Minas Selamu, Ayele Behailu Hawulte, Sisay Mekonnen, Fage Sagni Girma
West Hararghe Zonal Health Department, Chiro, Ethiopia.
School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.
SAGE Open Med. 2022 May 24;10:20503121221100143. doi: 10.1177/20503121221100143. eCollection 2022.
This study aims to assess the prevalence of undernutrition and factors associated with it among khat-chewer and non-chewer lactating women at Chiro district, west Hararghe zone, eastern Ethiopia.
A community-based comparative cross-sectional study was conducted among 446 (223 khat chewers and 223 non-chewers) randomly selected lactating women who have children aged 6 and 23 months. Data were collected through face-to-face interviews using structured questionnaires followed by weight and height measurements to calculate and categorize nutritional status based on body mass index (kg/m). Data were entered into EpiData version 3.1 and analyzed using STATA version 14.2. A binary logistic regression model was fitted to check the association between independent variables and undernutrition. The level of statistical significance was declared at a p-value less than 0.05.
The overall prevalence of undernutrition among lactating women was 30.7% (95% confidence interval = 26.6, 35.2). Undernutrition was significantly higher among khat chewers, 39.0% (95% confidence interval = 32.8, 45.6) than non-chewers, 22.4% (95% confidence interval = 17.4, 28.4), (χ (degree of freedom) = 14.4231, p < 0.0001). Chewing daily (adjusted odds ratio = 3.14, 95% confidence interval = 1.08, 9.15), reducing number of meals after chewing (adjusted odds ratio = 3.45, 95% confidence interval = 1.29, 9.20), and unavailability of latrine (adjusted odds ratio = 2.98, 95% confidence interval = 1.02, 8.75) were significantly associated with undernutrition among khat-chewer lactating women. Furthermore, age at first pregnancy (<18 years) (adjusted odds ratio = 3.17, 95% confidence interval = 1.17, 8.60), not taking any additional meals (adjusted odds ratio = 3.41, 95% confidence interval = 1.08, 10.7), and hand washing after toilet use (adjusted odds ratio = 6.10, 95% confidence interval = 2.51, 14.8) were significantly associated with undernutrition among non-chewer lactating women.
The overall prevalence of undernutrition is higher than previous studies and is alarming among khat-chewer lactating mothers. Thus, nutritional and public health interventions should target khat-chewer lactating mothers particularly focusing on daily chewer either to improve their dietary practice during and after chewing or to stop khat chewing if possible, in order to reduce the effect of khat on food absorption. Besides, improving latrine coverage and use, and prevention of early pregnancy are of paramount importance in reducing undernutrition among lactating mothers.
本研究旨在评估埃塞俄比亚东部哈拉尔格西区奇罗县嚼恰特草和不嚼恰特草的哺乳期妇女中营养不良的患病率及其相关因素。
对446名（223名嚼恰特草者和223名不嚼恰特草者）随机选取的、孩子年龄在6至23个月的哺乳期妇女进行了一项基于社区的比较横断面研究。通过使用结构化问卷进行面对面访谈收集数据，随后测量体重和身高，以根据体重指数（kg/m）计算并分类营养状况。数据录入EpiData 3.1版本，并使用STATA 14.2版本进行分析。采用二元逻辑回归模型来检验自变量与营养不良之间的关联。统计学显著性水平设定为p值小于0.05。
哺乳期妇女中营养不良的总体患病率为30.7%（95%置信区间 = 26.6, 35.2）。嚼恰特草者中的营养不良率显著高于不嚼恰特草者，分别为39.0%（95%置信区间 = 32.8, 45.6）和22.4%（95%置信区间 = 17.4, 28.4），（χ（自由度）= 14.4231，p < 0.0001）。每日嚼恰特草（调整后的优势比 = 3.14，95%置信区间 = 1.08, 9.15）、嚼恰特草后减少进餐次数（调整后的优势比 = 3.45，95%置信区间 = 1.29, 9.20）以及没有厕所（调整后的优势比 = 2.98，95%置信区间 = 1.02, 8.75）与嚼恰特草的哺乳期妇女的营养不良显著相关。此外，初孕年龄（<18岁）（调整后的优势比 = 3.17，95%置信区间 = 1.17, 8.60）、不额外进餐（调整后的优势比 = 3.41，95%置信区间 = 1.08, 10.7）以及便后洗手（调整后的优势比 = 6.10，95%置信区间 = 2.51, 14.8）与不嚼恰特草的哺乳期妇女的营养不良显著相关。
营养不良的总体患病率高于先前的研究，且在嚼恰特草的哺乳期母亲中令人担忧。因此，营养和公共卫生干预应针对嚼恰特草的哺乳期母亲，尤其关注每日嚼草者，要么改善她们嚼草期间及之后的饮食习惯，要么尽可能停止嚼恰特草，以减少恰特草对食物吸收的影响。此外，提高厕所覆盖率和使用率以及预防早孕对于降低哺乳期母亲的营养不良至关重要。
