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Prodromal psychotic symptoms and its associated factors Among students attending high schools in jimma city, Ethiopia 2025
No full textBackground: A prodrome is an early stage of psychosis that indicates a person's condition
before full-blown symptoms appear. Detection of prodrome helps on integrating predictive
indicators of early warning signs into clinical practice to prevent and mitigate the burden
associated with full-blown psychotic disorders. Compared to adulthood, adolescence is a
vulnerable period for developing psychosis and experiencing psychosis-like symptoms, because
it is marked by physical, emotional and social changes. Over the past two decades, extensive
study has been conducted into the early detection of prodrome but most research has been
conducted in high-income countries with dearth of literature in sub-Saharan Africa like Ethiopia.
Objective: The aim of this study was to assess the prevalence of prodromal psychotic symptoms
and its associated factors among students attending high schools in Jimma city, Ethiopia 2025.
Method: An institution based cross-sectional study was conducted on total of 603 high school
students in Jimma city from January to February, 2025. Multistage sampling was used to select
students. Data was collected by interviewer administered questionnaire using kobo tool box and
was exported to SPSS for analysis. Bivariate and multivariable logistic regression were carried
out to identify factors associated with prodromal psychotic symptoms. The Adjusted Odds Ratio
(AOR) with 95% CI and p-value < 0.05 were used to determine statistical significance.
Result: The prevalence of prodromal psychotic symptoms is 20.4 (95% CI=17.4-23.9) and being
female was associated with more than double the odds (AOR=2.38) of experiencing prodromal
psychosis compared to being male. Similarly, students with depression had nearly three times the
odds (AOR=2.87) of experiencing prodromal psychosis compared to students without
depression. The strongest association was observed for students with a family history of mental
illness, who had over three-and-a-half times the odds (AOR=3.63) of prodromal psychosis
compared to those without a family history of mental illness. Additionally, exposure to major life
events increased the odds of prodromal psychosis by approximately 3.4-fold.
Conclusion: This study reveals a prevalence of prodromal psychotic symptoms of 1 in 5 among
high school students and identifies four significant risk factors: family history of mental illness,
exposure to major life events, depression, and female sex
Political Economy of Agricultural Growth in East Africa: Institutional Quality and Distortion of Agricultural Incentives
No full textAgriculture is the main source of livelihoods for a substantial section of the impoverished in East
Africa. In this region, many agricultural products lack adequate support and protection.
Consequently, although policy reforms are imperative, understanding the prior political
economy of agricultural growth is vital for effective future agricultural policy design that
enhances agricultural incomes. This study examines the political economy of agricultural growth
in East Africa. Specifically, it investigates the effect of institutional quality on agricultural value
added, the effect of distortion of agricultural incentives on agricultural value-added, the
determinants of the distortion of agricultural incentives, and its welfare effects comparatively.
The employed data covers seven East African countries and spans from 1981 to 2020. The
datasets were obtained from the World Bank, International Food Policy Research Institute, Food
and Agriculture Organization, Mo Ibrahim Foundation, United Nations University World
Institute for Development Economics Research, and Centre for Systematic Peace data bases.
Both descriptive statistics and econometric models were used for data analyses. The bias
corrected least squares dummy variable model was used to analyze the first two specific
objectives, while a Prais-Winsten linear regression model with a panel-corrected standard error
procedure and the generalized least squares model were used to analyze the third and fourth
specific objectives, respectively.
The results show that the variable voice and accountability has a significant negative effect on
agricultural value-added, while government effectiveness has a significant positive effect.
Agricultural incentives had significantly increased agricultural value-added regardless of its
types. The results further showed that the progressive performance of the polity index had
significantly improved agricultural protection. Similarly, a higher local currency per unit of
USD has significantly improved agricultural incentive provisions, while a larger population size
in the agricultural sector has significantly reduced aggregate nominal assistance coefficient.
