), having 1000–2000 birr family monthly income (AOR 3.47; 95% CI :1.15, 7.45), and using well water (AOR 3.82; 95% CI : 1.46, 10.04) were significantly associated with thinness at 95% confidence interval. e study revealed that prevalence of thinness was high in the study area. Sex, place of residence, and family monthly income were found to be important factors associated with thinness among the respondents. 1. Introduction Both the UN and WHO define adolescence as a segment of population group age from 10 to 19 years old; it is a transition period from childhood to adulthood and has intense physical, psychosocial, and cognitive development [1]. During this period, the final growth spurt occurs; particularly, early adolescence after the first year of life is the critical period of rapid physical growth and changes in body composition, physiology, and endocrine [2]. Up to 45% of skeletal growth takes place, and 15 to 25% of adult height is achieved during adolescence; during the growth spurt of adolescence, up to 37% of total bone mass may be accu- mulated [3]. Regarding body composition change, girls begin to store fat around the breast, hips, and upper arm but boys start losing fat and develop muscle [4]. e adolescence period is a window of opportunity for human beings because there is possibility of little catch-up growth [5], and it is a time of changing lifestyles and food habit; changes affect both nutrient needs and intake, so it is an opportunity to shape this new behavior adoption [6]. Our world is a home to 1.8 billion (24.66%) young people be- tween the ages of 10 and 24, and the youth population is growing fastest in the poorest nations; currently, adolescents make up roughly 20% of the global population [7]. In de- veloping countries, adolescents have an even higher 85% demographic weight, for instance, roughly 26% in Salvador, compared to 14% in the USA [8]. Similarly, in Ethiopia, Hindawi e Scientific World Journal Volume 2020, Article ID 9170301, 9 pages https://doi.org/10.1155/2020/9170301

Upload: others

Post on 28-Jul-2020

0 views

Category:

Documents


0 download

TRANSCRIPT

Page 1: PrevalenceandAssociatedFactorsofThinnessamongAdolescent ...downloads.hindawi.com/journals/tswj/2020/9170301.pdf · Pretested structured questionnaireswere used to collect the data

Research ArticlePrevalence and Associated Factors of Thinness among AdolescentStudents in Finote Selam Town Northwest Ethiopia

Damitie Kebede Mengesha 12 Reddy P C J Prasad1 and Degnet Teferi Asres1

1Faculty of Chemical and Food Engineering Bahir Dar Institute of Technology Bahir Dar University P O Box 79Bahir Dar Ethiopia2College of Agriculture and Environmental Sciences Bahir Dar University P O Box 5501 Bahir Dar Ethiopia

Correspondence should be addressed to Damitie Kebede Mengesha dakebede10gmailcom

Received 29 January 2020 Revised 16 March 2020 Accepted 19 May 2020 Published 2 June 2020

Academic Editor Adriano Sfriso

Copyright copy 2020 Damitie Kebede Mengesha et al )is is an open access article distributed under the Creative CommonsAttribution License which permits unrestricted use distribution and reproduction in anymedium provided the original work isproperly cited

Even if adolescence is a window of opportunity to break the intergenerational cycle of malnutrition adolescents are the neglectedage groups Hence information regarding the nutritional status of adolescents is lacking making creating and implementingintervention programs difficult )is study aimed to assess the prevalence and determinants of thinness among school adolescentsin Finote Selam Town Northwest Ethiopia A school-based cross-sectional study among adolescent students aged 10ndash19 in publicprimary and secondary schools was carried out in Finote Selam Town from February 05 to March 27 2018 Stratified and simplerandom sampling techniques were employed to select study subjects A total of 397 adolescent students were included in the studyPretested structured questionnaires were used to collect the data Data were entered using Epi Info version 7 and analyzed usingSPSS version 20 and WHO AnthroPlus software A multivariable binary logistic regression analysis was employed to identifyfactors associated with thinness Crude and adjusted odds ratios with 95 level significance were used to measure the strength ofassociation and statistical significance was declared at p value less than 005 )e prevalence of thinness among adolescents was149 Early adolescent stage (AOR 481 95 CI 123 1851) being male adolescent students (AOR 233 95 CI 160 340)having less than 1000 birr family monthly income (AOR 654 95 CI 3 82 1489) having 1000ndash2000 birr family monthlyincome (AOR 347 95CI 115 745) and using well water (AOR 382 95 CI 146 1004) were significantly associated withthinness at 95 confidence interval )e study revealed that prevalence of thinness was high in the study area Sex place ofresidence and family monthly income were found to be important factors associated with thinness among the respondents

1 Introduction

Both the UN and WHO define adolescence as a segment ofpopulation group age from 10 to 19 years old it is atransition period from childhood to adulthood and hasintense physical psychosocial and cognitive development[1] During this period the final growth spurt occursparticularly early adolescence after the first year of life is thecritical period of rapid physical growth and changes in bodycomposition physiology and endocrine [2] Up to 45 ofskeletal growth takes place and 15 to 25 of adult height isachieved during adolescence during the growth spurt ofadolescence up to 37 of total bone mass may be accu-mulated [3] Regarding body composition change girls

begin to store fat around the breast hips and upper arm butboys start losing fat and develop muscle [4]

)e adolescence period is a window of opportunity forhuman beings because there is possibility of little catch-upgrowth [5] and it is a time of changing lifestyles and foodhabit changes affect both nutrient needs and intake so it isan opportunity to shape this new behavior adoption [6] Ourworld is a home to 18 billion (2466) young people be-tween the ages of 10 and 24 and the youth population isgrowing fastest in the poorest nations currently adolescentsmake up roughly 20 of the global population [7] In de-veloping countries adolescents have an even higher 85demographic weight for instance roughly 26 in Salvadorcompared to 14 in the USA [8] Similarly in Ethiopia

Hindawie Scientific World JournalVolume 2020 Article ID 9170301 9 pageshttpsdoiorg10115520209170301

children and adolescents constitute about 48 of Ethiopianpopulation and about 25 of the Ethiopian populations areadolescents but studies among this age group were insuf-ficient [9]

Different researchers conducted a study on thinnessamong school adolescents in different parts of the country)e prevalence of thinness varies across different regions ofEthiopia )e prevalence of thinness among adolescent girlswas 216 28 214 and 148 in studies conducted inBabille District [10] Bedlle [11] Adwa [12] and Arsi Zone[13] )e overall prevalence of thinness among adolescentschool girls in Lay Guyint Woreda Northwest Ethiopia was290 [14] )e prevalence of thinness among adolescentschool girls in Adwa Town North Ethiopia was 214 [12])e overall prevalence of thinness among school-goingadolescents in Mekelle City Northern Ethiopia was 378[15] )e prevalence of thinness among adolescents inWukro Northern Ethiopia was 261 [16] However therewas no any study report on thinness in the study area )isstudy would serve as a baseline for further study and beimportant for designing intervention and a guide for poli-cymakers and development planners )is study was mainlyfocused to assess the prevalence and explore determinants ofthinness among school adolescents in Finote Selam TownNorthwest Ethiopia

2 Methods

21 Study Design and Area )e study design was a school-based cross-sectional study among adolescent students aged10ndash19 in public primary and secondary schools )e studywas carried out from February 05 to March 27 2018 )isstudy was conducted in Finote Selam Town which is located389 km northwest of Addis Ababa and 176 km southeastfrom Bahir Dar the city of Amhara Region Finote Selamtown administration has been established to be the maintown of West Gojjam Zone since 2004 EC )e totalpopulation size of the town according to 2007 census reportwas 25913 (13 035 males and 12 878 females) )e town issituated at an altitude ranging from 1500ndash2300 meters abovesea level and has an area coverage of 116954 ha )e areareceives an average annual rainfall of 1250mm )e mini-mum and maximum daily temperatures of the area are 14and 32degC respectively It is bordered on the north by Sekelaand Quarit on the south by Dega Damot and Burie on theeast by Deg damot and Dembecha and on the west by Burie)ere are six primary schools one high school one pre-paratory school and five colleges in Finote Selam Town)etotal number of students from grade 5ndash12 was 12323 [17]

22 Source and Study Population All adolescent students(10ndash19) in Finote Selam town schools were the sourcepopulation Randomly selected adolescent students (10ndash19)in Finote Selam town schools were study population

23 Sample Size and Sampling Procedure )e minimumsample size required was calculated using single proportionformula )e proportion of thinness among school-going

adolescents of Mekelle City Northern Ethiopia was 378[18] at a 95 confidence level 5 margin of error adding10 as contingency for nonresponse rate

n z

d1113874 1113875

2xP(1 minus p) (1)

where n sample size ZZ score at 95 CI 196p 378 and dmarginal error 105

n (196)2 lowast 0378(1 minus 0378)

(005)2

38416lowast 0378lowast 0622

(005)2

361

(2)

By adding 10 nonresponse rate the minimum samplesize required to estimate the prevalence of thinness and itsassociated factors among adolescent students was 361 + 10(361 + 36) 397

To obtain the sample stratified random samplingtechnique was used )e schools were stratified into primaryschools junior schools high school and preparatory school)ree primary schools namely Bata Bakel and Efrata andthree junior schools namely Edgetber Bata and Bakel wereselected using simple random sampling from six primaryschools and six junior schools respectively whereas a highschool namely Finote Selam Secondary School and apreparatory school namely Damot Preparatory Schoolwere selected purposively since one high school and onepreparatory school were present in Finote Selam Town )etotal sample size was distributed proportionally to theschools )e sampling frame was studentsrsquo identificationnumber in their respective school Numbers of students to beincluded in the study were determined by a simple randomsampling method (Figure 1)

24 Data Collection To generate the data set used in thisstudy pretested structured questionnaires were used tocollect data by trained data collectors Explanatory variableswere selected after conducting a detailed literature reviewfrom related articles to collect data on the sociodemo-graphic nutritional and health-related variables [16ndash19])e questionnaires were translated into the local language(Amharic) for easy understanding by the respondents Eachstudent was interviewed to obtain information on socio-demographic nutritional and health-related characteristicsof the adolescentsrsquo family

Anthropometric data were collected by trained datacollectors who were health extension workers And theoverall activity was coordinated by the investigator )e ageof the adolescents was derived from the school registerHeight and weight were measured using a stadiometer andSeca Digital Scale (Seca Germany) respectively )e weightwas recorded to the nearest 01 kg It was calibrated againstthe known weight regularly Before the real anthropometricdata collection a standardization exercise was performedduring the training to capture technical error of

2 )e Scientific World Journal

measurement During the procedure the subjects wore lightclothes and took off their shoes Height was measured in cmusing a portable stadiometer All adolescents were measuredagainst the wall without foot wear and with heels togetherand their heads position and eyes looking straight ahead(Frankfurt plane) so that the line of sight was perpendicularto the body )e height was recorded to the nearest 01 cm)e same measurer was employed for a given anthropo-metric measurement to avoid variability

25 Data Quality Control and Management To ensure thereliability and validity of the study training was given for thedata collectors the data collection was done by two healthextension workers and close follow-up was done by theinvestigator during data collection )e Amharic version ofthe questionnaire was tested on 5 of the samples at theSelamamba Primary School who have similar characteristicswith the study participant but did not participate in thestudy )e data collectors and investigator were participatedon pretesting and standardization of the questionnairesProblems highlighted during the preliminary study werecorrected before the start of the actual survey Each questionwas properly coded continuous supervision was performedduring the pretest and data collection period by the in-vestigator Completeness and consistency of recording on

the questionnaire sheets were evaluated by the investigator atthe end of each working day so that correction measureswere taken for the next time

26 Data Analyses Sociodemographic anthropometricnutrition and health-related data were entered into Epi Infoversion 7 and checked for completeness and consistencyfollowed by data cleaning and editing on Epi Info )en thedata were analyzed by using SPSS (Statistical Package forSocial Sciences) version 20 software WHO AnthroPlussoftware was used for assessing growth of the adolescents[20] Descriptive statistics using frequencies and proportionswas used to present the study results For anthropometricdata analysis if the BMI-for-age Z-score is below minus twostandard deviations (minus2 SDs) from the median of the ref-erence population then the child is thin Odds ratio with95 confidence interval was used for checking the strengthof associations between the outcome variable (thinness) andindependent variables Bivariate logistic regression wasperformed and the variable with p value less than 025 wastransported into multivariable binary logistic regressionanalysis to identify the determinant of malnutrition ofunder-five children Finally variables with p values lt005 inthe multivariable logistic regression model were taken asstatistically significant [21]

Adolescent students (10ndash19 years) in FinoteSelam townschools (grade 5ndash12) (N = 12323)

Primary schools (grade 5ndash6)(Bata Bakel amp Efrata)

(N = 3458)

Junior schools (grade 7ndash8)(Edgetber Bata amp Bakel)

(N = 3928)

High school (grade 9ndash10)(Finote Selam Secondary

School) (N = 3289)

Preparatory School (grade 11ndash12)(Damot Preparatory School)

(N = 1648)

Proportional to size allocation

n = 111 n = 127 n = 106 n = 53

Simple random sample (SRS)

n = 397

Figure 1 Schematic presentation of sampling procedures

)e Scientific World Journal 3

3 Results

31 Sociodemographic Characteristics of Study Participantsand 1eir Family From a total of 397 adolescent studentswho were selected as a sample with 100 response rate allstudy participants were involved in this study Among these47 (118) were early adolescents 151 (380) were mid-adolescents and 199 (501) were late adolescents From theparticipants 108 (272) were from primary schools 132(322) were from junior schools while 116 (292) werefrom the high school and others 41 (103) were attendingthe preparatory school Of the total participants 195 (491)were from urban areas whereas 202 (509) were from ruralareas (Table 1)

32 Nutrition and Health-Related Characteristics of SchoolAdolescents Most of the adolescents 278 (700) wereconsuming meals three and above times per day whereas119 (300) of adolescents were consuming meals two timesper day Among the respondents 330 were reportedhaving illness in the last one month Among the respon-dents 288 (725) had home gardens Vegetables (461)and fruits (514) were consumed daily (Table 2)

33 Anthropometric Results )e minimum and maximumheights of study subjects were 12750 cm and 18670 cmrespectively )e meanplusmn SD overall height of the partici-pants was 158plusmn 1067 cm Similarly the minimum andmaximum weights of study participants were 205 kg and68 kg respectively )e meanplusmn SD overall weight of theparticipants was 4599plusmn 1009 kg )e mean heights of boysand girls were 15899plusmn 1224 cm and 15631plusmn 694 cm re-spectively Similarly the mean weights of boy and girl ad-olescents were 451plusmn 1097 kg and 4753plusmn 817 kgrespectively )e mean age of the study participants was1554 years (1554plusmn 241 SD)

Prevalence of thinness the overall prevalence of thinnessamong adolescent students at Finote Selam Town was 149

)e mean Z-score of BMI-for-age of all adolescents wasminus113 which revealed the distribution of BAZ (Figure 2)

)e mean Z-scores of BMI-for-age among boys and girlswere minus129 and minus051 that showed the distribution of BAZrespectively (Figure 3)

34 Factors Associated with 1inness Exploring determi-nants associated with thinness is important to take nutri-tional intervention action in the study area Results of themultivariable binary logistic regression model showed thatthe age sex family monthly income and sources of drinkingwater were significantly associated with thinness )e oddsof thinness were 481 times higher among adolescent stu-dents in the early adolescent stage as compared to adolescentstudents in the late adolescent stage (AOR 481 95 CI 123 1851) Male adolescent students had 213 times higherodds of thinness (AOR 213 95 CI 160 340) comparedto female adolescent students )e students who came from

Table 1 Sociodemographic-related characteristics of adolescentstudents at Finote Selam Town Ethiopia 2018

Variables Frequency PercentageAge groupEarly adolescent (10ndash13) 47 118Midadolescent (14ndash16) 151 380Late adolescent (17ndash19) 199 501SexFemale 148 373Male 249 627GradeGrade 5ndash6 108 272Grade 7ndash8 132 332Grade 9ndash10 116 292Grade 11ndash12 41 103ReligionMuslim 22 55Orthodox 375 945Place of residenceUrban 195 491Rural 202 509Fatherrsquos educationIlliterate 95 238Read and write 101 254Primary school (1ndash8) 41 103Secondary school (9ndash12) 92 232College and above 68 171Motherrsquos educationIlliterate 102 257Read and write 109 275Primary school (1ndash8) 34 86Secondary school (9ndash12) 89 224College and above 63 159Fatherrsquos occupationDaily laborer 57 144Farmer 119 300Merchant 85 214Governmentnongovernment employee 136 343Motherrsquos occupationDaily laborer 5 13Housewife 86 217Merchant 119 300Farmer 107 270Governmentnongovernment employee 80 202Family sizelt5 173 436ge5 224 564Monthly family incomelt1000 birr 77 1931000ndash2000 birr 107 270gt2000 birr 213 537Source of drinking waterSpring water 82 207Well water 106 267Public tap water 26 65Tap water 183 461Presence of functional latrineYes 257 647No 140 353

4 )e Scientific World Journal

rural area were 216 (AOR 261 95 CI 096 487) timesmore likely to be thin compare to those who came fromurban area )e students from less than 1000 and 1000ndash2000birr family monthly income were 654 (AOR 654 95 CI 382 1489) and 347 (AOR 347 95 CI 115 745) timesmore likely to be thin compared to greater than 2000 birrfamily monthly income respectively Students fromhouseholds that used well water supply as main source ofwater supply were 382 times more likely to be at risk ofbeing thin than students from households that used tapwater supply for human consumption (AOR 382 95 CI 146 1004) (Table 3)

4 Discussion

In this study the prevalence of thinness and associatedfactors in Finote Selam Town Northwest Ethiopia wasassessed )e prevalence of thinness was 149 and thisfinding was lower than the studies in Mekelle City (378)[15] Ambo City (275) [22] Wukro District (261) [16]and Seychelles (277) [23] Another study in Ethiopia inJimma Zone has reported a much higher level (808) ofthinness prevalence among adolescents [24] )e prevalenceof thinness of this study was higher than studies done inAddis Ababa (62) (13) [25] )is divergence might be

Table 2 Nutrition and health-related characteristics of school adolescents at Finote Selam Town Ethiopia 2018

Variables Frequency PercentageNumber of meals eaten per dayTwo times 119 300)ree times and above 278 700Illness reported in the last one monthYes 131 330No 266 670Availability of home gardenYes 288 725No 109 275Eating vegetables at least once per dayYes 183 461No 214 539Eating fruits at least once per dayYes 204 514No 193 486Eating farm animal products at least once per weekYes 115 290No 282 710Nutrition and health informationYes 47 118No 350 882

45

40

35

30

25

20

15

10

5

0

Child

ren

()

ndash5 ndash45 ndash4 ndash35 ndash3 ndash25 ndash2 ndash15 ndash1 ndash05 0 05 1 15 2 25 3 35 4 45 5Z-score

WHO child growth standards (birth to 60 months) WHO reference 2007 (61 months to 19 years)All children (n = 354)

Figure 2 BMI-for-age Z -score of adolescent students in Finote Selam Town Ethiopia

)e Scientific World Journal 5

due to the difference in socioeconomic background dietaryhabit and type of meals among the cities Findings in otherAfrican countries include Burkina Faso (137) [26]Asembo and Mumias Kenya (156) [27] Tunisia (13)[28] and Tamale Metropolis district Ghana (10) [29] )evariation might be due to socioeconomic backgroundgeographical characteristics of study area cultural differencein dietary habit and care practices

)e odds of thinness were 481 times higher amongadolescent students in the early adolescent stage as com-pared to adolescent students in the late adolescent stage)isfinding was in agreement with findings from Adwa TownNorthen Ethiopia [17] and in Community-Based Nutritionimplementing districts Amhara Region Ethiopia [30] )ismight be due to as age increases adolescents might accessfood easily by themselves on the other hand as age in-creases adolescents become more matured Male adolescentstudents had 213 times higher odds of thinness compared tofemale adolescent students )is study was in line with thestudies conducted in Mekelle City Northern Ethiopia [15]Jimma Zone Southwest Ethiopia [24] and WukroNorthern Ethiopia [16] which confirmed that males weremore affected in thinness than girls )is might be due tovariation of maturation time in boys and girls for which girlsreached maturation earlier than boys

)e students who came from rural area were 216 timesmore likely to be thin compared to those who came fromurban area )is finding is in agreement with other previ-ously conducted studies [12 16] )e variation might be dueto food preference food consumption pattern and in-equalities in dietary diversity between urban and rural areas)e risk of being thin among school adolescents whosemothers did not attend education was 178 times morecompared to school adolescents whose mother attendedcollege and above education )is finding is consistent withthe study that conducted in Adama City Central Ethiopia

[31] )e risk of being thin among school adolescents whosemothers attended primary school (1ndash8) and secondaryschool (9ndash12) education was 129 and 115 (AOR 115 95CI 066 197) times more compared to students whosemothers attended college and above education respectively)is finding is in line with the study that conducted inAdama City Central Ethiopia [32] )is is due to the factthat if the level of education of the mother is low her de-cision-making and her contribution to the total family in-come will be low)is places the family at risk of not meetingtheir needs including nutritional needs

)e odds of being thin were 190 times higher amongschool adolescents who lived in household members of ge5than school adolescents who had lived in householdmembers lt5 )is finding was in line with the study thatconducted in Adwa Town North Ethiopia [12] )is mightbe due to sharing of the available food for the largehousehold members causing inadequate consumption offood leading to be thin )e students who did not eatvegetables and fruits at least once per day were 130 and 123times more likely to be thin compared to those who ate onceper day )is finding is in agreement with the study thatconducted in Adwa Town North Ethiopia [12])is is mightbe due to the fact that consuming insufficient vegetables andfruits are leading to poor nutritional status

)e students from less than 1000 and 1000ndash2000 birrfamily monthly income were 654 and 347 times more likelyto be thinness compared to greater than 2000 birr familymonthly income respectively )is might be due to thebetter income level of the family would enhance the nu-trition status of the adolescents Students from householdsthat used well water supply as main source of water supplywere 382 times more likely to be at risk of being thinnessthan students from households that used tap water supplyfor human consumption )is finding was in line withfindings from Adwa Town Northen Ethiopia [17] )is

45

40

35

30

25

20

15

10

5

0

Child

ren

()

ndash5 ndash45 ndash4 ndash35 ndash3 ndash25 ndash2 ndash15 ndash1 ndash05 0 05 1 15 2 25 3 35 4 45 5Z-score

WHO child growth standards (birth to 60 months) WHO reference 2007 (61 months to 19 years)Female (n = 131)Male (n = 223)

Figure 3 BMI-for-age Z -score of by sex of adolescent students in Finote Selam Town Ethiopia

6 )e Scientific World Journal

Table 3 Bivariate and multivariable logistic regression of factors associated with thinness among adolescent school students Finote SelamTown Ethiopia 2018

Variables)inness

COR (95 CI) AOR (95 CI)Yes No

Age GroupEarly adolescent (10ndash13) 17 (362) 30 (638) 514 (239 1108)lowast 481 (123 1851)lowastMidadolescent (14ndash16) 24 (159) 127 (841) 190 (099 364) 168 (057 493)Late adolescent (17ndash19) 18 (90) 181 (910) 1 1SexFemale 4 (27) 144 (973) 1 1Male 55 (221) 194 (779) 268 (188 384) 213 (160 340)lowast

