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      Timely initiation of complementary feeding practices and associated factors among children aged 6–23 months in Dessie Zuria District, Northeast Ethiopia: a community-based cross-sectional study

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          Abstract

          Introduction

          Ethiopia has one of the highest infant and child mortality rates in the world. Starting from the age of 6 months, breast milk alone is not sufficient to cover all nutritional requirements. Infants and young children are at an increased risk of undernutrition. Complementary feeding must, therefore, begin at the age of 6 months. Infant and young child nutrition is a critical factor in human health, nutrition, survival, growth, and development. Therefore, the aim of this study is to evaluate the timely initiation of complementary feeding practices and associated factors in children aged 6–23 months in the Dessie Zuria District of North Ethiopia.

          Methods

          A community-based cross-sectional study design was used for the period between 16 March and 30 March 2019. The study included 770 mother–child pairs aged 6–23 months. A multistage sampling method was used to choose the study participants. Using a simple random sampling technique, nine kebeles in the district were selected from a total of 31, and from 103 Gotts or villages, 31 were selected with 770 HHs out of 2,329 HHs with children aged 6–23 months. Data were collected using a pretested semistructured interviewer-administered questionnaire, which was then entered into Epi Data version 3.1 statistical software before being transferred to SPSS version 21 for further analysis. To summarize the data, descriptive statistics were used, which included a simple frequency table and figures. To evaluate factors, bivariate and multivariable logistic regression were used. A p-value of less than 0.05 was used to determine statistical significance.

          Results

          The percentage of children who started complementary feeding practices on time was 70.9. Maternal occupation [AOR = 5.51, 95% CI (1.61–18.81)], radio availability [AOR = 2.03, 95% CI (1.32–3.12)], antenatal care follow-up [AOR = 6.19, 95% CI (4.08–9.40)], place of delivery [AOR = 5.06%, CI (3.34–7.68)], and postnatal care follow-up [AOR = 4.32, 95% CI (2.77–6.72)] were found to be the factors for the timely initiation of complementary feeding.

          Conclusion

          When compared with WHO cutoff points, timely initiation of complementary feeding practice was relatively low in the study area. Maternal occupation, radio availability, ANC follow-up, place of delivery, and postnatal care visit were all significantly associated with the timely initiation of complementary feeding.

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          Most cited references28

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          The Human Microbiome and Child Growth – First 1000 Days and Beyond

          The assembly of microbial communities within the gastrointestinal tract during early life plays a critical role in immune, endocrine, metabolic, and other host developmental pathways. Environmental insults during this period, such as food insecurity and infections, can disrupt this optimal microbial succession, which may contribute to lifelong and intergenerational deficits in growth and development. Here, we review the human microbiome in the first 1000 days - referring to the period from conception to 2 years of age - and using a developmental model, we examine the role of early microbial succession in growth and development. We propose that an 'undernourished' microbiome is intergenerational, thereby perpetuating growth impairments into successive generations. We also identify and discuss the intertwining host-microbe-environment interactions occurring prenatally and during early infancy, which may impair the trajectories of healthy growth and development, and explore their potential as novel microbial targets for intervention.
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            Biological control agent Rhizobium (= Agrobacterium ) vitis strain ARK-1 suppresses expression of the essential and non-essential vir genes of tumorigenic R. vitis

            Objective To gain insights into the virulence suppressive mechanism of a nonpathogenic strain of Rhizobium vitis ARK-1, we co-inoculated ARK-1 with a tumorigenic (Ti) strain of R. vitis to examine the expression of two essential virulence genes (virA and virG) and one non-essential gene (virD3) of the Ti strain at the wound site of grapevine. Results Co-inoculation of ARK-1 with a Ti strain VAT03-9 at a 1:1 cell ratio into grapevine shoots resulted in significantly lower expression of the virulence genes virA, virD3, and virG of VAT03-9 at 1 day after inoculation compared with those when shoots were inoculated only with VAT03-9. ARK-1 was not able to catabolize acetosyringone, which is the plant-derived metabolites inducing the entire vir regulon in Ti strains, suggesting the direct effect of ARK-1 on the induction of broad range of vir genes of R. vitis Ti strains. Electronic supplementary material The online version of this article (10.1186/s13104-018-4038-6) contains supplementary material, which is available to authorized users.
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              Contextualising complementary feeding in a broader framework for stunting prevention.

              An estimated 165 million children are stunted due to the combined effects of poor nutrition, repeated infection and inadequate psychosocial stimulation. The complementary feeding period, generally corresponding to age 6-24 months, represents an important period of sensitivity to stunting with lifelong, possibly irrevocable consequences. Interventions to improve complementary feeding practices or the nutritional quality of complementary foods must take into consideration the contextual as well as proximal determinants of stunting. This review presents a conceptual framework that highlights the role of complementary feeding within the layers of contextual and causal factors that lead to stunted growth and development and the resulting short- and long-term consequences. Contextual factors are organized into the following groups: political economy; health and health care systems; education; society and culture; agriculture and food systems; and water, sanitation and environment. We argue that these community and societal conditions underlie infant and young child feeding practices, which are a central pillar to healthy growth and development, and can serve to either impede or enable progress. Effectiveness studies with a strong process evaluation component are needed to identify transdisciplinary solutions. Programme and policy interventions aimed at preventing stunting should be informed by careful assessment of these factors at all levels. © 2013 John Wiley & Sons Ltd.
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                Author and article information

                Contributors
                Journal
                Front Pediatr
                Front Pediatr
                Front. Pediatr.
                Frontiers in Pediatrics
                Frontiers Media S.A.
                2296-2360
                06 June 2023
                2023
                : 11
                : 1062251
                Affiliations
                [ 1 ]Amhara Public Health Institute (APHI) , Health Research Development Directorate, Dessie, Ethiopia
                [ 2 ]Amhara Public Health Institute (APHI), Health Research Development Directorate , Bahir Dar, Ethiopia
                Author notes

                Edited by: Chandan Kumar, TERI School of Advanced Studies (TERI SAS), India

                Reviewed by: Suman Chakrabarty, West Bengal State University, India Marta Cristina Sanabria, National University of Asunción, Paraguay

                [* ] Correspondence: Anteneh Demelash Abate naniante7765@ 123456yahoo.com

                Abbreviations ANC, antenatal care; CF, complementary feeding; EBF, exclusive breastfeeding; EDHS, Ethiopian demography health survey; IEC, information, education, and communication, IYCF, infant and young child feeding; OR, odds ratio; PI, principal investigator; PNC, postnatal care; UNICEF, United Nation Children's Fund; WHO, World Health Organization; TICF, time of initiating complementary feeding.

                Article
                10.3389/fped.2023.1062251
                10280072
                37346895
                826371e7-f6a5-4b36-8f57-da8d423958fd
                © 2023 Abate, Hassen and Temesgen.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 01 November 2022
                : 16 May 2023
                Page count
                Figures: 4, Tables: 6, Equations: 0, References: 36, Pages: 0, Words: 0
                Funding
                Funded by: APHI
                Funding was not received from any organization, but the APHI covered all data enumeration costs.
                Categories
                Pediatrics
                Original Research
                Custom metadata
                Children and Health

                complementary feeding,dessie zuria,amhara region,ethiopia,timely initiation

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