Gross fixed capital formation has significantly improved output oriented aggregate agricultural
assistance, where the association turns negative when assistances targeting value addition
segments were considered. Arable land had negative association with exportable products
assistance coefficient and nominal rate of protection. In this region, the distortion of agricultural
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incentives has continued to influence welfare, and the effects vary significantly across countries.
Improving sectoral incentives were associated with improvement in the level of income
distribution in most countries. In some countries, improved agricultural price incentives had an
exacerbating effect on income inequality backed with a number of policy variables including
exchange rate.
The results generally imply that institutional quality and agricultural incentives have a vital role
in the growth of agricultural value-added in East Africa. It also suggests the heterogeneity of
factors that contribute to the distortion of agricultural incentives, which depend on the product
type and incentives proposed. In this region, stakeholders should thrive to enhance governance
effectiveness for a sustained increase of agricultural value-added. A favorable agricultural
incentive needs to be a crucial element of agricultural policy revisions. Besides these, given the
prevailing democratic institutions in each country, efforts towards improving government
effectiveness are vital. Complementing this with a slightly depreciating domestic currency could
be helpful to minimize the negative welfare consequences that may arise due to the
implementation of agricultural incentive policies
Effect of Medication Therapy Management on Drug Therapy Problem and Low Density Lipo-Protein Goal Attainment Among Ambulatory Atherosclerotic Cardiovascular Disease Patients at Jimma Medical Center, Jimma South West Ethiopia, 2025
No full textBackground: Uncontrolled low-density lipoprotein is a major contributing factor for the
occurrence of atherosclerotic cardiovascular diseases, including ischemic stroke and ischemic
heart disease. Drug therapy problems are common among these patients, yet their resolution and
low-density lipoprotein cholesterol goal attainment remains suboptimal which necessitates
implementation of medication therapy management.
Objective: To determine the effect of medication therapy management on drug therapy problem
resolution and low-density lipoprotein cholesterol goal attainment among ambulatory
atherosclerotic cardiovascular disease patients at Jimma University Medical Center, South west
Ethiopia from January, 2025 to April 2025.
Methods and Participants: A one-group pre-post quasi-experimental study was conducted from
January to April 2025 among atherosclerotic cardiovascular patients at Jimma medical center
ambulatory clinic. Data was collected at baseline, one month, and two months post-intervention.
Data was entered using Epidata 4.6.0.1 and analyzed using SPSS v26. Cochran’s Q and
McNemar’s post-hoc tests assessed changes over time, while multivariate logistic regression
identified factors associated with drug therapy problems and cholesterol goal attainment.
Results: A total of 115 patients were enrolled, with a mean age of 57.5 years and 59.1% being
male. At baseline 134 drug therapy problems were identified, while prevalence was 60.0% and
later dropped to 28.7% after medication therapy management. Before intervention, drug therapy
problems were significantly associated with non-prescription drug use (AOR=4.1, 95% CI:1.26
13.46), number of non-statin drugs (AOR=2.6, 95% CI:1.55–4.39), longer disease duration
(AOR=1.3, CI:1.03–1.64), and patients who are able to use both insurance and pocket money
reduced odd by 75% when compared to those who uses single payment method (AOR=0.25,
CI:0.08–0.76). After intervention, number of non-statin drugs (AOR=2.1, CI:1.32–3.25) payment
methods (AOR=0.22, CI:0.09–0.54) remained significant. Low-density lipoprotein cholesterol
goal attainment improved from 53.9% at baseline to 65.2% at second follow-up. High statin
adherence increased goal attainment over 20-fold at baseline (AOR=20.2, CI:5.15–79.39). Also,
urban residency increased attainment (AOR=5.0, 95% CI:1.42–17.36), while irregular follow-up
to clinic reduced it by 35% (AOR=0.65, CI:0.45–0.93). Post-intervention, baseline goal
achievers were 4 times more likely to meet goals at second follow-up (AOR=4.24, CI:1.53
11.73), and statin adherence increased likelihood over 6-fold (AOR=6.28, 95% CI:1.50–26.19).