GradeGrade 5ndash6 23 (213) 85 (787) 257 (091 724) 177 (040 787)Grade 7ndash8 22 (167) 110 (833) 208 (074 586) 133 (022 819)Grade 9ndash10 10 (86) 106 (914) 101 (032 315) 106 (020 558)Grade 11ndash12 4 (98) 37 (902) 1 1ReligionMuslim 1 (45) 21 (955) 1 1Orthodox 58 (155) 317 (845) 382 (050 2918) 390 (019 8194)Place of residenceUrban 18 (92) 177 (908) 1 1Rural 41 (203) 161 (797) 244 (135 440)lowast 216 (096 487)Fatherrsquos educationIlliterate 15 (158) 80 (842) 279 (092 845) 406 (023 7176)Read and write 17 (168) 84 (832) 197 (071 543) 273 (031 24 29)Primary school (1ndash8) 10 (244) 31 (756) 196 (073 532) 236 (026 2141)Secondary school (9ndash12) 11 (120) 81 (880) 144 (051 410) 080 (05 1290)College and above 6 (88) 62 (912) 1 1Motherrsquos educationIlliterate 17 (167) 85 (833) 238 (077 739) 178 (086 365)Read and write 16 (147) 93 (853) 186 (068 507) 140 (083 234)Primary school (1ndash8) 9 (265) 25 (735) 150 (055 409) 129 (061 271)Secondary school (9ndash12) 11 (124) 78 (876) 133 (047 381) 115 (066 197)College and above 6 (95) 57 (905) 1 1Fatherrsquos occupationDaily laborer 8 (140) 49 (860) 120 (047 307) 11 (055 21)Farmer 26 (218) 93 (782) 227 (112 461)lowast 155 (045 529)Merchant 11 (129) 74 (871) 118 (050 275) 152 (055 426)Governmentnongovernment employee 14 (103) 122 (897) 1 1Motherrsquos occupationDaily laborer 1 (200) 4 (800) 186 (019 1855) 210 (011 3874)Farmer 21 (244) 65 (756) 274 (116 646)lowast 216 (062 751)Housewife 15 (126) 104 (874) 133 (055 323) 246 (058 1047)Merchant 13 (121) 94 (879) 124 (051 304) 152 (043 536)Governmentnongovernment employee 9 (112) 71 (888) 1 1Family sizelt5 17 (98) 156 (902) 1 1ge5 42 (188) 182 (812) 243 (132 445)lowast 190 (080 451)Family monthly incomelt1000 29 (377) 48 (623) 610 (309 1204)lowast 1154 (382 3489)lowast1000ndash2000 14 (131) 93 (869) 171 (080 364) 347 (115 1045)lowastgt2000 16 (75) 197 (925) 1 1Source of drinking waterWell water 39 (213) 144 (787) 453 (171 1198) 382 (146 10 04)lowastSpring water 13 (123) 93 (877) 337 (088 1289) 256 (087 756)Public tap water 2 (77) 24 (923) 188 (023 1549) 146 (026 809)Tap water 5 (61) 77 (939) 1 1Presence of functional latrineYes 38 (148) 219 (852) 1 1

)e Scientific World Journal 7

might be due to the fact that impure water is a vehicle forintestinal parasites which leads to loss of appetite leading topoor nutritional status this might also be due to repeatedinfection causing depressed immunity and making the se-verity and duration of disease more severe contributing topoor nutritional status of the adolescents

5 Conclusions

)e prevalence of thinness was high in the study areaConsistent with this result the mean Z-scores of BMI-for-age were higher in boys than girls Age sex family monthlyincome and sources of drinking water were significantlyassociated with thinness among the respondents Based onthe finding there should be collaboration among healthsectors and education sectors of the town to address schooladolescents under nutrition problems of the town

Abbreviations

AOR Adjusted odds ratioCM CentimeterCOR Crude odds ratioCSA Central statistics agencyCV Confidence intervalEDHS Ethiopian demography and health surveySD Standard deviationSPSS Statistical Package for Social SciencesUN United NationsWHO World Health Organization

Data Availability

All data in this study are included in the figures tables andstatements

Ethical Approval

)e study was approved by the University Ethical Com-mittee of Faculty of Chemical and Food Engineering BahirDar University (protocol no 122010) Supportive letterswere obtained from the Amhara Public Health Institutewhich wrote a letter to the West Gojjam Zone Health Officeand then the West Gojjam Zone Health Office wrote a letterto the Finote Selam Town Administration Health OfficeFinally Finote Selam Town Administration Health Officewrote a letter to target schools

Consent

Written informed consent was obtained from the adoles-centsrsquo parents or legal guardians after clearly explaining theresearch objectives

Conflicts of Interest

)e authors declare that they have no conflicts of interest

Authorsrsquo Contributions

Damitie Kebede Mengesha has designed the study and in-volved in data collection supervision and data processingDamitie Kebede Mengesha has cleaned and analyzed thedata as well as interpreted the results and drafted the

Table 3 Continued

Variables)inness

COR (95 CI) AOR (95 CI)Yes No

No 21 (150) 119 (855) 108 (049 238) 105 (059 187)Number of meals eaten per dayTwo times 19 (160) 100 (840) 117 (064 213) 101 (053 191))ree times and above 40 (144) 238 (856) 1 1Illness reported in the last one monthYes 19 (145) 112 (855) 106 (057 196) 103 (057 187)No 40 (150) 226 (850) 1 1Availability of home gardenYes 50 (174) 238 (826) 1 1No 9 (83) 100 (917) 160 (101 254) 115 (066 199)Eating vegetables at least once per dayYes 23 (126) 160 (874) 1 1No 36 (168) 178 (832) 135 (076 260) 130 (072 236)Eating fruits at least once per dayYes 26 (127) 178 (873) 1 1No 33 (171) 160 (829) 133 (076 231) 123 (069 218)Eating farm animal products at least once per weekYes 14 (122) 101 (878) 1 1No 45 (160) 237 (840) 120 (062 229) 119 (061 234)Nutrition and health informationYes 6 (128) 41 (872) 1 1No 53 (151) 297 (849) 115 (049 271) 108 (043 269)

8 )e Scientific World Journal

manuscript Reddy P C J Prasad and Degnet Teferi Asresparticipated in cleaning analyzing and interpreting thedata Damitie Kebede Mengesha Reddy P C J Prasad andDegnet Teferi Asres critically reviewed the manuscript Allauthors read and approved the final manuscript

Acknowledgments

)e authors are thankful to adolescent students schooldirectors health officers data collectors and supervisors ofthis study

References

[1] WHO Adolescent Nutrition a Neglected Dimension WHOGeneva Switzerland 2013

[2] C Namrata and C Archana ldquoA comparative study of nu-tritional intake in adolescentgirlsrdquo 2013

[3] M R Khan and F Ahmed ldquoPhysical Status nutrient intakeand dietary pattern of adolescent female factory workers inUrban Bangladeshrdquo Asia Pacific Journal of Clinical Nutritionvol 14 no 1 pp 19ndash26 2005

[4] S Sally ldquoCalifornia state 4-H center for youth developmentthe biology of adolescencerdquo 2013

[5] UNICEF Adolescence an Age of Opportunity the State of theWorldrsquos Children United Nations Press New York NY USA2011

[6] J E Brown and J Stang Nutrition through Life the CycleWadsworth Cengage Learning Belmont CA USA 4th edi-tion 2011

[7] M D Gupta R Engelman J Levy G Luchsinger T Merrickand J E Rosen 1e Power of 18 Million Adolescent Youthand the Transformation of the Future United Nations Pop-ulation Fund New york NY USA 2014

[8] M R Burt ldquoWhy should we invest in adolescentsrdquo in Pro-ceedongs of the Paper Prepared for the Conference on Com-prehensive Health of Adolescents and Youth in Latin Americaand the Caribbean Washington DC USA 2013

[9] CSA Centeral Statistics Agency of Ethiopia Addis Ababa2007

[10] K Teji Y Dessie T Assebe et al ldquoAnaemia and nutritionalstatus of adolescent girls in Babile district Eastern EthiopiardquoPan African Medical Journal vol 24 p 62 2016

[11] T Wolde W A D Mekonnin F Yitayin et al ldquoNutritionalstatus of adolescent girls living in southwest of Ethiopiardquo FoodScience and Human Wellness vol 34 pp 58ndash64 2014

[12] T Gebregyorgis T Tadesse and A Atenafu ldquoPrevalence ofthinness and stunting and associated factors among adoles-cent schoolgirls in Adwa Town North Ethiopiardquo Interna-tional Journal of Food Science vol 2016 Article ID 83239828 pages 2016

[13] Y Yemaneh A Girma W Nigussie et al ldquoUndernutritionand its associated factors among adolescent girls in the ruralcommunity of Aseko district Eastern Arsi Zone Oromiaregion Eastern Ethiopia 2017rdquo International Journal ofClinical Obstetrics and Gynaecology vol 1 no 2 pp 17ndash262017

[14] G Arage M Assefa and T Worku ldquoSocio-demographic andeconomic factors are associated with nutritional status ofadolescent school girls in Lay Guyint Woreda NorthwestEthiopiardquo SAGE Open Medicine vol 7 2019

[15] H Gebremariam S Omer and H Assefa ldquoAssessment ofnutritional status and associated factors among school going

adolescents of Mekelle City Northern Ethiopiardquo Interna-tional Journal of Nutrition and Food Sciences vol 4 no 1pp 118ndash124 2015

[16] Y A Melaku G A Zello T K Gill R J Adams and Z ShildquoPrevalence and factors associated with stunting and thinnessamong adolescent students in Northern Ethiopia a com-parison to World Health Organization standardsrdquo Archives ofPublic Health vol 4 no 1 2015

[17] FTEO Finoteselam Education Office 2017[18] S M Birru A Tariku and A K Belew ldquoImproved dietary di-

versity of school adolescent girls in the context of urbanNorthwestEthiopiardquo Italian Journal of Pediatrics vol 44 p 48 2018

[19] A Y Mohammed and T B Tefera ldquoNutritional status andassociated risk factors among adolescents girls in Agarfa HighSchool Bale Zone Oromia Region South East EthiopiardquoInternational Journal of Nutrition and Food Sciences vol 4no 4 pp 445ndash152 2015

[20] WHO AnthroPlus for Personal Computers Manual Softwarefor Assessing Growth of the Worldrsquos Children and AdolescentsWHO Geneva Switzerland 2009

[21] D W Hosmer and S Lemeshow Applied Logistic RegressionJohnWiley amp Sons Inc New York NY USA 2nd edition 2000

[22] Z Alebachew Prevalence of Childhood and AdolescentOverweight and Obesity Among Elementary School StudentsAddis Ababa University Addis Ababa Ethiopia 2010

[23] P Bovet N Kizirian G Madeleine M Blossner andA Chiolero ldquoPrevalence of thinness in children and ado-lescents in the Seychelles comparison of two internationalgrowth referencesrdquo Nutrition Journal vol 10 p 65 2011

[24] H Assefa T Belachew and L Negash ldquoSocioeconomicfactors associated with underweight and stunting amongadolescents of Jimma Zone South West Ethiopiardquo ISRNPublic Health vol 2013 Article ID 238546 7 pages 2013

[25] M Yetubie ldquoAnthropometric assessment of adolescentmalnutrition in elementary and secondary schools of ambordquo)esis Addis Ababa University Addis Ababa Ethiopia 2012

[26] C Dabone H F Delisle and O Receveur ldquoPoor nutritionalstatus of schoolchildren in urban and peri-urban areas of Oua-gadougou (Burkina Faso)rdquo Nutrition Journal vol 10 p 34 2011

[27] T Leenstra L T Petersen S K Kariuki A J OlooP A Kager and F O t Kuile ldquoPrevalence and severity ofmalnutrition and age at menarche cross-sectional studies inadolescent schoolgirls in western Kenyardquo European Journal ofClinical Nutrition vol 59 no 1 pp 41ndash48 2005

[28] H Aounallah-Skhiri H B Romdhane P Traissac et alldquoNutritional status of Tunisian adolescents associated genderenvironmental and socio-economic factorsrdquo Public HealthNutrition vol 11 no 12 pp 1306ndash1317 2008

[29] A Abiba A N K Grace and K C Kubreziga ldquoEffects ofdietary patterns on the nutritional status of upper primaryschool children in Tamale metropolisrdquo Pakistan Journal ofNutrition vol 11 no 7 pp 591ndash609 2012

[30] M M Wassie A A Gete M E Yesuf G D Alene A Belayand T Moges ldquoPredictors of nutritional status of Ethiopianadolescent girls a community based cross sectional studyrdquoBMC Nutrition vol 1 no 1 p 20 2015

[31] A Kassa Tekile A AbateWoya and GW Basha ldquoPrevalence ofmalnutrition and associated factors among under-five children inEthiopia evidence from the 2016 Ethiopia Demographic andHealth Surveyrdquo BMC Research Notes vol 12 no 1 2019

[32] R Kt A M and T Wakayo ldquoNutritional status and its as-sociated factors among school adolescent girls in Adama CityCentral Ethiopiardquo Journal of Nutrition amp Food Sciences vol 6no 3 p 493 2016

)e Scientific World Journal 9

Page 2: PrevalenceandAssociatedFactorsofThinnessamongAdolescent ...downloads.hindawi.com/journals/tswj/2020/9170301.pdf · Pretested structured questionnaireswere used to collect the data

children and adolescents constitute about 48 of Ethiopianpopulation and about 25 of the Ethiopian populations areadolescents but studies among this age group were insuf-ficient [9]

Different researchers conducted a study on thinnessamong school adolescents in different parts of the country)e prevalence of thinness varies across different regions ofEthiopia )e prevalence of thinness among adolescent girlswas 216 28 214 and 148 in studies conducted inBabille District [10] Bedlle [11] Adwa [12] and Arsi Zone[13] )e overall prevalence of thinness among adolescentschool girls in Lay Guyint Woreda Northwest Ethiopia was290 [14] )e prevalence of thinness among adolescentschool girls in Adwa Town North Ethiopia was 214 [12])e overall prevalence of thinness among school-goingadolescents in Mekelle City Northern Ethiopia was 378[15] )e prevalence of thinness among adolescents inWukro Northern Ethiopia was 261 [16] However therewas no any study report on thinness in the study area )isstudy would serve as a baseline for further study and beimportant for designing intervention and a guide for poli-cymakers and development planners )is study was mainlyfocused to assess the prevalence and explore determinants ofthinness among school adolescents in Finote Selam TownNorthwest Ethiopia

2 Methods

21 Study Design and Area )e study design was a school-based cross-sectional study among adolescent students aged10ndash19 in public primary and secondary schools )e studywas carried out from February 05 to March 27 2018 )isstudy was conducted in Finote Selam Town which is located389 km northwest of Addis Ababa and 176 km southeastfrom Bahir Dar the city of Amhara Region Finote Selamtown administration has been established to be the maintown of West Gojjam Zone since 2004 EC )e totalpopulation size of the town according to 2007 census reportwas 25913 (13 035 males and 12 878 females) )e town issituated at an altitude ranging from 1500ndash2300 meters abovesea level and has an area coverage of 116954 ha )e areareceives an average annual rainfall of 1250mm )e mini-mum and maximum daily temperatures of the area are 14and 32degC respectively It is bordered on the north by Sekelaand Quarit on the south by Dega Damot and Burie on theeast by Deg damot and Dembecha and on the west by Burie)ere are six primary schools one high school one pre-paratory school and five colleges in Finote Selam Town)etotal number of students from grade 5ndash12 was 12323 [17]

22 Source and Study Population All adolescent students(10ndash19) in Finote Selam town schools were the sourcepopulation Randomly selected adolescent students (10ndash19)in Finote Selam town schools were study population

23 Sample Size and Sampling Procedure )e minimumsample size required was calculated using single proportionformula )e proportion of thinness among school-going

adolescents of Mekelle City Northern Ethiopia was 378[18] at a 95 confidence level 5 margin of error adding10 as contingency for nonresponse rate

n z

d1113874 1113875

2xP(1 minus p) (1)

where n sample size ZZ score at 95 CI 196p 378 and dmarginal error 105

n (196)2 lowast 0378(1 minus 0378)

(005)2

38416lowast 0378lowast 0622

(005)2

361

(2)

By adding 10 nonresponse rate the minimum samplesize required to estimate the prevalence of thinness and itsassociated factors among adolescent students was 361 + 10(361 + 36) 397

To obtain the sample stratified random samplingtechnique was used )e schools were stratified into primaryschools junior schools high school and preparatory school)ree primary schools namely Bata Bakel and Efrata andthree junior schools namely Edgetber Bata and Bakel wereselected using simple random sampling from six primaryschools and six junior schools respectively whereas a highschool namely Finote Selam Secondary School and apreparatory school namely Damot Preparatory Schoolwere selected purposively since one high school and onepreparatory school were present in Finote Selam Town )etotal sample size was distributed proportionally to theschools )e sampling frame was studentsrsquo identificationnumber in their respective school Numbers of students to beincluded in the study were determined by a simple randomsampling method (Figure 1)

24 Data Collection To generate the data set used in thisstudy pretested structured questionnaires were used tocollect data by trained data collectors Explanatory variableswere selected after conducting a detailed literature reviewfrom related articles to collect data on the sociodemo-graphic nutritional and health-related variables [16ndash19])e questionnaires were translated into the local language(Amharic) for easy understanding by the respondents Eachstudent was interviewed to obtain information on socio-demographic nutritional and health-related characteristicsof the adolescentsrsquo family

Anthropometric data were collected by trained datacollectors who were health extension workers And theoverall activity was coordinated by the investigator )e ageof the adolescents was derived from the school registerHeight and weight were measured using a stadiometer andSeca Digital Scale (Seca Germany) respectively )e weightwas recorded to the nearest 01 kg It was calibrated againstthe known weight regularly Before the real anthropometricdata collection a standardization exercise was performedduring the training to capture technical error of

2 )e Scientific World Journal

measurement During the procedure the subjects wore lightclothes and took off their shoes Height was measured in cmusing a portable stadiometer All adolescents were measuredagainst the wall without foot wear and with heels togetherand their heads position and eyes looking straight ahead(Frankfurt plane) so that the line of sight was perpendicularto the body )e height was recorded to the nearest 01 cm)e same measurer was employed for a given anthropo-metric measurement to avoid variability

25 Data Quality Control and Management To ensure thereliability and validity of the study training was given for thedata collectors the data collection was done by two healthextension workers and close follow-up was done by theinvestigator during data collection )e Amharic version ofthe questionnaire was tested on 5 of the samples at theSelamamba Primary School who have similar characteristicswith the study participant but did not participate in thestudy )e data collectors and investigator were participatedon pretesting and standardization of the questionnairesProblems highlighted during the preliminary study werecorrected before the start of the actual survey Each questionwas properly coded continuous supervision was performedduring the pretest and data collection period by the in-vestigator Completeness and consistency of recording on

the questionnaire sheets were evaluated by the investigator atthe end of each working day so that correction measureswere taken for the next time

26 Data Analyses Sociodemographic anthropometricnutrition and health-related data were entered into Epi Infoversion 7 and checked for completeness and consistencyfollowed by data cleaning and editing on Epi Info )en thedata were analyzed by using SPSS (Statistical Package forSocial Sciences) version 20 software WHO AnthroPlussoftware was used for assessing growth of the adolescents[20] Descriptive statistics using frequencies and proportionswas used to present the study results For anthropometricdata analysis if the BMI-for-age Z-score is below minus twostandard deviations (minus2 SDs) from the median of the ref-erence population then the child is thin Odds ratio with95 confidence interval was used for checking the strengthof associations between the outcome variable (thinness) andindependent variables Bivariate logistic regression wasperformed and the variable with p value less than 025 wastransported into multivariable binary logistic regressionanalysis to identify the determinant of malnutrition ofunder-five children Finally variables with p values lt005 inthe multivariable logistic regression model were taken asstatistically significant [21]

Adolescent students (10ndash19 years) in FinoteSelam townschools (grade 5ndash12) (N = 12323)

Primary schools (grade 5ndash6)(Bata Bakel amp Efrata)

(N = 3458)

Junior schools (grade 7ndash8)(Edgetber Bata amp Bakel)

(N = 3928)

High school (grade 9ndash10)(Finote Selam Secondary

School) (N = 3289)

Preparatory School (grade 11ndash12)(Damot Preparatory School)

(N = 1648)

Proportional to size allocation

n = 111 n = 127 n = 106 n = 53

Simple random sample (SRS)

n = 397

Figure 1 Schematic presentation of sampling procedures

)e Scientific World Journal 3

3 Results

31 Sociodemographic Characteristics of Study Participantsand 1eir Family From a total of 397 adolescent studentswho were selected as a sample with 100 response rate allstudy participants were involved in this study Among these47 (118) were early adolescents 151 (380) were mid-adolescents and 199 (501) were late adolescents From theparticipants 108 (272) were from primary schools 132(322) were from junior schools while 116 (292) werefrom the high school and others 41 (103) were attendingthe preparatory school Of the total participants 195 (491)were from urban areas whereas 202 (509) were from ruralareas (Table 1)

32 Nutrition and Health-Related Characteristics of SchoolAdolescents Most of the adolescents 278 (700) wereconsuming meals three and above times per day whereas119 (300) of adolescents were consuming meals two timesper day Among the respondents 330 were reportedhaving illness in the last one month Among the respon-dents 288 (725) had home gardens Vegetables (461)and fruits (514) were consumed daily (Table 2)

33 Anthropometric Results )e minimum and maximumheights of study subjects were 12750 cm and 18670 cmrespectively )e meanplusmn SD overall height of the partici-pants was 158plusmn 1067 cm Similarly the minimum andmaximum weights of study participants were 205 kg and68 kg respectively )e meanplusmn SD overall weight of theparticipants was 4599plusmn 1009 kg )e mean heights of boysand girls were 15899plusmn 1224 cm and 15631plusmn 694 cm re-spectively Similarly the mean weights of boy and girl ad-olescents were 451plusmn 1097 kg and 4753plusmn 817 kgrespectively )e mean age of the study participants was1554 years (1554plusmn 241 SD)

Prevalence of thinness the overall prevalence of thinnessamong adolescent students at Finote Selam Town was 149

)e mean Z-score of BMI-for-age of all adolescents wasminus113 which revealed the distribution of BAZ (Figure 2)

)e mean Z-scores of BMI-for-age among boys and girlswere minus129 and minus051 that showed the distribution of BAZrespectively (Figure 3)

34 Factors Associated with 1inness Exploring determi-nants associated with thinness is important to take nutri-tional intervention action in the study area Results of themultivariable binary logistic regression model showed thatthe age sex family monthly income and sources of drinkingwater were significantly associated with thinness )e oddsof thinness were 481 times higher among adolescent stu-dents in the early adolescent stage as compared to adolescentstudents in the late adolescent stage (AOR 481 95 CI 123 1851) Male adolescent students had 213 times higherodds of thinness (AOR 213 95 CI 160 340) comparedto female adolescent students )e students who came from

Table 1 Sociodemographic-related characteristics of adolescentstudents at Finote Selam Town Ethiopia 2018

Variables Frequency PercentageAge groupEarly adolescent (10ndash13) 47 118Midadolescent (14ndash16) 151 380Late adolescent (17ndash19) 199 501SexFemale 148 373Male 249 627GradeGrade 5ndash6 108 272Grade 7ndash8 132 332Grade 9ndash10 116 292Grade 11ndash12 41 103ReligionMuslim 22 55Orthodox 375 945Place of residenceUrban 195 491Rural 202 509Fatherrsquos educationIlliterate 95 238Read and write 101 254Primary school (1ndash8) 41 103Secondary school (9ndash12) 92 232College and above 68 171Motherrsquos educationIlliterate 102 257Read and write 109 275Primary school (1ndash8) 34 86Secondary school (9ndash12) 89 224College and above 63 159Fatherrsquos occupationDaily laborer 57 144Farmer 119 300Merchant 85 214Governmentnongovernment employee 136 343Motherrsquos occupationDaily laborer 5 13Housewife 86 217Merchant 119 300Farmer 107 270Governmentnongovernment employee 80 202Family sizelt5 173 436ge5 224 564Monthly family incomelt1000 birr 77 1931000ndash2000 birr 107 270gt2000 birr 213 537Source of drinking waterSpring water 82 207Well water 106 267Public tap water 26 65Tap water 183 461Presence of functional latrineYes 257 647No 140 353

4 )e Scientific World Journal

rural area were 216 (AOR 261 95 CI 096 487) timesmore likely to be thin compare to those who came fromurban area )e students from less than 1000 and 1000ndash2000birr family monthly income were 654 (AOR 654 95 CI 382 1489) and 347 (AOR 347 95 CI 115 745) timesmore likely to be thin compared to greater than 2000 birrfamily monthly income respectively Students fromhouseholds that used well water supply as main source ofwater supply were 382 times more likely to be at risk ofbeing thin than students from households that used tapwater supply for human consumption (AOR 382 95 CI 146 1004) (Table 3)

4 Discussion

In this study the prevalence of thinness and associatedfactors in Finote Selam Town Northwest Ethiopia wasassessed )e prevalence of thinness was 149 and thisfinding was lower than the studies in Mekelle City (378)[15] Ambo City (275) [22] Wukro District (261) [16]and Seychelles (277) [23] Another study in Ethiopia inJimma Zone has reported a much higher level (808) ofthinness prevalence among adolescents [24] )e prevalenceof thinness of this study was higher than studies done inAddis Ababa (62) (13) [25] )is divergence might be

Table 2 Nutrition and health-related characteristics of school adolescents at Finote Selam Town Ethiopia 2018

Variables Frequency PercentageNumber of meals eaten per dayTwo times 119 300)ree times and above 278 700Illness reported in the last one monthYes 131 330No 266 670Availability of home gardenYes 288 725No 109 275Eating vegetables at least once per dayYes 183 461No 214 539Eating fruits at least once per dayYes 204 514No 193 486Eating farm animal products at least once per weekYes 115 290No 282 710Nutrition and health informationYes 47 118No 350 882

45

40

35

30

25

20

15

10

5

0

Child

ren

()

ndash5 ndash45 ndash4 ndash35 ndash3 ndash25 ndash2 ndash15 ndash1 ndash05 0 05 1 15 2 25 3 35 4 45 5Z-score

WHO child growth standards (birth to 60 months) WHO reference 2007 (61 months to 19 years)All children (n = 354)

Figure 2 BMI-for-age Z -score of adolescent students in Finote Selam Town Ethiopia

)e Scientific World Journal 5

due to the difference in socioeconomic background dietaryhabit and type of meals among the cities Findings in otherAfrican countries include Burkina Faso (137) [26]Asembo and Mumias Kenya (156) [27] Tunisia (13)[28] and Tamale Metropolis district Ghana (10) [29] )evariation might be due to socioeconomic backgroundgeographical characteristics of study area cultural differencein dietary habit and care practices

)e odds of thinness were 481 times higher amongadolescent students in the early adolescent stage as com-pared to adolescent students in the late adolescent stage)isfinding was in agreement with findings from Adwa TownNorthen Ethiopia [17] and in Community-Based Nutritionimplementing districts Amhara Region Ethiopia [30] )ismight be due to as age increases adolescents might accessfood easily by themselves on the other hand as age in-creases adolescents become more matured Male adolescentstudents had 213 times higher odds of thinness compared tofemale adolescent students )is study was in line with thestudies conducted in Mekelle City Northern Ethiopia [15]Jimma Zone Southwest Ethiopia [24] and WukroNorthern Ethiopia [16] which confirmed that males weremore affected in thinness than girls )is might be due tovariation of maturation time in boys and girls for which girlsreached maturation earlier than boys

)e students who came from rural area were 216 timesmore likely to be thin compared to those who came fromurban area )is finding is in agreement with other previ-ously conducted studies [12 16] )e variation might be dueto food preference food consumption pattern and in-equalities in dietary diversity between urban and rural areas)e risk of being thin among school adolescents whosemothers did not attend education was 178 times morecompared to school adolescents whose mother attendedcollege and above education )is finding is consistent withthe study that conducted in Adama City Central Ethiopia

[31] )e risk of being thin among school adolescents whosemothers attended primary school (1ndash8) and secondaryschool (9ndash12) education was 129 and 115 (AOR 115 95CI 066 197) times more compared to students whosemothers attended college and above education respectively)is finding is in line with the study that conducted inAdama City Central Ethiopia [32] )is is due to the factthat if the level of education of the mother is low her de-cision-making and her contribution to the total family in-come will be low)is places the family at risk of not meetingtheir needs including nutritional needs

)e odds of being thin were 190 times higher amongschool adolescents who lived in household members of ge5than school adolescents who had lived in householdmembers lt5 )is finding was in line with the study thatconducted in Adwa Town North Ethiopia [12] )is mightbe due to sharing of the available food for the largehousehold members causing inadequate consumption offood leading to be thin )e students who did not eatvegetables and fruits at least once per day were 130 and 123times more likely to be thin compared to those who ate onceper day )is finding is in agreement with the study thatconducted in Adwa Town North Ethiopia [12])is is mightbe due to the fact that consuming insufficient vegetables andfruits are leading to poor nutritional status

)e students from less than 1000 and 1000ndash2000 birrfamily monthly income were 654 and 347 times more likelyto be thinness compared to greater than 2000 birr familymonthly income respectively )is might be due to thebetter income level of the family would enhance the nu-trition status of the adolescents Students from householdsthat used well water supply as main source of water supplywere 382 times more likely to be at risk of being thinnessthan students from households that used tap water supplyfor human consumption )is finding was in line withfindings from Adwa Town Northen Ethiopia [17] )is

45

40

35

30

25

20

15

10

5

0

Child

ren

()

ndash5 ndash45 ndash4 ndash35 ndash3 ndash25 ndash2 ndash15 ndash1 ndash05 0 05 1 15 2 25 3 35 4 45 5Z-score

WHO child growth standards (birth to 60 months) WHO reference 2007 (61 months to 19 years)Female (n = 131)Male (n = 223)

Figure 3 BMI-for-age Z -score of by sex of adolescent students in Finote Selam Town Ethiopia

6 )e Scientific World Journal

Table 3 Bivariate and multivariable logistic regression of factors associated with thinness among adolescent school students Finote SelamTown Ethiopia 2018

Variables)inness

COR (95 CI) AOR (95 CI)Yes No

Age GroupEarly adolescent (10ndash13) 17 (362) 30 (638) 514 (239 1108)lowast 481 (123 1851)lowastMidadolescent (14ndash16) 24 (159) 127 (841) 190 (099 364) 168 (057 493)Late adolescent (17ndash19) 18 (90) 181 (910) 1 1SexFemale 4 (27) 144 (973) 1 1Male 55 (221) 194 (779) 268 (188 384) 213 (160 340)lowast

GradeGrade 5ndash6 23 (213) 85 (787) 257 (091 724) 177 (040 787)Grade 7ndash8 22 (167) 110 (833) 208 (074 586) 133 (022 819)Grade 9ndash10 10 (86) 106 (914) 101 (032 315) 106 (020 558)Grade 11ndash12 4 (98) 37 (902) 1 1ReligionMuslim 1 (45) 21 (955) 1 1Orthodox 58 (155) 317 (845) 382 (050 2918) 390 (019 8194)Place of residenceUrban 18 (92) 177 (908) 1 1Rural 41 (203) 161 (797) 244 (135 440)lowast 216 (096 487)Fatherrsquos educationIlliterate 15 (158) 80 (842) 279 (092 845) 406 (023 7176)Read and write 17 (168) 84 (832) 197 (071 543) 273 (031 24 29)Primary school (1ndash8) 10 (244) 31 (756) 196 (073 532) 236 (026 2141)Secondary school (9ndash12) 11 (120) 81 (880) 144 (051 410) 080 (05 1290)College and above 6 (88) 62 (912) 1 1Motherrsquos educationIlliterate 17 (167) 85 (833) 238 (077 739) 178 (086 365)Read and write 16 (147) 93 (853) 186 (068 507) 140 (083 234)Primary school (1ndash8) 9 (265) 25 (735) 150 (055 409) 129 (061 271)Secondary school (9ndash12) 11 (124) 78 (876) 133 (047 381) 115 (066 197)College and above 6 (95) 57 (905) 1 1Fatherrsquos occupationDaily laborer 8 (140) 49 (860) 120 (047 307) 11 (055 21)Farmer 26 (218) 93 (782) 227 (112 461)lowast 155 (045 529)Merchant 11 (129) 74 (871) 118 (050 275) 152 (055 426)Governmentnongovernment employee 14 (103) 122 (897) 1 1Motherrsquos occupationDaily laborer 1 (200) 4 (800) 186 (019 1855) 210 (011 3874)Farmer 21 (244) 65 (756) 274 (116 646)lowast 216 (062 751)Housewife 15 (126) 104 (874) 133 (055 323) 246 (058 1047)Merchant 13 (121) 94 (879) 124 (051 304) 152 (043 536)Governmentnongovernment employee 9 (112) 71 (888) 1 1Family sizelt5 17 (98) 156 (902) 1 1ge5 42 (188) 182 (812) 243 (132 445)lowast 190 (080 451)Family monthly incomelt1000 29 (377) 48 (623) 610 (309 1204)lowast 1154 (382 3489)lowast1000ndash2000 14 (131) 93 (869) 171 (080 364) 347 (115 1045)lowastgt2000 16 (75) 197 (925) 1 1Source of drinking waterWell water 39 (213) 144 (787) 453 (171 1198) 382 (146 10 04)lowastSpring water 13 (123) 93 (877) 337 (088 1289) 256 (087 756)Public tap water 2 (77) 24 (923) 188 (023 1549) 146 (026 809)Tap water 5 (61) 77 (939) 1 1Presence of functional latrineYes 38 (148) 219 (852) 1 1

)e Scientific World Journal 7

might be due to the fact that impure water is a vehicle forintestinal parasites which leads to loss of appetite leading topoor nutritional status this might also be due to repeatedinfection causing depressed immunity and making the se-verity and duration of disease more severe contributing topoor nutritional status of the adolescents

5 Conclusions

)e prevalence of thinness was high in the study areaConsistent with this result the mean Z-scores of BMI-for-age were higher in boys than girls Age sex family monthlyincome and sources of drinking water were significantlyassociated with thinness among the respondents Based onthe finding there should be collaboration among healthsectors and education sectors of the town to address schooladolescents under nutrition problems of the town

Abbreviations

AOR Adjusted odds ratioCM CentimeterCOR Crude odds ratioCSA Central statistics agencyCV Confidence intervalEDHS Ethiopian demography and health surveySD Standard deviationSPSS Statistical Package for Social SciencesUN United NationsWHO World Health Organization

Data Availability

All data in this study are included in the figures tables andstatements

Ethical Approval

)e study was approved by the University Ethical Com-mittee of Faculty of Chemical and Food Engineering BahirDar University (protocol no 122010) Supportive letterswere obtained from the Amhara Public Health Institutewhich wrote a letter to the West Gojjam Zone Health Officeand then the West Gojjam Zone Health Office wrote a letterto the Finote Selam Town Administration Health OfficeFinally Finote Selam Town Administration Health Officewrote a letter to target schools

Consent

Written informed consent was obtained from the adoles-centsrsquo parents or legal guardians after clearly explaining theresearch objectives

Conflicts of Interest

)e authors declare that they have no conflicts of interest

Authorsrsquo Contributions

Damitie Kebede Mengesha has designed the study and in-volved in data collection supervision and data processingDamitie Kebede Mengesha has cleaned and analyzed thedata as well as interpreted the results and drafted the

Table 3 Continued

Variables)inness

COR (95 CI) AOR (95 CI)Yes No

No 21 (150) 119 (855) 108 (049 238) 105 (059 187)Number of meals eaten per dayTwo times 19 (160) 100 (840) 117 (064 213) 101 (053 191))ree times and above 40 (144) 238 (856) 1 1Illness reported in the last one monthYes 19 (145) 112 (855) 106 (057 196) 103 (057 187)No 40 (150) 226 (850) 1 1Availability of home gardenYes 50 (174) 238 (826) 1 1No 9 (83) 100 (917) 160 (101 254) 115 (066 199)Eating vegetables at least once per dayYes 23 (126) 160 (874) 1 1No 36 (168) 178 (832) 135 (076 260) 130 (072 236)Eating fruits at least once per dayYes 26 (127) 178 (873) 1 1No 33 (171) 160 (829) 133 (076 231) 123 (069 218)Eating farm animal products at least once per weekYes 14 (122) 101 (878) 1 1No 45 (160) 237 (840) 120 (062 229) 119 (061 234)Nutrition and health informationYes 6 (128) 41 (872) 1 1No 53 (151) 297 (849) 115 (049 271) 108 (043 269)

8 )e Scientific World Journal

manuscript Reddy P C J Prasad and Degnet Teferi Asresparticipated in cleaning analyzing and interpreting thedata Damitie Kebede Mengesha Reddy P C J Prasad andDegnet Teferi Asres critically reviewed the manuscript Allauthors read and approved the final manuscript

Acknowledgments

)e authors are thankful to adolescent students schooldirectors health officers data collectors and supervisors ofthis study

References

[1] WHO Adolescent Nutrition a Neglected Dimension WHOGeneva Switzerland 2013

[2] C Namrata and C Archana ldquoA comparative study of nu-tritional intake in adolescentgirlsrdquo 2013

[3] M R Khan and F Ahmed ldquoPhysical Status nutrient intakeand dietary pattern of adolescent female factory workers inUrban Bangladeshrdquo Asia Pacific Journal of Clinical Nutritionvol 14 no 1 pp 19ndash26 2005

[4] S Sally ldquoCalifornia state 4-H center for youth developmentthe biology of adolescencerdquo 2013

[5] UNICEF Adolescence an Age of Opportunity the State of theWorldrsquos Children United Nations Press New York NY USA2011

[6] J E Brown and J Stang Nutrition through Life the CycleWadsworth Cengage Learning Belmont CA USA 4th edi-tion 2011

[7] M D Gupta R Engelman J Levy G Luchsinger T Merrickand J E Rosen 1e Power of 18 Million Adolescent Youthand the Transformation of the Future United Nations Pop-ulation Fund New york NY USA 2014

[8] M R Burt ldquoWhy should we invest in adolescentsrdquo in Pro-ceedongs of the Paper Prepared for the Conference on Com-prehensive Health of Adolescents and Youth in Latin Americaand the Caribbean Washington DC USA 2013

[9] CSA Centeral Statistics Agency of Ethiopia Addis Ababa2007

[10] K Teji Y Dessie T Assebe et al ldquoAnaemia and nutritionalstatus of adolescent girls in Babile district Eastern EthiopiardquoPan African Medical Journal vol 24 p 62 2016

[11] T Wolde W A D Mekonnin F Yitayin et al ldquoNutritionalstatus of adolescent girls living in southwest of Ethiopiardquo FoodScience and Human Wellness vol 34 pp 58ndash64 2014

[12] T Gebregyorgis T Tadesse and A Atenafu ldquoPrevalence ofthinness and stunting and associated factors among adoles-cent schoolgirls in Adwa Town North Ethiopiardquo Interna-tional Journal of Food Science vol 2016 Article ID 83239828 pages 2016

[13] Y Yemaneh A Girma W Nigussie et al ldquoUndernutritionand its associated factors among adolescent girls in the ruralcommunity of Aseko district Eastern Arsi Zone Oromiaregion Eastern Ethiopia 2017rdquo International Journal ofClinical Obstetrics and Gynaecology vol 1 no 2 pp 17ndash262017

[14] G Arage M Assefa and T Worku ldquoSocio-demographic andeconomic factors are associated with nutritional status ofadolescent school girls in Lay Guyint Woreda NorthwestEthiopiardquo SAGE Open Medicine vol 7 2019

[15] H Gebremariam S Omer and H Assefa ldquoAssessment ofnutritional status and associated factors among school going

adolescents of Mekelle City Northern Ethiopiardquo Interna-tional Journal of Nutrition and Food Sciences vol 4 no 1pp 118ndash124 2015

[16] Y A Melaku G A Zello T K Gill R J Adams and Z ShildquoPrevalence and factors associated with stunting and thinnessamong adolescent students in Northern Ethiopia a com-parison to World Health Organization standardsrdquo Archives ofPublic Health vol 4 no 1 2015

[17] FTEO Finoteselam Education Office 2017[18] S M Birru A Tariku and A K Belew ldquoImproved dietary di-

versity of school adolescent girls in the context of urbanNorthwestEthiopiardquo Italian Journal of Pediatrics vol 44 p 48 2018

[19] A Y Mohammed and T B Tefera ldquoNutritional status andassociated risk factors among adolescents girls in Agarfa HighSchool Bale Zone Oromia Region South East EthiopiardquoInternational Journal of Nutrition and Food Sciences vol 4no 4 pp 445ndash152 2015

[20] WHO AnthroPlus for Personal Computers Manual Softwarefor Assessing Growth of the Worldrsquos Children and AdolescentsWHO Geneva Switzerland 2009

[21] D W Hosmer and S Lemeshow Applied Logistic RegressionJohnWiley amp Sons Inc New York NY USA 2nd edition 2000

[22] Z Alebachew Prevalence of Childhood and AdolescentOverweight and Obesity Among Elementary School StudentsAddis Ababa University Addis Ababa Ethiopia 2010

[23] P Bovet N Kizirian G Madeleine M Blossner andA Chiolero ldquoPrevalence of thinness in children and ado-lescents in the Seychelles comparison of two internationalgrowth referencesrdquo Nutrition Journal vol 10 p 65 2011

[24] H Assefa T Belachew and L Negash ldquoSocioeconomicfactors associated with underweight and stunting amongadolescents of Jimma Zone South West Ethiopiardquo ISRNPublic Health vol 2013 Article ID 238546 7 pages 2013

[25] M Yetubie ldquoAnthropometric assessment of adolescentmalnutrition in elementary and secondary schools of ambordquo)esis Addis Ababa University Addis Ababa Ethiopia 2012

[26] C Dabone H F Delisle and O Receveur ldquoPoor nutritionalstatus of schoolchildren in urban and peri-urban areas of Oua-gadougou (Burkina Faso)rdquo Nutrition Journal vol 10 p 34 2011

[27] T Leenstra L T Petersen S K Kariuki A J OlooP A Kager and F O t Kuile ldquoPrevalence and severity ofmalnutrition and age at menarche cross-sectional studies inadolescent schoolgirls in western Kenyardquo European Journal ofClinical Nutrition vol 59 no 1 pp 41ndash48 2005

[28] H Aounallah-Skhiri H B Romdhane P Traissac et alldquoNutritional status of Tunisian adolescents associated genderenvironmental and socio-economic factorsrdquo Public HealthNutrition vol 11 no 12 pp 1306ndash1317 2008

[29] A Abiba A N K Grace and K C Kubreziga ldquoEffects ofdietary patterns on the nutritional status of upper primaryschool children in Tamale metropolisrdquo Pakistan Journal ofNutrition vol 11 no 7 pp 591ndash609 2012

[30] M M Wassie A A Gete M E Yesuf G D Alene A Belayand T Moges ldquoPredictors of nutritional status of Ethiopianadolescent girls a community based cross sectional studyrdquoBMC Nutrition vol 1 no 1 p 20 2015

[31] A Kassa Tekile A AbateWoya and GW Basha ldquoPrevalence ofmalnutrition and associated factors among under-five children inEthiopia evidence from the 2016 Ethiopia Demographic andHealth Surveyrdquo BMC Research Notes vol 12 no 1 2019

[32] R Kt A M and T Wakayo ldquoNutritional status and its as-sociated factors among school adolescent girls in Adama CityCentral Ethiopiardquo Journal of Nutrition amp Food Sciences vol 6no 3 p 493 2016

)e Scientific World Journal 9

Page 3: PrevalenceandAssociatedFactorsofThinnessamongAdolescent ...downloads.hindawi.com/journals/tswj/2020/9170301.pdf · Pretested structured questionnaireswere used to collect the data

measurement During the procedure the subjects wore lightclothes and took off their shoes Height was measured in cmusing a portable stadiometer All adolescents were measuredagainst the wall without foot wear and with heels togetherand their heads position and eyes looking straight ahead(Frankfurt plane) so that the line of sight was perpendicularto the body )e height was recorded to the nearest 01 cm)e same measurer was employed for a given anthropo-metric measurement to avoid variability

25 Data Quality Control and Management To ensure thereliability and validity of the study training was given for thedata collectors the data collection was done by two healthextension workers and close follow-up was done by theinvestigator during data collection )e Amharic version ofthe questionnaire was tested on 5 of the samples at theSelamamba Primary School who have similar characteristicswith the study participant but did not participate in thestudy )e data collectors and investigator were participatedon pretesting and standardization of the questionnairesProblems highlighted during the preliminary study werecorrected before the start of the actual survey Each questionwas properly coded continuous supervision was performedduring the pretest and data collection period by the in-vestigator Completeness and consistency of recording on

the questionnaire sheets were evaluated by the investigator atthe end of each working day so that correction measureswere taken for the next time

26 Data Analyses Sociodemographic anthropometricnutrition and health-related data were entered into Epi Infoversion 7 and checked for completeness and consistencyfollowed by data cleaning and editing on Epi Info )en thedata were analyzed by using SPSS (Statistical Package forSocial Sciences) version 20 software WHO AnthroPlussoftware was used for assessing growth of the adolescents[20] Descriptive statistics using frequencies and proportionswas used to present the study results For anthropometricdata analysis if the BMI-for-age Z-score is below minus twostandard deviations (minus2 SDs) from the median of the ref-erence population then the child is thin Odds ratio with95 confidence interval was used for checking the strengthof associations between the outcome variable (thinness) andindependent variables Bivariate logistic regression wasperformed and the variable with p value less than 025 wastransported into multivariable binary logistic regressionanalysis to identify the determinant of malnutrition ofunder-five children Finally variables with p values lt005 inthe multivariable logistic regression model were taken asstatistically significant [21]

Adolescent students (10ndash19 years) in FinoteSelam townschools (grade 5ndash12) (N = 12323)

Primary schools (grade 5ndash6)(Bata Bakel amp Efrata)

(N = 3458)