Conclusion and Recommendation: Medication therapy management reduces drug therapy
problems and improves low density lipoprotein-cholesterol goal achievement in atherosclerotic
cardiovascular disease patients. Strengthening it through institutional support, policy changes,
training and adoption of practices in follow-up clinics is recommended to enhance these benefit
Treatment outcomes and associated factors of pediatric Epilepsy at jimma medical center, Ethiopia: a cross-sectional Study
No full textBackground: Epilepsy is among the most common neurological disorders and is highly treatable
with currently available antiepileptic drugs at a reasonable cost. In Ethiopia, although several
studies have revealed a high prevalence of epilepsy, little is known about the predictors of poorly
controlled seizures. Thus, this study aimed to assess epilepsy treatment outcomes and associated
factors among patients with epilepsy on follow-up at the ambulatory care unit of Jimma
University Medical Center (JMC).
Objective: To assess treatment outcomes and associated factors of epilepsy among pediatric
patients on follow-up at JMC, Jimma, Ethiopia.
Methods: An institution-based cross-sectional study was conducted among all children with
epilepsy attending the pediatric neurology clinic of JMC. The study was conducted from October
1, 2024, to January 1, 2025. The total sample size was 170. Participants were selected using a
systematic random sampling method, and data were collected using structured questionnaires
through Kobo Toolbox. The collected data were exported to Stata/MP 17 for analysis. Logistic
regression analysis was performed to identify factors associated with the outcome variables.
Statistical significance was considered at a *p*-value of less than 0.05.
Result: Overall, 170 child-caregiver pairs were successfully interviewed. Notably, 40.6% of the
children were in the 6–10-year age group. The majority of pediatric epilepsy patients (88.2%)
exhibited generalized tonic-clonic seizures, with rare instances of absence, focal unaware, or
myoclonic seizures (<4% each). The study revealed that 65.3% (*n* = 111) achieved controlled
seizures, while 34.7% (*n* = 59) remained uncontrolled.
Conclusion: This study highlights that 65.3% of pediatric epilepsy patients at Jimma Medical
Center achieved seizure control, while 34.7% remained uncontrolled, indicating gaps in care.
Key barriers included non-adherence to medication, Drug shortages, transportation challenges,
limited diagnostic tools, and comorbidities such as cerebral palsy.
Recommendation: To improve outcomes, I recommend expanding access to EEG and
neuroimaging, enhancing caregiver education, and integrating epilepsy care into primary health
system
Population size, Habitat preference, feeding ecology and activity patterns of Grivet monkey (Chlorocebus aethiops) in Tumet forest, Homosha district, Assosa zone, western Ethiopia
No full textGrivet monkeys are mostly herbivorous and feed on a wide range of food items. The study was
conducted in two seasons from February to August 2024 to identify grivet monkey habitat
preferences, population size, feeding ecology, and activity patterns. The stratified random
sampling design was used for line transect to study population size and habitat preferences of the
grivet monkey while instantaneous scan sampling design was used to study behavioral activity and
feeding ecology of grivet monkey in the study area. A total of 260 grivet in dry season and 225 in
wet season were counted in five study sites. Of which the highest number was accounted by adult
females 90(34.6%) in dry and 80(35.6%) in wet season followed juveniles 70(26.9%) in dry season
and 60(26.6%) in wet seasons. Ficus sure (29.9%) was the most frequently consumed followed,
Ficus vasta (17.5%), Syzygium guineense (15.1%). On the other hand, Syzygium guineense
comprised the highest (22%) followed by Oxytenanthera abyssinica (20%), and F. vasta (16.5%)
was consumed during the wet season. Their proportion of feeding on fruit was 65.06% (dry) and
54.85% (wet); leaves 15.31% (wet) and 6.02% (dry); insects 14.13% (dry) and 8.46% (wet);
flowers 1.77% (wet) and 1.5% (dry) and they consumed 13.31% (dry) and 19.71% (wet) on other
unidentified items. The percentage of activity time budget observed on feeding was 33.77% (dry)
and 25.89% (wet); resting 22.21% (wet) and 30.48% (dry); moving 23.78% (dry) and 27.92%
(wet); grooming 10.12% (wet) and 7.24% (dry); playing 3.15% (dry) and 9.40% (wet) and they
spent 1.59% and 4.46% of their behavioral activity on other social activities during the dry and
wet season, respectively. The main threats to grivet in the study area; selective logging, habitat
loss and degradation and also extensive agricultural expansion. Therefore, it is essential to local
and regional governments with local communities emphasis on protecting and replanting in and
around all habitat types
Dietary Practices during Pregnancy and Newborn Nutritional Status at Birth in Arba Minch Health and Demographic Surveillance Site, Gamo Zone, Southern Ethiopia
No full textMaternal and child undernutrition is considered a critical public health problem, with a global
burden of 22.3% stunting, 6.8% wasting, and 5.7% overweight among children under the age
of five in 2022. Additionally, 29.9% of women of reproductive age are anemic. Most children
with malnutrition live in low- and middle-income countries.