Junior schools (grade 7ndash8)(Edgetber Bata amp Bakel)

(N = 3928)

High school (grade 9ndash10)(Finote Selam Secondary

School) (N = 3289)

Preparatory School (grade 11ndash12)(Damot Preparatory School)

(N = 1648)

Proportional to size allocation

n = 111 n = 127 n = 106 n = 53

Simple random sample (SRS)

n = 397

Figure 1 Schematic presentation of sampling procedures

)e Scientific World Journal 3

3 Results

31 Sociodemographic Characteristics of Study Participantsand 1eir Family From a total of 397 adolescent studentswho were selected as a sample with 100 response rate allstudy participants were involved in this study Among these47 (118) were early adolescents 151 (380) were mid-adolescents and 199 (501) were late adolescents From theparticipants 108 (272) were from primary schools 132(322) were from junior schools while 116 (292) werefrom the high school and others 41 (103) were attendingthe preparatory school Of the total participants 195 (491)were from urban areas whereas 202 (509) were from ruralareas (Table 1)

32 Nutrition and Health-Related Characteristics of SchoolAdolescents Most of the adolescents 278 (700) wereconsuming meals three and above times per day whereas119 (300) of adolescents were consuming meals two timesper day Among the respondents 330 were reportedhaving illness in the last one month Among the respon-dents 288 (725) had home gardens Vegetables (461)and fruits (514) were consumed daily (Table 2)

33 Anthropometric Results )e minimum and maximumheights of study subjects were 12750 cm and 18670 cmrespectively )e meanplusmn SD overall height of the partici-pants was 158plusmn 1067 cm Similarly the minimum andmaximum weights of study participants were 205 kg and68 kg respectively )e meanplusmn SD overall weight of theparticipants was 4599plusmn 1009 kg )e mean heights of boysand girls were 15899plusmn 1224 cm and 15631plusmn 694 cm re-spectively Similarly the mean weights of boy and girl ad-olescents were 451plusmn 1097 kg and 4753plusmn 817 kgrespectively )e mean age of the study participants was1554 years (1554plusmn 241 SD)

Prevalence of thinness the overall prevalence of thinnessamong adolescent students at Finote Selam Town was 149

)e mean Z-score of BMI-for-age of all adolescents wasminus113 which revealed the distribution of BAZ (Figure 2)

)e mean Z-scores of BMI-for-age among boys and girlswere minus129 and minus051 that showed the distribution of BAZrespectively (Figure 3)

34 Factors Associated with 1inness Exploring determi-nants associated with thinness is important to take nutri-tional intervention action in the study area Results of themultivariable binary logistic regression model showed thatthe age sex family monthly income and sources of drinkingwater were significantly associated with thinness )e oddsof thinness were 481 times higher among adolescent stu-dents in the early adolescent stage as compared to adolescentstudents in the late adolescent stage (AOR 481 95 CI 123 1851) Male adolescent students had 213 times higherodds of thinness (AOR 213 95 CI 160 340) comparedto female adolescent students )e students who came from

Table 1 Sociodemographic-related characteristics of adolescentstudents at Finote Selam Town Ethiopia 2018

Variables Frequency PercentageAge groupEarly adolescent (10ndash13) 47 118Midadolescent (14ndash16) 151 380Late adolescent (17ndash19) 199 501SexFemale 148 373Male 249 627GradeGrade 5ndash6 108 272Grade 7ndash8 132 332Grade 9ndash10 116 292Grade 11ndash12 41 103ReligionMuslim 22 55Orthodox 375 945Place of residenceUrban 195 491Rural 202 509Fatherrsquos educationIlliterate 95 238Read and write 101 254Primary school (1ndash8) 41 103Secondary school (9ndash12) 92 232College and above 68 171Motherrsquos educationIlliterate 102 257Read and write 109 275Primary school (1ndash8) 34 86Secondary school (9ndash12) 89 224College and above 63 159Fatherrsquos occupationDaily laborer 57 144Farmer 119 300Merchant 85 214Governmentnongovernment employee 136 343Motherrsquos occupationDaily laborer 5 13Housewife 86 217Merchant 119 300Farmer 107 270Governmentnongovernment employee 80 202Family sizelt5 173 436ge5 224 564Monthly family incomelt1000 birr 77 1931000ndash2000 birr 107 270gt2000 birr 213 537Source of drinking waterSpring water 82 207Well water 106 267Public tap water 26 65Tap water 183 461Presence of functional latrineYes 257 647No 140 353

4 )e Scientific World Journal

rural area were 216 (AOR 261 95 CI 096 487) timesmore likely to be thin compare to those who came fromurban area )e students from less than 1000 and 1000ndash2000birr family monthly income were 654 (AOR 654 95 CI 382 1489) and 347 (AOR 347 95 CI 115 745) timesmore likely to be thin compared to greater than 2000 birrfamily monthly income respectively Students fromhouseholds that used well water supply as main source ofwater supply were 382 times more likely to be at risk ofbeing thin than students from households that used tapwater supply for human consumption (AOR 382 95 CI 146 1004) (Table 3)

4 Discussion

In this study the prevalence of thinness and associatedfactors in Finote Selam Town Northwest Ethiopia wasassessed )e prevalence of thinness was 149 and thisfinding was lower than the studies in Mekelle City (378)[15] Ambo City (275) [22] Wukro District (261) [16]and Seychelles (277) [23] Another study in Ethiopia inJimma Zone has reported a much higher level (808) ofthinness prevalence among adolescents [24] )e prevalenceof thinness of this study was higher than studies done inAddis Ababa (62) (13) [25] )is divergence might be

Table 2 Nutrition and health-related characteristics of school adolescents at Finote Selam Town Ethiopia 2018

Variables Frequency PercentageNumber of meals eaten per dayTwo times 119 300)ree times and above 278 700Illness reported in the last one monthYes 131 330No 266 670Availability of home gardenYes 288 725No 109 275Eating vegetables at least once per dayYes 183 461No 214 539Eating fruits at least once per dayYes 204 514No 193 486Eating farm animal products at least once per weekYes 115 290No 282 710Nutrition and health informationYes 47 118No 350 882

45

40

35

30

25

20

15

10

5

0

Child

ren

()

ndash5 ndash45 ndash4 ndash35 ndash3 ndash25 ndash2 ndash15 ndash1 ndash05 0 05 1 15 2 25 3 35 4 45 5Z-score

WHO child growth standards (birth to 60 months) WHO reference 2007 (61 months to 19 years)All children (n = 354)

Figure 2 BMI-for-age Z -score of adolescent students in Finote Selam Town Ethiopia

)e Scientific World Journal 5

due to the difference in socioeconomic background dietaryhabit and type of meals among the cities Findings in otherAfrican countries include Burkina Faso (137) [26]Asembo and Mumias Kenya (156) [27] Tunisia (13)[28] and Tamale Metropolis district Ghana (10) [29] )evariation might be due to socioeconomic backgroundgeographical characteristics of study area cultural differencein dietary habit and care practices

)e odds of thinness were 481 times higher amongadolescent students in the early adolescent stage as com-pared to adolescent students in the late adolescent stage)isfinding was in agreement with findings from Adwa TownNorthen Ethiopia [17] and in Community-Based Nutritionimplementing districts Amhara Region Ethiopia [30] )ismight be due to as age increases adolescents might accessfood easily by themselves on the other hand as age in-creases adolescents become more matured Male adolescentstudents had 213 times higher odds of thinness compared tofemale adolescent students )is study was in line with thestudies conducted in Mekelle City Northern Ethiopia [15]Jimma Zone Southwest Ethiopia [24] and WukroNorthern Ethiopia [16] which confirmed that males weremore affected in thinness than girls )is might be due tovariation of maturation time in boys and girls for which girlsreached maturation earlier than boys

)e students who came from rural area were 216 timesmore likely to be thin compared to those who came fromurban area )is finding is in agreement with other previ-ously conducted studies [12 16] )e variation might be dueto food preference food consumption pattern and in-equalities in dietary diversity between urban and rural areas)e risk of being thin among school adolescents whosemothers did not attend education was 178 times morecompared to school adolescents whose mother attendedcollege and above education )is finding is consistent withthe study that conducted in Adama City Central Ethiopia

[31] )e risk of being thin among school adolescents whosemothers attended primary school (1ndash8) and secondaryschool (9ndash12) education was 129 and 115 (AOR 115 95CI 066 197) times more compared to students whosemothers attended college and above education respectively)is finding is in line with the study that conducted inAdama City Central Ethiopia [32] )is is due to the factthat if the level of education of the mother is low her de-cision-making and her contribution to the total family in-come will be low)is places the family at risk of not meetingtheir needs including nutritional needs

)e odds of being thin were 190 times higher amongschool adolescents who lived in household members of ge5than school adolescents who had lived in householdmembers lt5 )is finding was in line with the study thatconducted in Adwa Town North Ethiopia [12] )is mightbe due to sharing of the available food for the largehousehold members causing inadequate consumption offood leading to be thin )e students who did not eatvegetables and fruits at least once per day were 130 and 123times more likely to be thin compared to those who ate onceper day )is finding is in agreement with the study thatconducted in Adwa Town North Ethiopia [12])is is mightbe due to the fact that consuming insufficient vegetables andfruits are leading to poor nutritional status

)e students from less than 1000 and 1000ndash2000 birrfamily monthly income were 654 and 347 times more likelyto be thinness compared to greater than 2000 birr familymonthly income respectively )is might be due to thebetter income level of the family would enhance the nu-trition status of the adolescents Students from householdsthat used well water supply as main source of water supplywere 382 times more likely to be at risk of being thinnessthan students from households that used tap water supplyfor human consumption )is finding was in line withfindings from Adwa Town Northen Ethiopia [17] )is

45

40

35

30

25

20

15

10

5

0

Child

ren

()

ndash5 ndash45 ndash4 ndash35 ndash3 ndash25 ndash2 ndash15 ndash1 ndash05 0 05 1 15 2 25 3 35 4 45 5Z-score

WHO child growth standards (birth to 60 months) WHO reference 2007 (61 months to 19 years)Female (n = 131)Male (n = 223)

Figure 3 BMI-for-age Z -score of by sex of adolescent students in Finote Selam Town Ethiopia

6 )e Scientific World Journal

Table 3 Bivariate and multivariable logistic regression of factors associated with thinness among adolescent school students Finote SelamTown Ethiopia 2018

Variables)inness

COR (95 CI) AOR (95 CI)Yes No

Age GroupEarly adolescent (10ndash13) 17 (362) 30 (638) 514 (239 1108)lowast 481 (123 1851)lowastMidadolescent (14ndash16) 24 (159) 127 (841) 190 (099 364) 168 (057 493)Late adolescent (17ndash19) 18 (90) 181 (910) 1 1SexFemale 4 (27) 144 (973) 1 1Male 55 (221) 194 (779) 268 (188 384) 213 (160 340)lowast

GradeGrade 5ndash6 23 (213) 85 (787) 257 (091 724) 177 (040 787)Grade 7ndash8 22 (167) 110 (833) 208 (074 586) 133 (022 819)Grade 9ndash10 10 (86) 106 (914) 101 (032 315) 106 (020 558)Grade 11ndash12 4 (98) 37 (902) 1 1ReligionMuslim 1 (45) 21 (955) 1 1Orthodox 58 (155) 317 (845) 382 (050 2918) 390 (019 8194)Place of residenceUrban 18 (92) 177 (908) 1 1Rural 41 (203) 161 (797) 244 (135 440)lowast 216 (096 487)Fatherrsquos educationIlliterate 15 (158) 80 (842) 279 (092 845) 406 (023 7176)Read and write 17 (168) 84 (832) 197 (071 543) 273 (031 24 29)Primary school (1ndash8) 10 (244) 31 (756) 196 (073 532) 236 (026 2141)Secondary school (9ndash12) 11 (120) 81 (880) 144 (051 410) 080 (05 1290)College and above 6 (88) 62 (912) 1 1Motherrsquos educationIlliterate 17 (167) 85 (833) 238 (077 739) 178 (086 365)Read and write 16 (147) 93 (853) 186 (068 507) 140 (083 234)Primary school (1ndash8) 9 (265) 25 (735) 150 (055 409) 129 (061 271)Secondary school (9ndash12) 11 (124) 78 (876) 133 (047 381) 115 (066 197)College and above 6 (95) 57 (905) 1 1Fatherrsquos occupationDaily laborer 8 (140) 49 (860) 120 (047 307) 11 (055 21)Farmer 26 (218) 93 (782) 227 (112 461)lowast 155 (045 529)Merchant 11 (129) 74 (871) 118 (050 275) 152 (055 426)Governmentnongovernment employee 14 (103) 122 (897) 1 1Motherrsquos occupationDaily laborer 1 (200) 4 (800) 186 (019 1855) 210 (011 3874)Farmer 21 (244) 65 (756) 274 (116 646)lowast 216 (062 751)Housewife 15 (126) 104 (874) 133 (055 323) 246 (058 1047)Merchant 13 (121) 94 (879) 124 (051 304) 152 (043 536)Governmentnongovernment employee 9 (112) 71 (888) 1 1Family sizelt5 17 (98) 156 (902) 1 1ge5 42 (188) 182 (812) 243 (132 445)lowast 190 (080 451)Family monthly incomelt1000 29 (377) 48 (623) 610 (309 1204)lowast 1154 (382 3489)lowast1000ndash2000 14 (131) 93 (869) 171 (080 364) 347 (115 1045)lowastgt2000 16 (75) 197 (925) 1 1Source of drinking waterWell water 39 (213) 144 (787) 453 (171 1198) 382 (146 10 04)lowastSpring water 13 (123) 93 (877) 337 (088 1289) 256 (087 756)Public tap water 2 (77) 24 (923) 188 (023 1549) 146 (026 809)Tap water 5 (61) 77 (939) 1 1Presence of functional latrineYes 38 (148) 219 (852) 1 1

)e Scientific World Journal 7

might be due to the fact that impure water is a vehicle forintestinal parasites which leads to loss of appetite leading topoor nutritional status this might also be due to repeatedinfection causing depressed immunity and making the se-verity and duration of disease more severe contributing topoor nutritional status of the adolescents

5 Conclusions

)e prevalence of thinness was high in the study areaConsistent with this result the mean Z-scores of BMI-for-age were higher in boys than girls Age sex family monthlyincome and sources of drinking water were significantlyassociated with thinness among the respondents Based onthe finding there should be collaboration among healthsectors and education sectors of the town to address schooladolescents under nutrition problems of the town

Abbreviations

AOR Adjusted odds ratioCM CentimeterCOR Crude odds ratioCSA Central statistics agencyCV Confidence intervalEDHS Ethiopian demography and health surveySD Standard deviationSPSS Statistical Package for Social SciencesUN United NationsWHO World Health Organization

Data Availability

All data in this study are included in the figures tables andstatements

Ethical Approval

)e study was approved by the University Ethical Com-mittee of Faculty of Chemical and Food Engineering BahirDar University (protocol no 122010) Supportive letterswere obtained from the Amhara Public Health Institutewhich wrote a letter to the West Gojjam Zone Health Officeand then the West Gojjam Zone Health Office wrote a letterto the Finote Selam Town Administration Health OfficeFinally Finote Selam Town Administration Health Officewrote a letter to target schools

Consent

Written informed consent was obtained from the adoles-centsrsquo parents or legal guardians after clearly explaining theresearch objectives

Conflicts of Interest

)e authors declare that they have no conflicts of interest

Authorsrsquo Contributions

Damitie Kebede Mengesha has designed the study and in-volved in data collection supervision and data processingDamitie Kebede Mengesha has cleaned and analyzed thedata as well as interpreted the results and drafted the

Table 3 Continued

Variables)inness

COR (95 CI) AOR (95 CI)Yes No

No 21 (150) 119 (855) 108 (049 238) 105 (059 187)Number of meals eaten per dayTwo times 19 (160) 100 (840) 117 (064 213) 101 (053 191))ree times and above 40 (144) 238 (856) 1 1Illness reported in the last one monthYes 19 (145) 112 (855) 106 (057 196) 103 (057 187)No 40 (150) 226 (850) 1 1Availability of home gardenYes 50 (174) 238 (826) 1 1No 9 (83) 100 (917) 160 (101 254) 115 (066 199)Eating vegetables at least once per dayYes 23 (126) 160 (874) 1 1No 36 (168) 178 (832) 135 (076 260) 130 (072 236)Eating fruits at least once per dayYes 26 (127) 178 (873) 1 1No 33 (171) 160 (829) 133 (076 231) 123 (069 218)Eating farm animal products at least once per weekYes 14 (122) 101 (878) 1 1No 45 (160) 237 (840) 120 (062 229) 119 (061 234)Nutrition and health informationYes 6 (128) 41 (872) 1 1No 53 (151) 297 (849) 115 (049 271) 108 (043 269)

8 )e Scientific World Journal

manuscript Reddy P C J Prasad and Degnet Teferi Asresparticipated in cleaning analyzing and interpreting thedata Damitie Kebede Mengesha Reddy P C J Prasad andDegnet Teferi Asres critically reviewed the manuscript Allauthors read and approved the final manuscript

Acknowledgments

)e authors are thankful to adolescent students schooldirectors health officers data collectors and supervisors ofthis study

References

[1] WHO Adolescent Nutrition a Neglected Dimension WHOGeneva Switzerland 2013

[2] C Namrata and C Archana ldquoA comparative study of nu-tritional intake in adolescentgirlsrdquo 2013

[3] M R Khan and F Ahmed ldquoPhysical Status nutrient intakeand dietary pattern of adolescent female factory workers inUrban Bangladeshrdquo Asia Pacific Journal of Clinical Nutritionvol 14 no 1 pp 19ndash26 2005

[4] S Sally ldquoCalifornia state 4-H center for youth developmentthe biology of adolescencerdquo 2013

[5] UNICEF Adolescence an Age of Opportunity the State of theWorldrsquos Children United Nations Press New York NY USA2011

[6] J E Brown and J Stang Nutrition through Life the CycleWadsworth Cengage Learning Belmont CA USA 4th edi-tion 2011

[7] M D Gupta R Engelman J Levy G Luchsinger T Merrickand J E Rosen 1e Power of 18 Million Adolescent Youthand the Transformation of the Future United Nations Pop-ulation Fund New york NY USA 2014

[8] M R Burt ldquoWhy should we invest in adolescentsrdquo in Pro-ceedongs of the Paper Prepared for the Conference on Com-prehensive Health of Adolescents and Youth in Latin Americaand the Caribbean Washington DC USA 2013

[9] CSA Centeral Statistics Agency of Ethiopia Addis Ababa2007

[10] K Teji Y Dessie T Assebe et al ldquoAnaemia and nutritionalstatus of adolescent girls in Babile district Eastern EthiopiardquoPan African Medical Journal vol 24 p 62 2016

[11] T Wolde W A D Mekonnin F Yitayin et al ldquoNutritionalstatus of adolescent girls living in southwest of Ethiopiardquo FoodScience and Human Wellness vol 34 pp 58ndash64 2014

[12] T Gebregyorgis T Tadesse and A Atenafu ldquoPrevalence ofthinness and stunting and associated factors among adoles-cent schoolgirls in Adwa Town North Ethiopiardquo Interna-tional Journal of Food Science vol 2016 Article ID 83239828 pages 2016

[13] Y Yemaneh A Girma W Nigussie et al ldquoUndernutritionand its associated factors among adolescent girls in the ruralcommunity of Aseko district Eastern Arsi Zone Oromiaregion Eastern Ethiopia 2017rdquo International Journal ofClinical Obstetrics and Gynaecology vol 1 no 2 pp 17ndash262017

[14] G Arage M Assefa and T Worku ldquoSocio-demographic andeconomic factors are associated with nutritional status ofadolescent school girls in Lay Guyint Woreda NorthwestEthiopiardquo SAGE Open Medicine vol 7 2019

[15] H Gebremariam S Omer and H Assefa ldquoAssessment ofnutritional status and associated factors among school going

adolescents of Mekelle City Northern Ethiopiardquo Interna-tional Journal of Nutrition and Food Sciences vol 4 no 1pp 118ndash124 2015

[16] Y A Melaku G A Zello T K Gill R J Adams and Z ShildquoPrevalence and factors associated with stunting and thinnessamong adolescent students in Northern Ethiopia a com-parison to World Health Organization standardsrdquo Archives ofPublic Health vol 4 no 1 2015

[17] FTEO Finoteselam Education Office 2017[18] S M Birru A Tariku and A K Belew ldquoImproved dietary di-

versity of school adolescent girls in the context of urbanNorthwestEthiopiardquo Italian Journal of Pediatrics vol 44 p 48 2018

[19] A Y Mohammed and T B Tefera ldquoNutritional status andassociated risk factors among adolescents girls in Agarfa HighSchool Bale Zone Oromia Region South East EthiopiardquoInternational Journal of Nutrition and Food Sciences vol 4no 4 pp 445ndash152 2015

[20] WHO AnthroPlus for Personal Computers Manual Softwarefor Assessing Growth of the Worldrsquos Children and AdolescentsWHO Geneva Switzerland 2009

[21] D W Hosmer and S Lemeshow Applied Logistic RegressionJohnWiley amp Sons Inc New York NY USA 2nd edition 2000

[22] Z Alebachew Prevalence of Childhood and AdolescentOverweight and Obesity Among Elementary School StudentsAddis Ababa University Addis Ababa Ethiopia 2010

[23] P Bovet N Kizirian G Madeleine M Blossner andA Chiolero ldquoPrevalence of thinness in children and ado-lescents in the Seychelles comparison of two internationalgrowth referencesrdquo Nutrition Journal vol 10 p 65 2011

[24] H Assefa T Belachew and L Negash ldquoSocioeconomicfactors associated with underweight and stunting amongadolescents of Jimma Zone South West Ethiopiardquo ISRNPublic Health vol 2013 Article ID 238546 7 pages 2013

[25] M Yetubie ldquoAnthropometric assessment of adolescentmalnutrition in elementary and secondary schools of ambordquo)esis Addis Ababa University Addis Ababa Ethiopia 2012

[26] C Dabone H F Delisle and O Receveur ldquoPoor nutritionalstatus of schoolchildren in urban and peri-urban areas of Oua-gadougou (Burkina Faso)rdquo Nutrition Journal vol 10 p 34 2011

[27] T Leenstra L T Petersen S K Kariuki A J OlooP A Kager and F O t Kuile ldquoPrevalence and severity ofmalnutrition and age at menarche cross-sectional studies inadolescent schoolgirls in western Kenyardquo European Journal ofClinical Nutrition vol 59 no 1 pp 41ndash48 2005

[28] H Aounallah-Skhiri H B Romdhane P Traissac et alldquoNutritional status of Tunisian adolescents associated genderenvironmental and socio-economic factorsrdquo Public HealthNutrition vol 11 no 12 pp 1306ndash1317 2008

[29] A Abiba A N K Grace and K C Kubreziga ldquoEffects ofdietary patterns on the nutritional status of upper primaryschool children in Tamale metropolisrdquo Pakistan Journal ofNutrition vol 11 no 7 pp 591ndash609 2012

[30] M M Wassie A A Gete M E Yesuf G D Alene A Belayand T Moges ldquoPredictors of nutritional status of Ethiopianadolescent girls a community based cross sectional studyrdquoBMC Nutrition vol 1 no 1 p 20 2015

[31] A Kassa Tekile A AbateWoya and GW Basha ldquoPrevalence ofmalnutrition and associated factors among under-five children inEthiopia evidence from the 2016 Ethiopia Demographic andHealth Surveyrdquo BMC Research Notes vol 12 no 1 2019

[32] R Kt A M and T Wakayo ldquoNutritional status and its as-sociated factors among school adolescent girls in Adama CityCentral Ethiopiardquo Journal of Nutrition amp Food Sciences vol 6no 3 p 493 2016

)e Scientific World Journal 9

Page 4: PrevalenceandAssociatedFactorsofThinnessamongAdolescent ...downloads.hindawi.com/journals/tswj/2020/9170301.pdf · Pretested structured questionnaireswere used to collect the data

3 Results

31 Sociodemographic Characteristics of Study Participantsand 1eir Family From a total of 397 adolescent studentswho were selected as a sample with 100 response rate allstudy participants were involved in this study Among these47 (118) were early adolescents 151 (380) were mid-adolescents and 199 (501) were late adolescents From theparticipants 108 (272) were from primary schools 132(322) were from junior schools while 116 (292) werefrom the high school and others 41 (103) were attendingthe preparatory school Of the total participants 195 (491)were from urban areas whereas 202 (509) were from ruralareas (Table 1)

32 Nutrition and Health-Related Characteristics of SchoolAdolescents Most of the adolescents 278 (700) wereconsuming meals three and above times per day whereas119 (300) of adolescents were consuming meals two timesper day Among the respondents 330 were reportedhaving illness in the last one month Among the respon-dents 288 (725) had home gardens Vegetables (461)and fruits (514) were consumed daily (Table 2)

33 Anthropometric Results )e minimum and maximumheights of study subjects were 12750 cm and 18670 cmrespectively )e meanplusmn SD overall height of the partici-pants was 158plusmn 1067 cm Similarly the minimum andmaximum weights of study participants were 205 kg and68 kg respectively )e meanplusmn SD overall weight of theparticipants was 4599plusmn 1009 kg )e mean heights of boysand girls were 15899plusmn 1224 cm and 15631plusmn 694 cm re-spectively Similarly the mean weights of boy and girl ad-olescents were 451plusmn 1097 kg and 4753plusmn 817 kgrespectively )e mean age of the study participants was1554 years (1554plusmn 241 SD)

Prevalence of thinness the overall prevalence of thinnessamong adolescent students at Finote Selam Town was 149

)e mean Z-score of BMI-for-age of all adolescents wasminus113 which revealed the distribution of BAZ (Figure 2)

)e mean Z-scores of BMI-for-age among boys and girlswere minus129 and minus051 that showed the distribution of BAZrespectively (Figure 3)

34 Factors Associated with 1inness Exploring determi-nants associated with thinness is important to take nutri-tional intervention action in the study area Results of themultivariable binary logistic regression model showed thatthe age sex family monthly income and sources of drinkingwater were significantly associated with thinness )e oddsof thinness were 481 times higher among adolescent stu-dents in the early adolescent stage as compared to adolescentstudents in the late adolescent stage (AOR 481 95 CI 123 1851) Male adolescent students had 213 times higherodds of thinness (AOR 213 95 CI 160 340) comparedto female adolescent students )e students who came from

Table 1 Sociodemographic-related characteristics of adolescentstudents at Finote Selam Town Ethiopia 2018

Variables Frequency PercentageAge groupEarly adolescent (10ndash13) 47 118Midadolescent (14ndash16) 151 380Late adolescent (17ndash19) 199 501SexFemale 148 373Male 249 627GradeGrade 5ndash6 108 272Grade 7ndash8 132 332Grade 9ndash10 116 292Grade 11ndash12 41 103ReligionMuslim 22 55Orthodox 375 945Place of residenceUrban 195 491Rural 202 509Fatherrsquos educationIlliterate 95 238Read and write 101 254Primary school (1ndash8) 41 103Secondary school (9ndash12) 92 232College and above 68 171Motherrsquos educationIlliterate 102 257Read and write 109 275Primary school (1ndash8) 34 86Secondary school (9ndash12) 89 224College and above 63 159Fatherrsquos occupationDaily laborer 57 144Farmer 119 300Merchant 85 214Governmentnongovernment employee 136 343Motherrsquos occupationDaily laborer 5 13Housewife 86 217Merchant 119 300Farmer 107 270Governmentnongovernment employee 80 202Family sizelt5 173 436ge5 224 564Monthly family incomelt1000 birr 77 1931000ndash2000 birr 107 270gt2000 birr 213 537Source of drinking waterSpring water 82 207Well water 106 267Public tap water 26 65Tap water 183 461Presence of functional latrineYes 257 647No 140 353

4 )e Scientific World Journal

rural area were 216 (AOR 261 95 CI 096 487) timesmore likely to be thin compare to those who came fromurban area )e students from less than 1000 and 1000ndash2000birr family monthly income were 654 (AOR 654 95 CI 382 1489) and 347 (AOR 347 95 CI 115 745) timesmore likely to be thin compared to greater than 2000 birrfamily monthly income respectively Students fromhouseholds that used well water supply as main source ofwater supply were 382 times more likely to be at risk ofbeing thin than students from households that used tapwater supply for human consumption (AOR 382 95 CI 146 1004) (Table 3)

4 Discussion

In this study the prevalence of thinness and associatedfactors in Finote Selam Town Northwest Ethiopia wasassessed )e prevalence of thinness was 149 and thisfinding was lower than the studies in Mekelle City (378)[15] Ambo City (275) [22] Wukro District (261) [16]and Seychelles (277) [23] Another study in Ethiopia inJimma Zone has reported a much higher level (808) ofthinness prevalence among adolescents [24] )e prevalenceof thinness of this study was higher than studies done inAddis Ababa (62) (13) [25] )is divergence might be

Table 2 Nutrition and health-related characteristics of school adolescents at Finote Selam Town Ethiopia 2018

Variables Frequency PercentageNumber of meals eaten per dayTwo times 119 300)ree times and above 278 700Illness reported in the last one monthYes 131 330No 266 670Availability of home gardenYes 288 725No 109 275Eating vegetables at least once per dayYes 183 461No 214 539Eating fruits at least once per dayYes 204 514No 193 486Eating farm animal products at least once per weekYes 115 290No 282 710Nutrition and health informationYes 47 118No 350 882

45

40

35

30

25

20

15

10

5

0

Child

ren

()

ndash5 ndash45 ndash4 ndash35 ndash3 ndash25 ndash2 ndash15 ndash1 ndash05 0 05 1 15 2 25 3 35 4 45 5Z-score

WHO child growth standards (birth to 60 months) WHO reference 2007 (61 months to 19 years)All children (n = 354)

Figure 2 BMI-for-age Z -score of adolescent students in Finote Selam Town Ethiopia

)e Scientific World Journal 5

due to the difference in socioeconomic background dietaryhabit and type of meals among the cities Findings in otherAfrican countries include Burkina Faso (137) [26]Asembo and Mumias Kenya (156) [27] Tunisia (13)[28] and Tamale Metropolis district Ghana (10) [29] )evariation might be due to socioeconomic backgroundgeographical characteristics of study area cultural differencein dietary habit and care practices

)e odds of thinness were 481 times higher amongadolescent students in the early adolescent stage as com-pared to adolescent students in the late adolescent stage)isfinding was in agreement with findings from Adwa TownNorthen Ethiopia [17] and in Community-Based Nutritionimplementing districts Amhara Region Ethiopia [30] )ismight be due to as age increases adolescents might accessfood easily by themselves on the other hand as age in-creases adolescents become more matured Male adolescentstudents had 213 times higher odds of thinness compared tofemale adolescent students )is study was in line with thestudies conducted in Mekelle City Northern Ethiopia [15]Jimma Zone Southwest Ethiopia [24] and WukroNorthern Ethiopia [16] which confirmed that males weremore affected in thinness than girls )is might be due tovariation of maturation time in boys and girls for which girlsreached maturation earlier than boys

)e students who came from rural area were 216 timesmore likely to be thin compared to those who came fromurban area )is finding is in agreement with other previ-ously conducted studies [12 16] )e variation might be dueto food preference food consumption pattern and in-equalities in dietary diversity between urban and rural areas)e risk of being thin among school adolescents whosemothers did not attend education was 178 times morecompared to school adolescents whose mother attendedcollege and above education )is finding is consistent withthe study that conducted in Adama City Central Ethiopia

[31] )e risk of being thin among school adolescents whosemothers attended primary school (1ndash8) and secondaryschool (9ndash12) education was 129 and 115 (AOR 115 95CI 066 197) times more compared to students whosemothers attended college and above education respectively)is finding is in line with the study that conducted inAdama City Central Ethiopia [32] )is is due to the factthat if the level of education of the mother is low her de-cision-making and her contribution to the total family in-come will be low)is places the family at risk of not meetingtheir needs including nutritional needs

)e odds of being thin were 190 times higher amongschool adolescents who lived in household members of ge5than school adolescents who had lived in householdmembers lt5 )is finding was in line with the study thatconducted in Adwa Town North Ethiopia [12] )is mightbe due to sharing of the available food for the largehousehold members causing inadequate consumption offood leading to be thin )e students who did not eatvegetables and fruits at least once per day were 130 and 123times more likely to be thin compared to those who ate onceper day )is finding is in agreement with the study thatconducted in Adwa Town North Ethiopia [12])is is mightbe due to the fact that consuming insufficient vegetables andfruits are leading to poor nutritional status

)e students from less than 1000 and 1000ndash2000 birrfamily monthly income were 654 and 347 times more likelyto be thinness compared to greater than 2000 birr familymonthly income respectively )is might be due to thebetter income level of the family would enhance the nu-trition status of the adolescents Students from householdsthat used well water supply as main source of water supplywere 382 times more likely to be at risk of being thinnessthan students from households that used tap water supplyfor human consumption )is finding was in line withfindings from Adwa Town Northen Ethiopia [17] )is

45

40

35

30

25

20

15

10

5

0

Child

ren

()

ndash5 ndash45 ndash4 ndash35 ndash3 ndash25 ndash2 ndash15 ndash1 ndash05 0 05 1 15 2 25 3 35 4 45 5Z-score

WHO child growth standards (birth to 60 months) WHO reference 2007 (61 months to 19 years)Female (n = 131)Male (n = 223)

Figure 3 BMI-for-age Z -score of by sex of adolescent students in Finote Selam Town Ethiopia

6 )e Scientific World Journal

Table 3 Bivariate and multivariable logistic regression of factors associated with thinness among adolescent school students Finote SelamTown Ethiopia 2018

Variables)inness

COR (95 CI) AOR (95 CI)Yes No

Age GroupEarly adolescent (10ndash13) 17 (362) 30 (638) 514 (239 1108)lowast 481 (123 1851)lowastMidadolescent (14ndash16) 24 (159) 127 (841) 190 (099 364) 168 (057 493)Late adolescent (17ndash19) 18 (90) 181 (910) 1 1SexFemale 4 (27) 144 (973) 1 1Male 55 (221) 194 (779) 268 (188 384) 213 (160 340)lowast

GradeGrade 5ndash6 23 (213) 85 (787) 257 (091 724) 177 (040 787)Grade 7ndash8 22 (167) 110 (833) 208 (074 586) 133 (022 819)Grade 9ndash10 10 (86) 106 (914) 101 (032 315) 106 (020 558)Grade 11ndash12 4 (98) 37 (902) 1 1ReligionMuslim 1 (45) 21 (955) 1 1Orthodox 58 (155) 317 (845) 382 (050 2918) 390 (019 8194)Place of residenceUrban 18 (92) 177 (908) 1 1Rural 41 (203) 161 (797) 244 (135 440)lowast 216 (096 487)Fatherrsquos educationIlliterate 15 (158) 80 (842) 279 (092 845) 406 (023 7176)Read and write 17 (168) 84 (832) 197 (071 543) 273 (031 24 29)Primary school (1ndash8) 10 (244) 31 (756) 196 (073 532) 236 (026 2141)Secondary school (9ndash12) 11 (120) 81 (880) 144 (051 410) 080 (05 1290)College and above 6 (88) 62 (912) 1 1Motherrsquos educationIlliterate 17 (167) 85 (833) 238 (077 739) 178 (086 365)Read and write 16 (147) 93 (853) 186 (068 507) 140 (083 234)Primary school (1ndash8) 9 (265) 25 (735) 150 (055 409) 129 (061 271)Secondary school (9ndash12) 11 (124) 78 (876) 133 (047 381) 115 (066 197)College and above 6 (95) 57 (905) 1 1Fatherrsquos occupationDaily laborer 8 (140) 49 (860) 120 (047 307) 11 (055 21)Farmer 26 (218) 93 (782) 227 (112 461)lowast 155 (045 529)Merchant 11 (129) 74 (871) 118 (050 275) 152 (055 426)Governmentnongovernment employee 14 (103) 122 (897) 1 1Motherrsquos occupationDaily laborer 1 (200) 4 (800) 186 (019 1855) 210 (011 3874)Farmer 21 (244) 65 (756) 274 (116 646)lowast 216 (062 751)Housewife 15 (126) 104 (874) 133 (055 323) 246 (058 1047)Merchant 13 (121) 94 (879) 124 (051 304) 152 (043 536)Governmentnongovernment employee 9 (112) 71 (888) 1 1Family sizelt5 17 (98) 156 (902) 1 1ge5 42 (188) 182 (812) 243 (132 445)lowast 190 (080 451)Family monthly incomelt1000 29 (377) 48 (623) 610 (309 1204)lowast 1154 (382 3489)lowast1000ndash2000 14 (131) 93 (869) 171 (080 364) 347 (115 1045)lowastgt2000 16 (75) 197 (925) 1 1Source of drinking waterWell water 39 (213) 144 (787) 453 (171 1198) 382 (146 10 04)lowastSpring water 13 (123) 93 (877) 337 (088 1289) 256 (087 756)Public tap water 2 (77) 24 (923) 188 (023 1549) 146 (026 809)Tap water 5 (61) 77 (939) 1 1Presence of functional latrineYes 38 (148) 219 (852) 1 1

)e Scientific World Journal 7

might be due to the fact that impure water is a vehicle forintestinal parasites which leads to loss of appetite leading topoor nutritional status this might also be due to repeatedinfection causing depressed immunity and making the se-verity and duration of disease more severe contributing topoor nutritional status of the adolescents

5 Conclusions

)e prevalence of thinness was high in the study areaConsistent with this result the mean Z-scores of BMI-for-age were higher in boys than girls Age sex family monthlyincome and sources of drinking water were significantlyassociated with thinness among the respondents Based onthe finding there should be collaboration among healthsectors and education sectors of the town to address schooladolescents under nutrition problems of the town

Abbreviations

AOR Adjusted odds ratioCM CentimeterCOR Crude odds ratioCSA Central statistics agencyCV Confidence intervalEDHS Ethiopian demography and health surveySD Standard deviationSPSS Statistical Package for Social SciencesUN United NationsWHO World Health Organization

Data Availability

All data in this study are included in the figures tables andstatements

Ethical Approval

)e study was approved by the University Ethical Com-mittee of Faculty of Chemical and Food Engineering BahirDar University (protocol no 122010) Supportive letterswere obtained from the Amhara Public Health Institutewhich wrote a letter to the West Gojjam Zone Health Officeand then the West Gojjam Zone Health Office wrote a letterto the Finote Selam Town Administration Health OfficeFinally Finote Selam Town Administration Health Officewrote a letter to target schools

Consent

Written informed consent was obtained from the adoles-centsrsquo parents or legal guardians after clearly explaining theresearch objectives

Conflicts of Interest

)e authors declare that they have no conflicts of interest

Authorsrsquo Contributions

Damitie Kebede Mengesha has designed the study and in-volved in data collection supervision and data processingDamitie Kebede Mengesha has cleaned and analyzed thedata as well as interpreted the results and drafted the

Table 3 Continued

Variables)inness

COR (95 CI) AOR (95 CI)Yes No

No 21 (150) 119 (855) 108 (049 238) 105 (059 187)Number of meals eaten per dayTwo times 19 (160) 100 (840) 117 (064 213) 101 (053 191))ree times and above 40 (144) 238 (856) 1 1Illness reported in the last one monthYes 19 (145) 112 (855) 106 (057 196) 103 (057 187)No 40 (150) 226 (850) 1 1Availability of home gardenYes 50 (174) 238 (826) 1 1No 9 (83) 100 (917) 160 (101 254) 115 (066 199)Eating vegetables at least once per dayYes 23 (126) 160 (874) 1 1No 36 (168) 178 (832) 135 (076 260) 130 (072 236)Eating fruits at least once per dayYes 26 (127) 178 (873) 1 1No 33 (171) 160 (829) 133 (076 231) 123 (069 218)Eating farm animal products at least once per weekYes 14 (122) 101 (878) 1 1No 45 (160) 237 (840) 120 (062 229) 119 (061 234)Nutrition and health informationYes 6 (128) 41 (872) 1 1No 53 (151) 297 (849) 115 (049 271) 108 (043 269)

8 )e Scientific World Journal

manuscript Reddy P C J Prasad and Degnet Teferi Asresparticipated in cleaning analyzing and interpreting thedata Damitie Kebede Mengesha Reddy P C J Prasad andDegnet Teferi Asres critically reviewed the manuscript Allauthors read and approved the final manuscript

Acknowledgments

)e authors are thankful to adolescent students schooldirectors health officers data collectors and supervisors ofthis study

References

[1] WHO Adolescent Nutrition a Neglected Dimension WHOGeneva Switzerland 2013

[2] C Namrata and C Archana ldquoA comparative study of nu-tritional intake in adolescentgirlsrdquo 2013

[3] M R Khan and F Ahmed ldquoPhysical Status nutrient intakeand dietary pattern of adolescent female factory workers inUrban Bangladeshrdquo Asia Pacific Journal of Clinical Nutritionvol 14 no 1 pp 19ndash26 2005

[4] S Sally ldquoCalifornia state 4-H center for youth developmentthe biology of adolescencerdquo 2013

[5] UNICEF Adolescence an Age of Opportunity the State of theWorldrsquos Children United Nations Press New York NY USA2011

[6] J E Brown and J Stang Nutrition through Life the CycleWadsworth Cengage Learning Belmont CA USA 4th edi-tion 2011

[7] M D Gupta R Engelman J Levy G Luchsinger T Merrickand J E Rosen 1e Power of 18 Million Adolescent Youthand the Transformation of the Future United Nations Pop-ulation Fund New york NY USA 2014

[8] M R Burt ldquoWhy should we invest in adolescentsrdquo in Pro-ceedongs of the Paper Prepared for the Conference on Com-prehensive Health of Adolescents and Youth in Latin Americaand the Caribbean Washington DC USA 2013

[9] CSA Centeral Statistics Agency of Ethiopia Addis Ababa2007

[10] K Teji Y Dessie T Assebe et al ldquoAnaemia and nutritionalstatus of adolescent girls in Babile district Eastern EthiopiardquoPan African Medical Journal vol 24 p 62 2016

[11] T Wolde W A D Mekonnin F Yitayin et al ldquoNutritionalstatus of adolescent girls living in southwest of Ethiopiardquo FoodScience and Human Wellness vol 34 pp 58ndash64 2014

[12] T Gebregyorgis T Tadesse and A Atenafu ldquoPrevalence ofthinness and stunting and associated factors among adoles-cent schoolgirls in Adwa Town North Ethiopiardquo Interna-tional Journal of Food Science vol 2016 Article ID 83239828 pages 2016

[13] Y Yemaneh A Girma W Nigussie et al ldquoUndernutritionand its associated factors among adolescent girls in the ruralcommunity of Aseko district Eastern Arsi Zone Oromiaregion Eastern Ethiopia 2017rdquo International Journal ofClinical Obstetrics and Gynaecology vol 1 no 2 pp 17ndash262017

[14] G Arage M Assefa and T Worku ldquoSocio-demographic andeconomic factors are associated with nutritional status ofadolescent school girls in Lay Guyint Woreda NorthwestEthiopiardquo SAGE Open Medicine vol 7 2019

[15] H Gebremariam S Omer and H Assefa ldquoAssessment ofnutritional status and associated factors among school going

adolescents of Mekelle City Northern Ethiopiardquo Interna-tional Journal of Nutrition and Food Sciences vol 4 no 1pp 118ndash124 2015

[16] Y A Melaku G A Zello T K Gill R J Adams and Z ShildquoPrevalence and factors associated with stunting and thinnessamong adolescent students in Northern Ethiopia a com-parison to World Health Organization standardsrdquo Archives ofPublic Health vol 4 no 1 2015

[17] FTEO Finoteselam Education Office 2017[18] S M Birru A Tariku and A K Belew ldquoImproved dietary di-

versity of school adolescent girls in the context of urbanNorthwestEthiopiardquo Italian Journal of Pediatrics vol 44 p 48 2018

[19] A Y Mohammed and T B Tefera ldquoNutritional status andassociated risk factors among adolescents girls in Agarfa HighSchool Bale Zone Oromia Region South East EthiopiardquoInternational Journal of Nutrition and Food Sciences vol 4no 4 pp 445ndash152 2015

[20] WHO AnthroPlus for Personal Computers Manual Softwarefor Assessing Growth of the Worldrsquos Children and AdolescentsWHO Geneva Switzerland 2009

[21] D W Hosmer and S Lemeshow Applied Logistic RegressionJohnWiley amp Sons Inc New York NY USA 2nd edition 2000

[22] Z Alebachew Prevalence of Childhood and AdolescentOverweight and Obesity Among Elementary School StudentsAddis Ababa University Addis Ababa Ethiopia 2010

[23] P Bovet N Kizirian G Madeleine M Blossner andA Chiolero ldquoPrevalence of thinness in children and ado-lescents in the Seychelles comparison of two internationalgrowth referencesrdquo Nutrition Journal vol 10 p 65 2011

[24] H Assefa T Belachew and L Negash ldquoSocioeconomicfactors associated with underweight and stunting amongadolescents of Jimma Zone South West Ethiopiardquo ISRNPublic Health vol 2013 Article ID 238546 7 pages 2013

[25] M Yetubie ldquoAnthropometric assessment of adolescentmalnutrition in elementary and secondary schools of ambordquo)esis Addis Ababa University Addis Ababa Ethiopia 2012

[26] C Dabone H F Delisle and O Receveur ldquoPoor nutritionalstatus of schoolchildren in urban and peri-urban areas of Oua-gadougou (Burkina Faso)rdquo Nutrition Journal vol 10 p 34 2011

[27] T Leenstra L T Petersen S K Kariuki A J OlooP A Kager and F O t Kuile ldquoPrevalence and severity ofmalnutrition and age at menarche cross-sectional studies inadolescent schoolgirls in western Kenyardquo European Journal ofClinical Nutrition vol 59 no 1 pp 41ndash48 2005

[28] H Aounallah-Skhiri H B Romdhane P Traissac et alldquoNutritional status of Tunisian adolescents associated genderenvironmental and socio-economic factorsrdquo Public HealthNutrition vol 11 no 12 pp 1306ndash1317 2008