Maternal and child undernutrition contributes to 800,000 neonatal deaths and 3.1 million
deaths among children under the age of 5 years annually, respectively
Pregnant women are recommended to consume diets rich in adequate energy, protein,
vitamins, and minerals from a variety of foods, maintain a healthy lifestyle, monitor weight
gain during pregnancy, engage in regular exercise, and avoid smoking and alcohol. However,
many pregnant women consume inadeqaute amounts of fruits, vegetables, meat, and dairy
products due to a lack of dietary diversity, which can lead to undernutrition.
Recent studies in Ethiopia indicate that 51.20% to 81.50% of pregnant women have an
acceptable Food Consumption Score (FCS). However, only 24.78% of the pregnant women
consumed animal source foods (ASFs), and 44.6% to 78.4% of them have inadequate dietary
diversity. As a result, 17.7% to 47.9% of pregnant women experience undernutrition. These
findings suggest that dietary practices during pregnancy are suboptimal, with a notable
percentage of pregnant women facing undernutrition.
Although many epidemiological studies have been conducted on the nutritional status and
dietary practices among pregnant women in Ethiopia, there is limited evidence on dietary
patterns, breakfast skipping, and the FCS during pregnancy. To our knowledge, no
documented study has been carried out the association between adequate dietary practices
during pregnancy and newborn nutritional status. Therefore, this study aims to evaluate the
role of adequate dietary practices during pregnancy on newborn nutritional status.
Chapter 1 provides a general overview of maternal and child malnutrition, including both the
long- and short-term consequences of malnutrition during pregnancy on the health of women
and children, as well as on future generations, from both global and local perspectives.
Additionally, it presents an overview of global studies on undernutrition at birth.
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Chapter 2 outlines the study setting, sampling methods, measurement of variables, and the
methodological approaches applied throughout the study.
Chapter 3 summarizes the review of evidence on the magnitude and predictors of stunting at
birth. We collected studies from major databases, appraised them, analyzed the data, and
presented the best available evidence. In total, eleven studies were included in the review, with
10,181 participants. The meta-analysis revealed that the pooled magnitude of stunting at birth
was 24.41% (95% CI: 19.33–29.49%). Predictors of stunting at birth included small for
gestational age (AOR = 6.21; 95% CI: 1.19–32.33), low birth weight (AOR = 12.97; 95% CI:
8.02–21.00), preterm birth (AOR = 1.99; 95% CI: 1.41–2.82), maternal short stature (AOR =
2.83; 95% CI: 1.67–5.33), primiparous mothers (AOR = 1.59; 95% CI: 1.09–2.32), and
undernourished mothers (AOR = 4.33; 95% CI: 3.18–5.33).