[29] A Abiba A N K Grace and K C Kubreziga ldquoEffects ofdietary patterns on the nutritional status of upper primaryschool children in Tamale metropolisrdquo Pakistan Journal ofNutrition vol 11 no 7 pp 591ndash609 2012

[30] M M Wassie A A Gete M E Yesuf G D Alene A Belayand T Moges ldquoPredictors of nutritional status of Ethiopianadolescent girls a community based cross sectional studyrdquoBMC Nutrition vol 1 no 1 p 20 2015

[31] A Kassa Tekile A AbateWoya and GW Basha ldquoPrevalence ofmalnutrition and associated factors among under-five children inEthiopia evidence from the 2016 Ethiopia Demographic andHealth Surveyrdquo BMC Research Notes vol 12 no 1 2019

[32] R Kt A M and T Wakayo ldquoNutritional status and its as-sociated factors among school adolescent girls in Adama CityCentral Ethiopiardquo Journal of Nutrition amp Food Sciences vol 6no 3 p 493 2016

)e Scientific World Journal 9

Page 5: PrevalenceandAssociatedFactorsofThinnessamongAdolescent ...downloads.hindawi.com/journals/tswj/2020/9170301.pdf · Pretested structured questionnaireswere used to collect the data

rural area were 216 (AOR 261 95 CI 096 487) timesmore likely to be thin compare to those who came fromurban area )e students from less than 1000 and 1000ndash2000birr family monthly income were 654 (AOR 654 95 CI 382 1489) and 347 (AOR 347 95 CI 115 745) timesmore likely to be thin compared to greater than 2000 birrfamily monthly income respectively Students fromhouseholds that used well water supply as main source ofwater supply were 382 times more likely to be at risk ofbeing thin than students from households that used tapwater supply for human consumption (AOR 382 95 CI 146 1004) (Table 3)

4 Discussion

In this study the prevalence of thinness and associatedfactors in Finote Selam Town Northwest Ethiopia wasassessed )e prevalence of thinness was 149 and thisfinding was lower than the studies in Mekelle City (378)[15] Ambo City (275) [22] Wukro District (261) [16]and Seychelles (277) [23] Another study in Ethiopia inJimma Zone has reported a much higher level (808) ofthinness prevalence among adolescents [24] )e prevalenceof thinness of this study was higher than studies done inAddis Ababa (62) (13) [25] )is divergence might be

Table 2 Nutrition and health-related characteristics of school adolescents at Finote Selam Town Ethiopia 2018

Variables Frequency PercentageNumber of meals eaten per dayTwo times 119 300)ree times and above 278 700Illness reported in the last one monthYes 131 330No 266 670Availability of home gardenYes 288 725No 109 275Eating vegetables at least once per dayYes 183 461No 214 539Eating fruits at least once per dayYes 204 514No 193 486Eating farm animal products at least once per weekYes 115 290No 282 710Nutrition and health informationYes 47 118No 350 882

45

40

35

30

25

20

15

10

5

0

Child

ren

()

ndash5 ndash45 ndash4 ndash35 ndash3 ndash25 ndash2 ndash15 ndash1 ndash05 0 05 1 15 2 25 3 35 4 45 5Z-score

WHO child growth standards (birth to 60 months) WHO reference 2007 (61 months to 19 years)All children (n = 354)

Figure 2 BMI-for-age Z -score of adolescent students in Finote Selam Town Ethiopia

)e Scientific World Journal 5

due to the difference in socioeconomic background dietaryhabit and type of meals among the cities Findings in otherAfrican countries include Burkina Faso (137) [26]Asembo and Mumias Kenya (156) [27] Tunisia (13)[28] and Tamale Metropolis district Ghana (10) [29] )evariation might be due to socioeconomic backgroundgeographical characteristics of study area cultural differencein dietary habit and care practices

)e odds of thinness were 481 times higher amongadolescent students in the early adolescent stage as com-pared to adolescent students in the late adolescent stage)isfinding was in agreement with findings from Adwa TownNorthen Ethiopia [17] and in Community-Based Nutritionimplementing districts Amhara Region Ethiopia [30] )ismight be due to as age increases adolescents might accessfood easily by themselves on the other hand as age in-creases adolescents become more matured Male adolescentstudents had 213 times higher odds of thinness compared tofemale adolescent students )is study was in line with thestudies conducted in Mekelle City Northern Ethiopia [15]Jimma Zone Southwest Ethiopia [24] and WukroNorthern Ethiopia [16] which confirmed that males weremore affected in thinness than girls )is might be due tovariation of maturation time in boys and girls for which girlsreached maturation earlier than boys

)e students who came from rural area were 216 timesmore likely to be thin compared to those who came fromurban area )is finding is in agreement with other previ-ously conducted studies [12 16] )e variation might be dueto food preference food consumption pattern and in-equalities in dietary diversity between urban and rural areas)e risk of being thin among school adolescents whosemothers did not attend education was 178 times morecompared to school adolescents whose mother attendedcollege and above education )is finding is consistent withthe study that conducted in Adama City Central Ethiopia

[31] )e risk of being thin among school adolescents whosemothers attended primary school (1ndash8) and secondaryschool (9ndash12) education was 129 and 115 (AOR 115 95CI 066 197) times more compared to students whosemothers attended college and above education respectively)is finding is in line with the study that conducted inAdama City Central Ethiopia [32] )is is due to the factthat if the level of education of the mother is low her de-cision-making and her contribution to the total family in-come will be low)is places the family at risk of not meetingtheir needs including nutritional needs

)e odds of being thin were 190 times higher amongschool adolescents who lived in household members of ge5than school adolescents who had lived in householdmembers lt5 )is finding was in line with the study thatconducted in Adwa Town North Ethiopia [12] )is mightbe due to sharing of the available food for the largehousehold members causing inadequate consumption offood leading to be thin )e students who did not eatvegetables and fruits at least once per day were 130 and 123times more likely to be thin compared to those who ate onceper day )is finding is in agreement with the study thatconducted in Adwa Town North Ethiopia [12])is is mightbe due to the fact that consuming insufficient vegetables andfruits are leading to poor nutritional status

)e students from less than 1000 and 1000ndash2000 birrfamily monthly income were 654 and 347 times more likelyto be thinness compared to greater than 2000 birr familymonthly income respectively )is might be due to thebetter income level of the family would enhance the nu-trition status of the adolescents Students from householdsthat used well water supply as main source of water supplywere 382 times more likely to be at risk of being thinnessthan students from households that used tap water supplyfor human consumption )is finding was in line withfindings from Adwa Town Northen Ethiopia [17] )is

45

40

35

30

25

20

15

10

5

0

Child

ren

()

ndash5 ndash45 ndash4 ndash35 ndash3 ndash25 ndash2 ndash15 ndash1 ndash05 0 05 1 15 2 25 3 35 4 45 5Z-score

WHO child growth standards (birth to 60 months) WHO reference 2007 (61 months to 19 years)Female (n = 131)Male (n = 223)

Figure 3 BMI-for-age Z -score of by sex of adolescent students in Finote Selam Town Ethiopia

6 )e Scientific World Journal

Table 3 Bivariate and multivariable logistic regression of factors associated with thinness among adolescent school students Finote SelamTown Ethiopia 2018

Variables)inness

COR (95 CI) AOR (95 CI)Yes No

Age GroupEarly adolescent (10ndash13) 17 (362) 30 (638) 514 (239 1108)lowast 481 (123 1851)lowastMidadolescent (14ndash16) 24 (159) 127 (841) 190 (099 364) 168 (057 493)Late adolescent (17ndash19) 18 (90) 181 (910) 1 1SexFemale 4 (27) 144 (973) 1 1Male 55 (221) 194 (779) 268 (188 384) 213 (160 340)lowast

GradeGrade 5ndash6 23 (213) 85 (787) 257 (091 724) 177 (040 787)Grade 7ndash8 22 (167) 110 (833) 208 (074 586) 133 (022 819)Grade 9ndash10 10 (86) 106 (914) 101 (032 315) 106 (020 558)Grade 11ndash12 4 (98) 37 (902) 1 1ReligionMuslim 1 (45) 21 (955) 1 1Orthodox 58 (155) 317 (845) 382 (050 2918) 390 (019 8194)Place of residenceUrban 18 (92) 177 (908) 1 1Rural 41 (203) 161 (797) 244 (135 440)lowast 216 (096 487)Fatherrsquos educationIlliterate 15 (158) 80 (842) 279 (092 845) 406 (023 7176)Read and write 17 (168) 84 (832) 197 (071 543) 273 (031 24 29)Primary school (1ndash8) 10 (244) 31 (756) 196 (073 532) 236 (026 2141)Secondary school (9ndash12) 11 (120) 81 (880) 144 (051 410) 080 (05 1290)College and above 6 (88) 62 (912) 1 1Motherrsquos educationIlliterate 17 (167) 85 (833) 238 (077 739) 178 (086 365)Read and write 16 (147) 93 (853) 186 (068 507) 140 (083 234)Primary school (1ndash8) 9 (265) 25 (735) 150 (055 409) 129 (061 271)Secondary school (9ndash12) 11 (124) 78 (876) 133 (047 381) 115 (066 197)College and above 6 (95) 57 (905) 1 1Fatherrsquos occupationDaily laborer 8 (140) 49 (860) 120 (047 307) 11 (055 21)Farmer 26 (218) 93 (782) 227 (112 461)lowast 155 (045 529)Merchant 11 (129) 74 (871) 118 (050 275) 152 (055 426)Governmentnongovernment employee 14 (103) 122 (897) 1 1Motherrsquos occupationDaily laborer 1 (200) 4 (800) 186 (019 1855) 210 (011 3874)Farmer 21 (244) 65 (756) 274 (116 646)lowast 216 (062 751)Housewife 15 (126) 104 (874) 133 (055 323) 246 (058 1047)Merchant 13 (121) 94 (879) 124 (051 304) 152 (043 536)Governmentnongovernment employee 9 (112) 71 (888) 1 1Family sizelt5 17 (98) 156 (902) 1 1ge5 42 (188) 182 (812) 243 (132 445)lowast 190 (080 451)Family monthly incomelt1000 29 (377) 48 (623) 610 (309 1204)lowast 1154 (382 3489)lowast1000ndash2000 14 (131) 93 (869) 171 (080 364) 347 (115 1045)lowastgt2000 16 (75) 197 (925) 1 1Source of drinking waterWell water 39 (213) 144 (787) 453 (171 1198) 382 (146 10 04)lowastSpring water 13 (123) 93 (877) 337 (088 1289) 256 (087 756)Public tap water 2 (77) 24 (923) 188 (023 1549) 146 (026 809)Tap water 5 (61) 77 (939) 1 1Presence of functional latrineYes 38 (148) 219 (852) 1 1

)e Scientific World Journal 7

might be due to the fact that impure water is a vehicle forintestinal parasites which leads to loss of appetite leading topoor nutritional status this might also be due to repeatedinfection causing depressed immunity and making the se-verity and duration of disease more severe contributing topoor nutritional status of the adolescents

5 Conclusions

)e prevalence of thinness was high in the study areaConsistent with this result the mean Z-scores of BMI-for-age were higher in boys than girls Age sex family monthlyincome and sources of drinking water were significantlyassociated with thinness among the respondents Based onthe finding there should be collaboration among healthsectors and education sectors of the town to address schooladolescents under nutrition problems of the town

Abbreviations

AOR Adjusted odds ratioCM CentimeterCOR Crude odds ratioCSA Central statistics agencyCV Confidence intervalEDHS Ethiopian demography and health surveySD Standard deviationSPSS Statistical Package for Social SciencesUN United NationsWHO World Health Organization

Data Availability

All data in this study are included in the figures tables andstatements

Ethical Approval

)e study was approved by the University Ethical Com-mittee of Faculty of Chemical and Food Engineering BahirDar University (protocol no 122010) Supportive letterswere obtained from the Amhara Public Health Institutewhich wrote a letter to the West Gojjam Zone Health Officeand then the West Gojjam Zone Health Office wrote a letterto the Finote Selam Town Administration Health OfficeFinally Finote Selam Town Administration Health Officewrote a letter to target schools

Consent

Written informed consent was obtained from the adoles-centsrsquo parents or legal guardians after clearly explaining theresearch objectives

Conflicts of Interest

)e authors declare that they have no conflicts of interest

Authorsrsquo Contributions

Damitie Kebede Mengesha has designed the study and in-volved in data collection supervision and data processingDamitie Kebede Mengesha has cleaned and analyzed thedata as well as interpreted the results and drafted the

Table 3 Continued

Variables)inness

COR (95 CI) AOR (95 CI)Yes No

No 21 (150) 119 (855) 108 (049 238) 105 (059 187)Number of meals eaten per dayTwo times 19 (160) 100 (840) 117 (064 213) 101 (053 191))ree times and above 40 (144) 238 (856) 1 1Illness reported in the last one monthYes 19 (145) 112 (855) 106 (057 196) 103 (057 187)No 40 (150) 226 (850) 1 1Availability of home gardenYes 50 (174) 238 (826) 1 1No 9 (83) 100 (917) 160 (101 254) 115 (066 199)Eating vegetables at least once per dayYes 23 (126) 160 (874) 1 1No 36 (168) 178 (832) 135 (076 260) 130 (072 236)Eating fruits at least once per dayYes 26 (127) 178 (873) 1 1No 33 (171) 160 (829) 133 (076 231) 123 (069 218)Eating farm animal products at least once per weekYes 14 (122) 101 (878) 1 1No 45 (160) 237 (840) 120 (062 229) 119 (061 234)Nutrition and health informationYes 6 (128) 41 (872) 1 1No 53 (151) 297 (849) 115 (049 271) 108 (043 269)

8 )e Scientific World Journal

manuscript Reddy P C J Prasad and Degnet Teferi Asresparticipated in cleaning analyzing and interpreting thedata Damitie Kebede Mengesha Reddy P C J Prasad andDegnet Teferi Asres critically reviewed the manuscript Allauthors read and approved the final manuscript

Acknowledgments

)e authors are thankful to adolescent students schooldirectors health officers data collectors and supervisors ofthis study

References

[1] WHO Adolescent Nutrition a Neglected Dimension WHOGeneva Switzerland 2013

[2] C Namrata and C Archana ldquoA comparative study of nu-tritional intake in adolescentgirlsrdquo 2013

[3] M R Khan and F Ahmed ldquoPhysical Status nutrient intakeand dietary pattern of adolescent female factory workers inUrban Bangladeshrdquo Asia Pacific Journal of Clinical Nutritionvol 14 no 1 pp 19ndash26 2005

[4] S Sally ldquoCalifornia state 4-H center for youth developmentthe biology of adolescencerdquo 2013

[5] UNICEF Adolescence an Age of Opportunity the State of theWorldrsquos Children United Nations Press New York NY USA2011

[6] J E Brown and J Stang Nutrition through Life the CycleWadsworth Cengage Learning Belmont CA USA 4th edi-tion 2011

[7] M D Gupta R Engelman J Levy G Luchsinger T Merrickand J E Rosen 1e Power of 18 Million Adolescent Youthand the Transformation of the Future United Nations Pop-ulation Fund New york NY USA 2014

[8] M R Burt ldquoWhy should we invest in adolescentsrdquo in Pro-ceedongs of the Paper Prepared for the Conference on Com-prehensive Health of Adolescents and Youth in Latin Americaand the Caribbean Washington DC USA 2013

[9] CSA Centeral Statistics Agency of Ethiopia Addis Ababa2007

[10] K Teji Y Dessie T Assebe et al ldquoAnaemia and nutritionalstatus of adolescent girls in Babile district Eastern EthiopiardquoPan African Medical Journal vol 24 p 62 2016

[11] T Wolde W A D Mekonnin F Yitayin et al ldquoNutritionalstatus of adolescent girls living in southwest of Ethiopiardquo FoodScience and Human Wellness vol 34 pp 58ndash64 2014

[12] T Gebregyorgis T Tadesse and A Atenafu ldquoPrevalence ofthinness and stunting and associated factors among adoles-cent schoolgirls in Adwa Town North Ethiopiardquo Interna-tional Journal of Food Science vol 2016 Article ID 83239828 pages 2016

[13] Y Yemaneh A Girma W Nigussie et al ldquoUndernutritionand its associated factors among adolescent girls in the ruralcommunity of Aseko district Eastern Arsi Zone Oromiaregion Eastern Ethiopia 2017rdquo International Journal ofClinical Obstetrics and Gynaecology vol 1 no 2 pp 17ndash262017

[14] G Arage M Assefa and T Worku ldquoSocio-demographic andeconomic factors are associated with nutritional status ofadolescent school girls in Lay Guyint Woreda NorthwestEthiopiardquo SAGE Open Medicine vol 7 2019

[15] H Gebremariam S Omer and H Assefa ldquoAssessment ofnutritional status and associated factors among school going

adolescents of Mekelle City Northern Ethiopiardquo Interna-tional Journal of Nutrition and Food Sciences vol 4 no 1pp 118ndash124 2015

[16] Y A Melaku G A Zello T K Gill R J Adams and Z ShildquoPrevalence and factors associated with stunting and thinnessamong adolescent students in Northern Ethiopia a com-parison to World Health Organization standardsrdquo Archives ofPublic Health vol 4 no 1 2015

[17] FTEO Finoteselam Education Office 2017[18] S M Birru A Tariku and A K Belew ldquoImproved dietary di-

versity of school adolescent girls in the context of urbanNorthwestEthiopiardquo Italian Journal of Pediatrics vol 44 p 48 2018

[19] A Y Mohammed and T B Tefera ldquoNutritional status andassociated risk factors among adolescents girls in Agarfa HighSchool Bale Zone Oromia Region South East EthiopiardquoInternational Journal of Nutrition and Food Sciences vol 4no 4 pp 445ndash152 2015

[20] WHO AnthroPlus for Personal Computers Manual Softwarefor Assessing Growth of the Worldrsquos Children and AdolescentsWHO Geneva Switzerland 2009

[21] D W Hosmer and S Lemeshow Applied Logistic RegressionJohnWiley amp Sons Inc New York NY USA 2nd edition 2000

[22] Z Alebachew Prevalence of Childhood and AdolescentOverweight and Obesity Among Elementary School StudentsAddis Ababa University Addis Ababa Ethiopia 2010

[23] P Bovet N Kizirian G Madeleine M Blossner andA Chiolero ldquoPrevalence of thinness in children and ado-lescents in the Seychelles comparison of two internationalgrowth referencesrdquo Nutrition Journal vol 10 p 65 2011

[24] H Assefa T Belachew and L Negash ldquoSocioeconomicfactors associated with underweight and stunting amongadolescents of Jimma Zone South West Ethiopiardquo ISRNPublic Health vol 2013 Article ID 238546 7 pages 2013

[25] M Yetubie ldquoAnthropometric assessment of adolescentmalnutrition in elementary and secondary schools of ambordquo)esis Addis Ababa University Addis Ababa Ethiopia 2012

[26] C Dabone H F Delisle and O Receveur ldquoPoor nutritionalstatus of schoolchildren in urban and peri-urban areas of Oua-gadougou (Burkina Faso)rdquo Nutrition Journal vol 10 p 34 2011

[27] T Leenstra L T Petersen S K Kariuki A J OlooP A Kager and F O t Kuile ldquoPrevalence and severity ofmalnutrition and age at menarche cross-sectional studies inadolescent schoolgirls in western Kenyardquo European Journal ofClinical Nutrition vol 59 no 1 pp 41ndash48 2005

[28] H Aounallah-Skhiri H B Romdhane P Traissac et alldquoNutritional status of Tunisian adolescents associated genderenvironmental and socio-economic factorsrdquo Public HealthNutrition vol 11 no 12 pp 1306ndash1317 2008

[29] A Abiba A N K Grace and K C Kubreziga ldquoEffects ofdietary patterns on the nutritional status of upper primaryschool children in Tamale metropolisrdquo Pakistan Journal ofNutrition vol 11 no 7 pp 591ndash609 2012

[30] M M Wassie A A Gete M E Yesuf G D Alene A Belayand T Moges ldquoPredictors of nutritional status of Ethiopianadolescent girls a community based cross sectional studyrdquoBMC Nutrition vol 1 no 1 p 20 2015

[31] A Kassa Tekile A AbateWoya and GW Basha ldquoPrevalence ofmalnutrition and associated factors among under-five children inEthiopia evidence from the 2016 Ethiopia Demographic andHealth Surveyrdquo BMC Research Notes vol 12 no 1 2019

[32] R Kt A M and T Wakayo ldquoNutritional status and its as-sociated factors among school adolescent girls in Adama CityCentral Ethiopiardquo Journal of Nutrition amp Food Sciences vol 6no 3 p 493 2016

)e Scientific World Journal 9

Page 6: PrevalenceandAssociatedFactorsofThinnessamongAdolescent ...downloads.hindawi.com/journals/tswj/2020/9170301.pdf · Pretested structured questionnaireswere used to collect the data

due to the difference in socioeconomic background dietaryhabit and type of meals among the cities Findings in otherAfrican countries include Burkina Faso (137) [26]Asembo and Mumias Kenya (156) [27] Tunisia (13)[28] and Tamale Metropolis district Ghana (10) [29] )evariation might be due to socioeconomic backgroundgeographical characteristics of study area cultural differencein dietary habit and care practices

)e odds of thinness were 481 times higher amongadolescent students in the early adolescent stage as com-pared to adolescent students in the late adolescent stage)isfinding was in agreement with findings from Adwa TownNorthen Ethiopia [17] and in Community-Based Nutritionimplementing districts Amhara Region Ethiopia [30] )ismight be due to as age increases adolescents might accessfood easily by themselves on the other hand as age in-creases adolescents become more matured Male adolescentstudents had 213 times higher odds of thinness compared tofemale adolescent students )is study was in line with thestudies conducted in Mekelle City Northern Ethiopia [15]Jimma Zone Southwest Ethiopia [24] and WukroNorthern Ethiopia [16] which confirmed that males weremore affected in thinness than girls )is might be due tovariation of maturation time in boys and girls for which girlsreached maturation earlier than boys

)e students who came from rural area were 216 timesmore likely to be thin compared to those who came fromurban area )is finding is in agreement with other previ-ously conducted studies [12 16] )e variation might be dueto food preference food consumption pattern and in-equalities in dietary diversity between urban and rural areas)e risk of being thin among school adolescents whosemothers did not attend education was 178 times morecompared to school adolescents whose mother attendedcollege and above education )is finding is consistent withthe study that conducted in Adama City Central Ethiopia

[31] )e risk of being thin among school adolescents whosemothers attended primary school (1ndash8) and secondaryschool (9ndash12) education was 129 and 115 (AOR 115 95CI 066 197) times more compared to students whosemothers attended college and above education respectively)is finding is in line with the study that conducted inAdama City Central Ethiopia [32] )is is due to the factthat if the level of education of the mother is low her de-cision-making and her contribution to the total family in-come will be low)is places the family at risk of not meetingtheir needs including nutritional needs

)e odds of being thin were 190 times higher amongschool adolescents who lived in household members of ge5than school adolescents who had lived in householdmembers lt5 )is finding was in line with the study thatconducted in Adwa Town North Ethiopia [12] )is mightbe due to sharing of the available food for the largehousehold members causing inadequate consumption offood leading to be thin )e students who did not eatvegetables and fruits at least once per day were 130 and 123times more likely to be thin compared to those who ate onceper day )is finding is in agreement with the study thatconducted in Adwa Town North Ethiopia [12])is is mightbe due to the fact that consuming insufficient vegetables andfruits are leading to poor nutritional status

)e students from less than 1000 and 1000ndash2000 birrfamily monthly income were 654 and 347 times more likelyto be thinness compared to greater than 2000 birr familymonthly income respectively )is might be due to thebetter income level of the family would enhance the nu-trition status of the adolescents Students from householdsthat used well water supply as main source of water supplywere 382 times more likely to be at risk of being thinnessthan students from households that used tap water supplyfor human consumption )is finding was in line withfindings from Adwa Town Northen Ethiopia [17] )is

45

40

35

30

25

20

15

10

5

0

Child

ren

()

ndash5 ndash45 ndash4 ndash35 ndash3 ndash25 ndash2 ndash15 ndash1 ndash05 0 05 1 15 2 25 3 35 4 45 5Z-score

WHO child growth standards (birth to 60 months) WHO reference 2007 (61 months to 19 years)Female (n = 131)Male (n = 223)

Figure 3 BMI-for-age Z -score of by sex of adolescent students in Finote Selam Town Ethiopia

6 )e Scientific World Journal

Table 3 Bivariate and multivariable logistic regression of factors associated with thinness among adolescent school students Finote SelamTown Ethiopia 2018

Variables)inness

COR (95 CI) AOR (95 CI)Yes No

Age GroupEarly adolescent (10ndash13) 17 (362) 30 (638) 514 (239 1108)lowast 481 (123 1851)lowastMidadolescent (14ndash16) 24 (159) 127 (841) 190 (099 364) 168 (057 493)Late adolescent (17ndash19) 18 (90) 181 (910) 1 1SexFemale 4 (27) 144 (973) 1 1Male 55 (221) 194 (779) 268 (188 384) 213 (160 340)lowast

GradeGrade 5ndash6 23 (213) 85 (787) 257 (091 724) 177 (040 787)Grade 7ndash8 22 (167) 110 (833) 208 (074 586) 133 (022 819)Grade 9ndash10 10 (86) 106 (914) 101 (032 315) 106 (020 558)Grade 11ndash12 4 (98) 37 (902) 1 1ReligionMuslim 1 (45) 21 (955) 1 1Orthodox 58 (155) 317 (845) 382 (050 2918) 390 (019 8194)Place of residenceUrban 18 (92) 177 (908) 1 1Rural 41 (203) 161 (797) 244 (135 440)lowast 216 (096 487)Fatherrsquos educationIlliterate 15 (158) 80 (842) 279 (092 845) 406 (023 7176)Read and write 17 (168) 84 (832) 197 (071 543) 273 (031 24 29)Primary school (1ndash8) 10 (244) 31 (756) 196 (073 532) 236 (026 2141)Secondary school (9ndash12) 11 (120) 81 (880) 144 (051 410) 080 (05 1290)College and above 6 (88) 62 (912) 1 1Motherrsquos educationIlliterate 17 (167) 85 (833) 238 (077 739) 178 (086 365)Read and write 16 (147) 93 (853) 186 (068 507) 140 (083 234)Primary school (1ndash8) 9 (265) 25 (735) 150 (055 409) 129 (061 271)Secondary school (9ndash12) 11 (124) 78 (876) 133 (047 381) 115 (066 197)College and above 6 (95) 57 (905) 1 1Fatherrsquos occupationDaily laborer 8 (140) 49 (860) 120 (047 307) 11 (055 21)Farmer 26 (218) 93 (782) 227 (112 461)lowast 155 (045 529)Merchant 11 (129) 74 (871) 118 (050 275) 152 (055 426)Governmentnongovernment employee 14 (103) 122 (897) 1 1Motherrsquos occupationDaily laborer 1 (200) 4 (800) 186 (019 1855) 210 (011 3874)Farmer 21 (244) 65 (756) 274 (116 646)lowast 216 (062 751)Housewife 15 (126) 104 (874) 133 (055 323) 246 (058 1047)Merchant 13 (121) 94 (879) 124 (051 304) 152 (043 536)Governmentnongovernment employee 9 (112) 71 (888) 1 1Family sizelt5 17 (98) 156 (902) 1 1ge5 42 (188) 182 (812) 243 (132 445)lowast 190 (080 451)Family monthly incomelt1000 29 (377) 48 (623) 610 (309 1204)lowast 1154 (382 3489)lowast1000ndash2000 14 (131) 93 (869) 171 (080 364) 347 (115 1045)lowastgt2000 16 (75) 197 (925) 1 1Source of drinking waterWell water 39 (213) 144 (787) 453 (171 1198) 382 (146 10 04)lowastSpring water 13 (123) 93 (877) 337 (088 1289) 256 (087 756)Public tap water 2 (77) 24 (923) 188 (023 1549) 146 (026 809)Tap water 5 (61) 77 (939) 1 1Presence of functional latrineYes 38 (148) 219 (852) 1 1

)e Scientific World Journal 7

might be due to the fact that impure water is a vehicle forintestinal parasites which leads to loss of appetite leading topoor nutritional status this might also be due to repeatedinfection causing depressed immunity and making the se-verity and duration of disease more severe contributing topoor nutritional status of the adolescents

5 Conclusions

)e prevalence of thinness was high in the study areaConsistent with this result the mean Z-scores of BMI-for-age were higher in boys than girls Age sex family monthlyincome and sources of drinking water were significantlyassociated with thinness among the respondents Based onthe finding there should be collaboration among healthsectors and education sectors of the town to address schooladolescents under nutrition problems of the town

Abbreviations

AOR Adjusted odds ratioCM CentimeterCOR Crude odds ratioCSA Central statistics agencyCV Confidence intervalEDHS Ethiopian demography and health surveySD Standard deviationSPSS Statistical Package for Social SciencesUN United NationsWHO World Health Organization

Data Availability

All data in this study are included in the figures tables andstatements

Ethical Approval

)e study was approved by the University Ethical Com-mittee of Faculty of Chemical and Food Engineering BahirDar University (protocol no 122010) Supportive letterswere obtained from the Amhara Public Health Institutewhich wrote a letter to the West Gojjam Zone Health Officeand then the West Gojjam Zone Health Office wrote a letterto the Finote Selam Town Administration Health OfficeFinally Finote Selam Town Administration Health Officewrote a letter to target schools

Consent

Written informed consent was obtained from the adoles-centsrsquo parents or legal guardians after clearly explaining theresearch objectives

Conflicts of Interest

)e authors declare that they have no conflicts of interest

Authorsrsquo Contributions

Damitie Kebede Mengesha has designed the study and in-volved in data collection supervision and data processingDamitie Kebede Mengesha has cleaned and analyzed thedata as well as interpreted the results and drafted the

Table 3 Continued

Variables)inness

COR (95 CI) AOR (95 CI)Yes No

No 21 (150) 119 (855) 108 (049 238) 105 (059 187)Number of meals eaten per dayTwo times 19 (160) 100 (840) 117 (064 213) 101 (053 191))ree times and above 40 (144) 238 (856) 1 1Illness reported in the last one monthYes 19 (145) 112 (855) 106 (057 196) 103 (057 187)No 40 (150) 226 (850) 1 1Availability of home gardenYes 50 (174) 238 (826) 1 1No 9 (83) 100 (917) 160 (101 254) 115 (066 199)Eating vegetables at least once per dayYes 23 (126) 160 (874) 1 1No 36 (168) 178 (832) 135 (076 260) 130 (072 236)Eating fruits at least once per dayYes 26 (127) 178 (873) 1 1No 33 (171) 160 (829) 133 (076 231) 123 (069 218)Eating farm animal products at least once per weekYes 14 (122) 101 (878) 1 1No 45 (160) 237 (840) 120 (062 229) 119 (061 234)Nutrition and health informationYes 6 (128) 41 (872) 1 1No 53 (151) 297 (849) 115 (049 271) 108 (043 269)

8 )e Scientific World Journal

manuscript Reddy P C J Prasad and Degnet Teferi Asresparticipated in cleaning analyzing and interpreting thedata Damitie Kebede Mengesha Reddy P C J Prasad andDegnet Teferi Asres critically reviewed the manuscript Allauthors read and approved the final manuscript

Acknowledgments

)e authors are thankful to adolescent students schooldirectors health officers data collectors and supervisors ofthis study

References

[1] WHO Adolescent Nutrition a Neglected Dimension WHOGeneva Switzerland 2013

[2] C Namrata and C Archana ldquoA comparative study of nu-tritional intake in adolescentgirlsrdquo 2013

[3] M R Khan and F Ahmed ldquoPhysical Status nutrient intakeand dietary pattern of adolescent female factory workers inUrban Bangladeshrdquo Asia Pacific Journal of Clinical Nutritionvol 14 no 1 pp 19ndash26 2005

[4] S Sally ldquoCalifornia state 4-H center for youth developmentthe biology of adolescencerdquo 2013

[5] UNICEF Adolescence an Age of Opportunity the State of theWorldrsquos Children United Nations Press New York NY USA2011

[6] J E Brown and J Stang Nutrition through Life the CycleWadsworth Cengage Learning Belmont CA USA 4th edi-tion 2011

[7] M D Gupta R Engelman J Levy G Luchsinger T Merrickand J E Rosen 1e Power of 18 Million Adolescent Youthand the Transformation of the Future United Nations Pop-ulation Fund New york NY USA 2014

[8] M R Burt ldquoWhy should we invest in adolescentsrdquo in Pro-ceedongs of the Paper Prepared for the Conference on Com-prehensive Health of Adolescents and Youth in Latin Americaand the Caribbean Washington DC USA 2013

[9] CSA Centeral Statistics Agency of Ethiopia Addis Ababa2007

[10] K Teji Y Dessie T Assebe et al ldquoAnaemia and nutritionalstatus of adolescent girls in Babile district Eastern EthiopiardquoPan African Medical Journal vol 24 p 62 2016

[11] T Wolde W A D Mekonnin F Yitayin et al ldquoNutritionalstatus of adolescent girls living in southwest of Ethiopiardquo FoodScience and Human Wellness vol 34 pp 58ndash64 2014

[12] T Gebregyorgis T Tadesse and A Atenafu ldquoPrevalence ofthinness and stunting and associated factors among adoles-cent schoolgirls in Adwa Town North Ethiopiardquo Interna-tional Journal of Food Science vol 2016 Article ID 83239828 pages 2016

[13] Y Yemaneh A Girma W Nigussie et al ldquoUndernutritionand its associated factors among adolescent girls in the ruralcommunity of Aseko district Eastern Arsi Zone Oromiaregion Eastern Ethiopia 2017rdquo International Journal ofClinical Obstetrics and Gynaecology vol 1 no 2 pp 17ndash262017

[14] G Arage M Assefa and T Worku ldquoSocio-demographic andeconomic factors are associated with nutritional status ofadolescent school girls in Lay Guyint Woreda NorthwestEthiopiardquo SAGE Open Medicine vol 7 2019

[15] H Gebremariam S Omer and H Assefa ldquoAssessment ofnutritional status and associated factors among school going

adolescents of Mekelle City Northern Ethiopiardquo Interna-tional Journal of Nutrition and Food Sciences vol 4 no 1pp 118ndash124 2015

[16] Y A Melaku G A Zello T K Gill R J Adams and Z ShildquoPrevalence and factors associated with stunting and thinnessamong adolescent students in Northern Ethiopia a com-parison to World Health Organization standardsrdquo Archives ofPublic Health vol 4 no 1 2015

[17] FTEO Finoteselam Education Office 2017[18] S M Birru A Tariku and A K Belew ldquoImproved dietary di-

versity of school adolescent girls in the context of urbanNorthwestEthiopiardquo Italian Journal of Pediatrics vol 44 p 48 2018

[19] A Y Mohammed and T B Tefera ldquoNutritional status andassociated risk factors among adolescents girls in Agarfa HighSchool Bale Zone Oromia Region South East EthiopiardquoInternational Journal of Nutrition and Food Sciences vol 4no 4 pp 445ndash152 2015

[20] WHO AnthroPlus for Personal Computers Manual Softwarefor Assessing Growth of the Worldrsquos Children and AdolescentsWHO Geneva Switzerland 2009

[21] D W Hosmer and S Lemeshow Applied Logistic RegressionJohnWiley amp Sons Inc New York NY USA 2nd edition 2000

[22] Z Alebachew Prevalence of Childhood and AdolescentOverweight and Obesity Among Elementary School StudentsAddis Ababa University Addis Ababa Ethiopia 2010

[23] P Bovet N Kizirian G Madeleine M Blossner andA Chiolero ldquoPrevalence of thinness in children and ado-lescents in the Seychelles comparison of two internationalgrowth referencesrdquo Nutrition Journal vol 10 p 65 2011

[24] H Assefa T Belachew and L Negash ldquoSocioeconomicfactors associated with underweight and stunting amongadolescents of Jimma Zone South West Ethiopiardquo ISRNPublic Health vol 2013 Article ID 238546 7 pages 2013

[25] M Yetubie ldquoAnthropometric assessment of adolescentmalnutrition in elementary and secondary schools of ambordquo)esis Addis Ababa University Addis Ababa Ethiopia 2012

[26] C Dabone H F Delisle and O Receveur ldquoPoor nutritionalstatus of schoolchildren in urban and peri-urban areas of Oua-gadougou (Burkina Faso)rdquo Nutrition Journal vol 10 p 34 2011

[27] T Leenstra L T Petersen S K Kariuki A J OlooP A Kager and F O t Kuile ldquoPrevalence and severity ofmalnutrition and age at menarche cross-sectional studies inadolescent schoolgirls in western Kenyardquo European Journal ofClinical Nutrition vol 59 no 1 pp 41ndash48 2005

[28] H Aounallah-Skhiri H B Romdhane P Traissac et alldquoNutritional status of Tunisian adolescents associated genderenvironmental and socio-economic factorsrdquo Public HealthNutrition vol 11 no 12 pp 1306ndash1317 2008

[29] A Abiba A N K Grace and K C Kubreziga ldquoEffects ofdietary patterns on the nutritional status of upper primaryschool children in Tamale metropolisrdquo Pakistan Journal ofNutrition vol 11 no 7 pp 591ndash609 2012

[30] M M Wassie A A Gete M E Yesuf G D Alene A Belayand T Moges ldquoPredictors of nutritional status of Ethiopianadolescent girls a community based cross sectional studyrdquoBMC Nutrition vol 1 no 1 p 20 2015

[31] A Kassa Tekile A AbateWoya and GW Basha ldquoPrevalence ofmalnutrition and associated factors among under-five children inEthiopia evidence from the 2016 Ethiopia Demographic andHealth Surveyrdquo BMC Research Notes vol 12 no 1 2019

[32] R Kt A M and T Wakayo ldquoNutritional status and its as-sociated factors among school adolescent girls in Adama CityCentral Ethiopiardquo Journal of Nutrition amp Food Sciences vol 6no 3 p 493 2016

)e Scientific World Journal 9

Page 7: PrevalenceandAssociatedFactorsofThinnessamongAdolescent ...downloads.hindawi.com/journals/tswj/2020/9170301.pdf · Pretested structured questionnaireswere used to collect the data

Table 3 Bivariate and multivariable logistic regression of factors associated with thinness among adolescent school students Finote SelamTown Ethiopia 2018

Variables)inness

COR (95 CI) AOR (95 CI)Yes No

Age GroupEarly adolescent (10ndash13) 17 (362) 30 (638) 514 (239 1108)lowast 481 (123 1851)lowastMidadolescent (14ndash16) 24 (159) 127 (841) 190 (099 364) 168 (057 493)Late adolescent (17ndash19) 18 (90) 181 (910) 1 1SexFemale 4 (27) 144 (973) 1 1Male 55 (221) 194 (779) 268 (188 384) 213 (160 340)lowast

GradeGrade 5ndash6 23 (213) 85 (787) 257 (091 724) 177 (040 787)Grade 7ndash8 22 (167) 110 (833) 208 (074 586) 133 (022 819)Grade 9ndash10 10 (86) 106 (914) 101 (032 315) 106 (020 558)Grade 11ndash12 4 (98) 37 (902) 1 1ReligionMuslim 1 (45) 21 (955) 1 1Orthodox 58 (155) 317 (845) 382 (050 2918) 390 (019 8194)Place of residenceUrban 18 (92) 177 (908) 1 1Rural 41 (203) 161 (797) 244 (135 440)lowast 216 (096 487)Fatherrsquos educationIlliterate 15 (158) 80 (842) 279 (092 845) 406 (023 7176)Read and write 17 (168) 84 (832) 197 (071 543) 273 (031 24 29)Primary school (1ndash8) 10 (244) 31 (756) 196 (073 532) 236 (026 2141)Secondary school (9ndash12) 11 (120) 81 (880) 144 (051 410) 080 (05 1290)College and above 6 (88) 62 (912) 1 1Motherrsquos educationIlliterate 17 (167) 85 (833) 238 (077 739) 178 (086 365)Read and write 16 (147) 93 (853) 186 (068 507) 140 (083 234)Primary school (1ndash8) 9 (265) 25 (735) 150 (055 409) 129 (061 271)Secondary school (9ndash12) 11 (124) 78 (876) 133 (047 381) 115 (066 197)College and above 6 (95) 57 (905) 1 1Fatherrsquos occupationDaily laborer 8 (140) 49 (860) 120 (047 307) 11 (055 21)Farmer 26 (218) 93 (782) 227 (112 461)lowast 155 (045 529)Merchant 11 (129) 74 (871) 118 (050 275) 152 (055 426)Governmentnongovernment employee 14 (103) 122 (897) 1 1Motherrsquos occupationDaily laborer 1 (200) 4 (800) 186 (019 1855) 210 (011 3874)Farmer 21 (244) 65 (756) 274 (116 646)lowast 216 (062 751)Housewife 15 (126) 104 (874) 133 (055 323) 246 (058 1047)Merchant 13 (121) 94 (879) 124 (051 304) 152 (043 536)Governmentnongovernment employee 9 (112) 71 (888) 1 1Family sizelt5 17 (98) 156 (902) 1 1ge5 42 (188) 182 (812) 243 (132 445)lowast 190 (080 451)Family monthly incomelt1000 29 (377) 48 (623) 610 (309 1204)lowast 1154 (382 3489)lowast1000ndash2000 14 (131) 93 (869) 171 (080 364) 347 (115 1045)lowastgt2000 16 (75) 197 (925) 1 1Source of drinking waterWell water 39 (213) 144 (787) 453 (171 1198) 382 (146 10 04)lowastSpring water 13 (123) 93 (877) 337 (088 1289) 256 (087 756)Public tap water 2 (77) 24 (923) 188 (023 1549) 146 (026 809)Tap water 5 (61) 77 (939) 1 1Presence of functional latrineYes 38 (148) 219 (852) 1 1

)e Scientific World Journal 7

might be due to the fact that impure water is a vehicle forintestinal parasites which leads to loss of appetite leading topoor nutritional status this might also be due to repeatedinfection causing depressed immunity and making the se-verity and duration of disease more severe contributing topoor nutritional status of the adolescents

5 Conclusions

)e prevalence of thinness was high in the study areaConsistent with this result the mean Z-scores of BMI-for-age were higher in boys than girls Age sex family monthlyincome and sources of drinking water were significantlyassociated with thinness among the respondents Based onthe finding there should be collaboration among healthsectors and education sectors of the town to address schooladolescents under nutrition problems of the town

Abbreviations

AOR Adjusted odds ratioCM CentimeterCOR Crude odds ratioCSA Central statistics agencyCV Confidence intervalEDHS Ethiopian demography and health surveySD Standard deviationSPSS Statistical Package for Social SciencesUN United NationsWHO World Health Organization

Data Availability

All data in this study are included in the figures tables andstatements

Ethical Approval

)e study was approved by the University Ethical Com-mittee of Faculty of Chemical and Food Engineering BahirDar University (protocol no 122010) Supportive letterswere obtained from the Amhara Public Health Institutewhich wrote a letter to the West Gojjam Zone Health Officeand then the West Gojjam Zone Health Office wrote a letterto the Finote Selam Town Administration Health OfficeFinally Finote Selam Town Administration Health Officewrote a letter to target schools

Consent

Written informed consent was obtained from the adoles-centsrsquo parents or legal guardians after clearly explaining theresearch objectives

Conflicts of Interest

)e authors declare that they have no conflicts of interest

Authorsrsquo Contributions

Damitie Kebede Mengesha has designed the study and in-volved in data collection supervision and data processingDamitie Kebede Mengesha has cleaned and analyzed thedata as well as interpreted the results and drafted the

Table 3 Continued

Variables)inness

COR (95 CI) AOR (95 CI)Yes No

No 21 (150) 119 (855) 108 (049 238) 105 (059 187)Number of meals eaten per dayTwo times 19 (160) 100 (840) 117 (064 213) 101 (053 191))ree times and above 40 (144) 238 (856) 1 1Illness reported in the last one monthYes 19 (145) 112 (855) 106 (057 196) 103 (057 187)No 40 (150) 226 (850) 1 1Availability of home gardenYes 50 (174) 238 (826) 1 1No 9 (83) 100 (917) 160 (101 254) 115 (066 199)Eating vegetables at least once per dayYes 23 (126) 160 (874) 1 1No 36 (168) 178 (832) 135 (076 260) 130 (072 236)Eating fruits at least once per dayYes 26 (127) 178 (873) 1 1No 33 (171) 160 (829) 133 (076 231) 123 (069 218)Eating farm animal products at least once per weekYes 14 (122) 101 (878) 1 1No 45 (160) 237 (840) 120 (062 229) 119 (061 234)Nutrition and health informationYes 6 (128) 41 (872) 1 1No 53 (151) 297 (849) 115 (049 271) 108 (043 269)

8 )e Scientific World Journal

manuscript Reddy P C J Prasad and Degnet Teferi Asresparticipated in cleaning analyzing and interpreting thedata Damitie Kebede Mengesha Reddy P C J Prasad andDegnet Teferi Asres critically reviewed the manuscript Allauthors read and approved the final manuscript

Acknowledgments

)e authors are thankful to adolescent students schooldirectors health officers data collectors and supervisors ofthis study

References

[1] WHO Adolescent Nutrition a Neglected Dimension WHOGeneva Switzerland 2013

[2] C Namrata and C Archana ldquoA comparative study of nu-tritional intake in adolescentgirlsrdquo 2013

[3] M R Khan and F Ahmed ldquoPhysical Status nutrient intakeand dietary pattern of adolescent female factory workers inUrban Bangladeshrdquo Asia Pacific Journal of Clinical Nutritionvol 14 no 1 pp 19ndash26 2005

[4] S Sally ldquoCalifornia state 4-H center for youth developmentthe biology of adolescencerdquo 2013

[5] UNICEF Adolescence an Age of Opportunity the State of theWorldrsquos Children United Nations Press New York NY USA2011

[6] J E Brown and J Stang Nutrition through Life the CycleWadsworth Cengage Learning Belmont CA USA 4th edi-tion 2011

[7] M D Gupta R Engelman J Levy G Luchsinger T Merrickand J E Rosen 1e Power of 18 Million Adolescent Youthand the Transformation of the Future United Nations Pop-ulation Fund New york NY USA 2014

[8] M R Burt ldquoWhy should we invest in adolescentsrdquo in Pro-ceedongs of the Paper Prepared for the Conference on Com-prehensive Health of Adolescents and Youth in Latin Americaand the Caribbean Washington DC USA 2013

[9] CSA Centeral Statistics Agency of Ethiopia Addis Ababa2007

[10] K Teji Y Dessie T Assebe et al ldquoAnaemia and nutritionalstatus of adolescent girls in Babile district Eastern EthiopiardquoPan African Medical Journal vol 24 p 62 2016

[11] T Wolde W A D Mekonnin F Yitayin et al ldquoNutritionalstatus of adolescent girls living in southwest of Ethiopiardquo FoodScience and Human Wellness vol 34 pp 58ndash64 2014

[12] T Gebregyorgis T Tadesse and A Atenafu ldquoPrevalence ofthinness and stunting and associated factors among adoles-cent schoolgirls in Adwa Town North Ethiopiardquo Interna-tional Journal of Food Science vol 2016 Article ID 83239828 pages 2016

[13] Y Yemaneh A Girma W Nigussie et al ldquoUndernutritionand its associated factors among adolescent girls in the ruralcommunity of Aseko district Eastern Arsi Zone Oromiaregion Eastern Ethiopia 2017rdquo International Journal ofClinical Obstetrics and Gynaecology vol 1 no 2 pp 17ndash262017

[14] G Arage M Assefa and T Worku ldquoSocio-demographic andeconomic factors are associated with nutritional status ofadolescent school girls in Lay Guyint Woreda NorthwestEthiopiardquo SAGE Open Medicine vol 7 2019

[15] H Gebremariam S Omer and H Assefa ldquoAssessment ofnutritional status and associated factors among school going

adolescents of Mekelle City Northern Ethiopiardquo Interna-tional Journal of Nutrition and Food Sciences vol 4 no 1pp 118ndash124 2015

[16] Y A Melaku G A Zello T K Gill R J Adams and Z ShildquoPrevalence and factors associated with stunting and thinnessamong adolescent students in Northern Ethiopia a com-parison to World Health Organization standardsrdquo Archives ofPublic Health vol 4 no 1 2015

[17] FTEO Finoteselam Education Office 2017[18] S M Birru A Tariku and A K Belew ldquoImproved dietary di-

versity of school adolescent girls in the context of urbanNorthwestEthiopiardquo Italian Journal of Pediatrics vol 44 p 48 2018

[19] A Y Mohammed and T B Tefera ldquoNutritional status andassociated risk factors among adolescents girls in Agarfa HighSchool Bale Zone Oromia Region South East EthiopiardquoInternational Journal of Nutrition and Food Sciences vol 4no 4 pp 445ndash152 2015

[20] WHO AnthroPlus for Personal Computers Manual Softwarefor Assessing Growth of the Worldrsquos Children and AdolescentsWHO Geneva Switzerland 2009

[21] D W Hosmer and S Lemeshow Applied Logistic RegressionJohnWiley amp Sons Inc New York NY USA 2nd edition 2000

[22] Z Alebachew Prevalence of Childhood and AdolescentOverweight and Obesity Among Elementary School StudentsAddis Ababa University Addis Ababa Ethiopia 2010

[23] P Bovet N Kizirian G Madeleine M Blossner andA Chiolero ldquoPrevalence of thinness in children and ado-lescents in the Seychelles comparison of two internationalgrowth referencesrdquo Nutrition Journal vol 10 p 65 2011

[24] H Assefa T Belachew and L Negash ldquoSocioeconomicfactors associated with underweight and stunting amongadolescents of Jimma Zone South West Ethiopiardquo ISRNPublic Health vol 2013 Article ID 238546 7 pages 2013

[25] M Yetubie ldquoAnthropometric assessment of adolescentmalnutrition in elementary and secondary schools of ambordquo)esis Addis Ababa University Addis Ababa Ethiopia 2012

[26] C Dabone H F Delisle and O Receveur ldquoPoor nutritionalstatus of schoolchildren in urban and peri-urban areas of Oua-gadougou (Burkina Faso)rdquo Nutrition Journal vol 10 p 34 2011

[27] T Leenstra L T Petersen S K Kariuki A J OlooP A Kager and F O t Kuile ldquoPrevalence and severity ofmalnutrition and age at menarche cross-sectional studies inadolescent schoolgirls in western Kenyardquo European Journal ofClinical Nutrition vol 59 no 1 pp 41ndash48 2005

[28] H Aounallah-Skhiri H B Romdhane P Traissac et alldquoNutritional status of Tunisian adolescents associated genderenvironmental and socio-economic factorsrdquo Public HealthNutrition vol 11 no 12 pp 1306ndash1317 2008

[29] A Abiba A N K Grace and K C Kubreziga ldquoEffects ofdietary patterns on the nutritional status of upper primaryschool children in Tamale metropolisrdquo Pakistan Journal ofNutrition vol 11 no 7 pp 591ndash609 2012

[30] M M Wassie A A Gete M E Yesuf G D Alene A Belayand T Moges ldquoPredictors of nutritional status of Ethiopianadolescent girls a community based cross sectional studyrdquoBMC Nutrition vol 1 no 1 p 20 2015

[31] A Kassa Tekile A AbateWoya and GW Basha ldquoPrevalence ofmalnutrition and associated factors among under-five children inEthiopia evidence from the 2016 Ethiopia Demographic andHealth Surveyrdquo BMC Research Notes vol 12 no 1 2019

[32] R Kt A M and T Wakayo ldquoNutritional status and its as-sociated factors among school adolescent girls in Adama CityCentral Ethiopiardquo Journal of Nutrition amp Food Sciences vol 6no 3 p 493 2016

)e Scientific World Journal 9

Page 8: PrevalenceandAssociatedFactorsofThinnessamongAdolescent ...downloads.hindawi.com/journals/tswj/2020/9170301.pdf · Pretested structured questionnaireswere used to collect the data

might be due to the fact that impure water is a vehicle forintestinal parasites which leads to loss of appetite leading topoor nutritional status this might also be due to repeatedinfection causing depressed immunity and making the se-verity and duration of disease more severe contributing topoor nutritional status of the adolescents

5 Conclusions

)e prevalence of thinness was high in the study areaConsistent with this result the mean Z-scores of BMI-for-age were higher in boys than girls Age sex family monthlyincome and sources of drinking water were significantlyassociated with thinness among the respondents Based onthe finding there should be collaboration among healthsectors and education sectors of the town to address schooladolescents under nutrition problems of the town

Abbreviations

AOR Adjusted odds ratioCM CentimeterCOR Crude odds ratioCSA Central statistics agencyCV Confidence intervalEDHS Ethiopian demography and health surveySD Standard deviationSPSS Statistical Package for Social SciencesUN United NationsWHO World Health Organization

Data Availability

All data in this study are included in the figures tables andstatements

Ethical Approval

)e study was approved by the University Ethical Com-mittee of Faculty of Chemical and Food Engineering BahirDar University (protocol no 122010) Supportive letterswere obtained from the Amhara Public Health Institutewhich wrote a letter to the West Gojjam Zone Health Officeand then the West Gojjam Zone Health Office wrote a letterto the Finote Selam Town Administration Health OfficeFinally Finote Selam Town Administration Health Officewrote a letter to target schools

Consent

Written informed consent was obtained from the adoles-centsrsquo parents or legal guardians after clearly explaining theresearch objectives

Conflicts of Interest

)e authors declare that they have no conflicts of interest

Authorsrsquo Contributions

Damitie Kebede Mengesha has designed the study and in-volved in data collection supervision and data processingDamitie Kebede Mengesha has cleaned and analyzed thedata as well as interpreted the results and drafted the

Table 3 Continued

Variables)inness

COR (95 CI) AOR (95 CI)Yes No

No 21 (150) 119 (855) 108 (049 238) 105 (059 187)Number of meals eaten per dayTwo times 19 (160) 100 (840) 117 (064 213) 101 (053 191))ree times and above 40 (144) 238 (856) 1 1Illness reported in the last one monthYes 19 (145) 112 (855) 106 (057 196) 103 (057 187)No 40 (150) 226 (850) 1 1Availability of home gardenYes 50 (174) 238 (826) 1 1No 9 (83) 100 (917) 160 (101 254) 115 (066 199)Eating vegetables at least once per dayYes 23 (126) 160 (874) 1 1No 36 (168) 178 (832) 135 (076 260) 130 (072 236)Eating fruits at least once per dayYes 26 (127) 178 (873) 1 1No 33 (171) 160 (829) 133 (076 231) 123 (069 218)Eating farm animal products at least once per weekYes 14 (122) 101 (878) 1 1No 45 (160) 237 (840) 120 (062 229) 119 (061 234)Nutrition and health informationYes 6 (128) 41 (872) 1 1No 53 (151) 297 (849) 115 (049 271) 108 (043 269)

8 )e Scientific World Journal

manuscript Reddy P C J Prasad and Degnet Teferi Asresparticipated in cleaning analyzing and interpreting thedata Damitie Kebede Mengesha Reddy P C J Prasad andDegnet Teferi Asres critically reviewed the manuscript Allauthors read and approved the final manuscript

Acknowledgments

)e authors are thankful to adolescent students schooldirectors health officers data collectors and supervisors ofthis study

References

[1] WHO Adolescent Nutrition a Neglected Dimension WHOGeneva Switzerland 2013

[2] C Namrata and C Archana ldquoA comparative study of nu-tritional intake in adolescentgirlsrdquo 2013

[3] M R Khan and F Ahmed ldquoPhysical Status nutrient intakeand dietary pattern of adolescent female factory workers inUrban Bangladeshrdquo Asia Pacific Journal of Clinical Nutritionvol 14 no 1 pp 19ndash26 2005

[4] S Sally ldquoCalifornia state 4-H center for youth developmentthe biology of adolescencerdquo 2013

[5] UNICEF Adolescence an Age of Opportunity the State of theWorldrsquos Children United Nations Press New York NY USA2011

[6] J E Brown and J Stang Nutrition through Life the CycleWadsworth Cengage Learning Belmont CA USA 4th edi-tion 2011

[7] M D Gupta R Engelman J Levy G Luchsinger T Merrickand J E Rosen 1e Power of 18 Million Adolescent Youthand the Transformation of the Future United Nations Pop-ulation Fund New york NY USA 2014

[8] M R Burt ldquoWhy should we invest in adolescentsrdquo in Pro-ceedongs of the Paper Prepared for the Conference on Com-prehensive Health of Adolescents and Youth in Latin Americaand the Caribbean Washington DC USA 2013

[9] CSA Centeral Statistics Agency of Ethiopia Addis Ababa2007

[10] K Teji Y Dessie T Assebe et al ldquoAnaemia and nutritionalstatus of adolescent girls in Babile district Eastern EthiopiardquoPan African Medical Journal vol 24 p 62 2016

[11] T Wolde W A D Mekonnin F Yitayin et al ldquoNutritionalstatus of adolescent girls living in southwest of Ethiopiardquo FoodScience and Human Wellness vol 34 pp 58ndash64 2014

[12] T Gebregyorgis T Tadesse and A Atenafu ldquoPrevalence ofthinness and stunting and associated factors among adoles-cent schoolgirls in Adwa Town North Ethiopiardquo Interna-tional Journal of Food Science vol 2016 Article ID 83239828 pages 2016

[13] Y Yemaneh A Girma W Nigussie et al ldquoUndernutritionand its associated factors among adolescent girls in the ruralcommunity of Aseko district Eastern Arsi Zone Oromiaregion Eastern Ethiopia 2017rdquo International Journal ofClinical Obstetrics and Gynaecology vol 1 no 2 pp 17ndash262017

[14] G Arage M Assefa and T Worku ldquoSocio-demographic andeconomic factors are associated with nutritional status ofadolescent school girls in Lay Guyint Woreda NorthwestEthiopiardquo SAGE Open Medicine vol 7 2019

[15] H Gebremariam S Omer and H Assefa ldquoAssessment ofnutritional status and associated factors among school going

adolescents of Mekelle City Northern Ethiopiardquo Interna-tional Journal of Nutrition and Food Sciences vol 4 no 1pp 118ndash124 2015

[16] Y A Melaku G A Zello T K Gill R J Adams and Z ShildquoPrevalence and factors associated with stunting and thinnessamong adolescent students in Northern Ethiopia a com-parison to World Health Organization standardsrdquo Archives ofPublic Health vol 4 no 1 2015

[17] FTEO Finoteselam Education Office 2017[18] S M Birru A Tariku and A K Belew ldquoImproved dietary di-

versity of school adolescent girls in the context of urbanNorthwestEthiopiardquo Italian Journal of Pediatrics vol 44 p 48 2018

[19] A Y Mohammed and T B Tefera ldquoNutritional status andassociated risk factors among adolescents girls in Agarfa HighSchool Bale Zone Oromia Region South East EthiopiardquoInternational Journal of Nutrition and Food Sciences vol 4no 4 pp 445ndash152 2015

[20] WHO AnthroPlus for Personal Computers Manual Softwarefor Assessing Growth of the Worldrsquos Children and AdolescentsWHO Geneva Switzerland 2009

[21] D W Hosmer and S Lemeshow Applied Logistic RegressionJohnWiley amp Sons Inc New York NY USA 2nd edition 2000

[22] Z Alebachew Prevalence of Childhood and AdolescentOverweight and Obesity Among Elementary School StudentsAddis Ababa University Addis Ababa Ethiopia 2010

[23] P Bovet N Kizirian G Madeleine M Blossner andA Chiolero ldquoPrevalence of thinness in children and ado-lescents in the Seychelles comparison of two internationalgrowth referencesrdquo Nutrition Journal vol 10 p 65 2011

[24] H Assefa T Belachew and L Negash ldquoSocioeconomicfactors associated with underweight and stunting amongadolescents of Jimma Zone South West Ethiopiardquo ISRNPublic Health vol 2013 Article ID 238546 7 pages 2013

[25] M Yetubie ldquoAnthropometric assessment of adolescentmalnutrition in elementary and secondary schools of ambordquo)esis Addis Ababa University Addis Ababa Ethiopia 2012

[26] C Dabone H F Delisle and O Receveur ldquoPoor nutritionalstatus of schoolchildren in urban and peri-urban areas of Oua-gadougou (Burkina Faso)rdquo Nutrition Journal vol 10 p 34 2011

[27] T Leenstra L T Petersen S K Kariuki A J OlooP A Kager and F O t Kuile ldquoPrevalence and severity ofmalnutrition and age at menarche cross-sectional studies inadolescent schoolgirls in western Kenyardquo European Journal ofClinical Nutrition vol 59 no 1 pp 41ndash48 2005

[28] H Aounallah-Skhiri H B Romdhane P Traissac et alldquoNutritional status of Tunisian adolescents associated genderenvironmental and socio-economic factorsrdquo Public HealthNutrition vol 11 no 12 pp 1306ndash1317 2008

[29] A Abiba A N K Grace and K C Kubreziga ldquoEffects ofdietary patterns on the nutritional status of upper primaryschool children in Tamale metropolisrdquo Pakistan Journal ofNutrition vol 11 no 7 pp 591ndash609 2012

[30] M M Wassie A A Gete M E Yesuf G D Alene A Belayand T Moges ldquoPredictors of nutritional status of Ethiopianadolescent girls a community based cross sectional studyrdquoBMC Nutrition vol 1 no 1 p 20 2015

[31] A Kassa Tekile A AbateWoya and GW Basha ldquoPrevalence ofmalnutrition and associated factors among under-five children inEthiopia evidence from the 2016 Ethiopia Demographic andHealth Surveyrdquo BMC Research Notes vol 12 no 1 2019

[32] R Kt A M and T Wakayo ldquoNutritional status and its as-sociated factors among school adolescent girls in Adama CityCentral Ethiopiardquo Journal of Nutrition amp Food Sciences vol 6no 3 p 493 2016

)e Scientific World Journal 9

Page 9: PrevalenceandAssociatedFactorsofThinnessamongAdolescent ...downloads.hindawi.com/journals/tswj/2020/9170301.pdf · Pretested structured questionnaireswere used to collect the data

manuscript Reddy P C J Prasad and Degnet Teferi Asresparticipated in cleaning analyzing and interpreting thedata Damitie Kebede Mengesha Reddy P C J Prasad andDegnet Teferi Asres critically reviewed the manuscript Allauthors read and approved the final manuscript

Acknowledgments

)e authors are thankful to adolescent students schooldirectors health officers data collectors and supervisors ofthis study

References

[1] WHO Adolescent Nutrition a Neglected Dimension WHOGeneva Switzerland 2013

[2] C Namrata and C Archana ldquoA comparative study of nu-tritional intake in adolescentgirlsrdquo 2013

[3] M R Khan and F Ahmed ldquoPhysical Status nutrient intakeand dietary pattern of adolescent female factory workers inUrban Bangladeshrdquo Asia Pacific Journal of Clinical Nutritionvol 14 no 1 pp 19ndash26 2005

[4] S Sally ldquoCalifornia state 4-H center for youth developmentthe biology of adolescencerdquo 2013

[5] UNICEF Adolescence an Age of Opportunity the State of theWorldrsquos Children United Nations Press New York NY USA2011

[6] J E Brown and J Stang Nutrition through Life the CycleWadsworth Cengage Learning Belmont CA USA 4th edi-tion 2011

[7] M D Gupta R Engelman J Levy G Luchsinger T Merrickand J E Rosen 1e Power of 18 Million Adolescent Youthand the Transformation of the Future United Nations Pop-ulation Fund New york NY USA 2014

[8] M R Burt ldquoWhy should we invest in adolescentsrdquo in Pro-ceedongs of the Paper Prepared for the Conference on Com-prehensive Health of Adolescents and Youth in Latin Americaand the Caribbean Washington DC USA 2013

[9] CSA Centeral Statistics Agency of Ethiopia Addis Ababa2007

[10] K Teji Y Dessie T Assebe et al ldquoAnaemia and nutritionalstatus of adolescent girls in Babile district Eastern EthiopiardquoPan African Medical Journal vol 24 p 62 2016

[11] T Wolde W A D Mekonnin F Yitayin et al ldquoNutritionalstatus of adolescent girls living in southwest of Ethiopiardquo FoodScience and Human Wellness vol 34 pp 58ndash64 2014

[12] T Gebregyorgis T Tadesse and A Atenafu ldquoPrevalence ofthinness and stunting and associated factors among adoles-cent schoolgirls in Adwa Town North Ethiopiardquo Interna-tional Journal of Food Science vol 2016 Article ID 83239828 pages 2016

[13] Y Yemaneh A Girma W Nigussie et al ldquoUndernutritionand its associated factors among adolescent girls in the ruralcommunity of Aseko district Eastern Arsi Zone Oromiaregion Eastern Ethiopia 2017rdquo International Journal ofClinical Obstetrics and Gynaecology vol 1 no 2 pp 17ndash262017

[14] G Arage M Assefa and T Worku ldquoSocio-demographic andeconomic factors are associated with nutritional status ofadolescent school girls in Lay Guyint Woreda NorthwestEthiopiardquo SAGE Open Medicine vol 7 2019

[15] H Gebremariam S Omer and H Assefa ldquoAssessment ofnutritional status and associated factors among school going

adolescents of Mekelle City Northern Ethiopiardquo Interna-tional Journal of Nutrition and Food Sciences vol 4 no 1pp 118ndash124 2015

[16] Y A Melaku G A Zello T K Gill R J Adams and Z ShildquoPrevalence and factors associated with stunting and thinnessamong adolescent students in Northern Ethiopia a com-parison to World Health Organization standardsrdquo Archives ofPublic Health vol 4 no 1 2015

[17] FTEO Finoteselam Education Office 2017[18] S M Birru A Tariku and A K Belew ldquoImproved dietary di-

versity of school adolescent girls in the context of urbanNorthwestEthiopiardquo Italian Journal of Pediatrics vol 44 p 48 2018

[19] A Y Mohammed and T B Tefera ldquoNutritional status andassociated risk factors among adolescents girls in Agarfa HighSchool Bale Zone Oromia Region South East EthiopiardquoInternational Journal of Nutrition and Food Sciences vol 4no 4 pp 445ndash152 2015

[20] WHO AnthroPlus for Personal Computers Manual Softwarefor Assessing Growth of the Worldrsquos Children and AdolescentsWHO Geneva Switzerland 2009

[21] D W Hosmer and S Lemeshow Applied Logistic RegressionJohnWiley amp Sons Inc New York NY USA 2nd edition 2000

[22] Z Alebachew Prevalence of Childhood and AdolescentOverweight and Obesity Among Elementary School StudentsAddis Ababa University Addis Ababa Ethiopia 2010

[23] P Bovet N Kizirian G Madeleine M Blossner andA Chiolero ldquoPrevalence of thinness in children and ado-lescents in the Seychelles comparison of two internationalgrowth referencesrdquo Nutrition Journal vol 10 p 65 2011

[24] H Assefa T Belachew and L Negash ldquoSocioeconomicfactors associated with underweight and stunting amongadolescents of Jimma Zone South West Ethiopiardquo ISRNPublic Health vol 2013 Article ID 238546 7 pages 2013

[25] M Yetubie ldquoAnthropometric assessment of adolescentmalnutrition in elementary and secondary schools of ambordquo)esis Addis Ababa University Addis Ababa Ethiopia 2012

[26] C Dabone H F Delisle and O Receveur ldquoPoor nutritionalstatus of schoolchildren in urban and peri-urban areas of Oua-gadougou (Burkina Faso)rdquo Nutrition Journal vol 10 p 34 2011

[27] T Leenstra L T Petersen S K Kariuki A J OlooP A Kager and F O t Kuile ldquoPrevalence and severity ofmalnutrition and age at menarche cross-sectional studies inadolescent schoolgirls in western Kenyardquo European Journal ofClinical Nutrition vol 59 no 1 pp 41ndash48 2005

[28] H Aounallah-Skhiri H B Romdhane P Traissac et alldquoNutritional status of Tunisian adolescents associated genderenvironmental and socio-economic factorsrdquo Public HealthNutrition vol 11 no 12 pp 1306ndash1317 2008

[29] A Abiba A N K Grace and K C Kubreziga ldquoEffects ofdietary patterns on the nutritional status of upper primaryschool children in Tamale metropolisrdquo Pakistan Journal ofNutrition vol 11 no 7 pp 591ndash609 2012

[30] M M Wassie A A Gete M E Yesuf G D Alene A Belayand T Moges ldquoPredictors of nutritional status of Ethiopianadolescent girls a community based cross sectional studyrdquoBMC Nutrition vol 1 no 1 p 20 2015

[31] A Kassa Tekile A AbateWoya and GW Basha ldquoPrevalence ofmalnutrition and associated factors among under-five children inEthiopia evidence from the 2016 Ethiopia Demographic andHealth Surveyrdquo BMC Research Notes vol 12 no 1 2019

[32] R Kt A M and T Wakayo ldquoNutritional status and its as-sociated factors among school adolescent girls in Adama CityCentral Ethiopiardquo Journal of Nutrition amp Food Sciences vol 6no 3 p 493 2016

)e Scientific World Journal 9