Chapter 4 presents the findings on the factors associated with dietary patterns, food
consumption scores, and their nexus to the nutritional status of pregnant women in the study
area. It was found that 76.96% pregnant women had acceptable food consumption scores,
while 31.97% were undernourished in Arma Minch HDSS.
The ―Cereals-pulses and dairy,‖ ―leafy local food,‖ and ―nutrient-dense‖ dietary patterns were
identified. Place of residence (AOR= 2.18; 95% CI: 1.33, 3.59), socio-economic status (AOR=
2.43; 95% CI: 1.68, 3.51), and gravidity (AOR= 1.72; 95% CI: 1.07, 2.78) were predictors of
the ―cereals-pulses and dairy‖ dietary pattern.
Maternal educational status (AOR= 1.60; 95% CI: 1.02, 2.51), socioeconomic status (AOR=
1.56; 95% CI: 1.02, 2.38), food aversion (AOR= 1.98; 95% CI: 1.16, 3.39), and dietary
knowledge (AOR= 2.16; 95% CI: 1.08, 4.32) were predictors of the ―Nutrient-dense‖ dietary
pattern.
Maternal educational status (AOR= 2.22; 95% CI: 1.48, 3.36), maternal decision-making
autonomy (AOR= 1.91; 95% CI: 1.26, 2.90), and dietary knowledge (AOR= 1.86; 95% CI:
1.13, 3.08) were predictors of ―leafy local food‖ dietary pattern.
The ―nutrient-dense‖ dietary pattern (AOR = 1.63; 95% CI: 1.07, 2.47) and the ―leafy local
food‖ dietary pattern (AOR = 2.32; 95% CI: 1.54, 3.51) were determinants of undernutrition
during pregnancy.
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Place of residence (APR = 1.09; 95% CI: 1.02, 1.20), socioeconomic status (APR = 1.05; 95%
CI: 1.01, 1.16), pregnancy status (APR = 1.13; 95% CI: 1.02, 1.25), mass media exposure
(APR = 1.19; 95% CI: 1.07, 1.31), vegetable garden (APR = 1.14; 95% CI: 1.04, 1.25),
antenatal care visits (APR = 1.13; 95% CI: 1.02, 1.26), meal frequency (APR = 1.23; 95% CI:
1.11, 1.36), BMI (APR = 1.02; 95% CI: 1.01, 1.04), MUAC in cm (APR = 1.03; 95% CI: 1.01,
1.05), and gestational age (APR = 1.04; 95% CI: 1.01, 1.07) were determinants of acceptable
food consumption scores.
Chapter 5 presents the findings on determinants of breakfast skipping during pregnancy. The
odds of non-formal education (AOR = 3.92; 95% CI: 1.75, 8.78), low socioeconomic status
(AOR = 2.93; 95% CI: 1.12, 7.68), poor dietary knowledge (AOR = 2.89; 95% CI: 1.29, 6.47),
and experiencing morning sickness (AOR = 2.57; 95% CI: 1.13, 5.84) were higher among
cases than controls. The odds of breakfast skipping were higher among cases than controls
with every increase in family size (AOR = 1.65; 95% CI: 1.25, 2.18), but decrease with every
unit increase in mid-upper arm circumference (AOR = 0.58; 95% CI: 0.46, 0.72) and weekly
frequency of drinking coffee leaf tea (AOR = 0.84; 95% CI: 0.78, 0.89).
Chapter 6 illustrates that 25.30% of newborns were stunted, 10.32% were wasted, and 1.82%
experienced concurrent undernutrition (both stunting and wasting). These conditions were
significantly higher among newborns whose mothers had inadequate dietary practices during
pregnancy. Path analysis identified the following independent predictors of the LAZ-score:
inadequate dietary practice (β = 0.48; 95% CI: 0.12, 0.84), maternal nutritional status (β =
0.10; 95% CI: 0.03, 0.17), maternal decision-making autonomy (β = 0.61; 95% CI: 0.18, 1.05),
dietary information (β = 1.12; 95% CI: 0.64, 1.60), meal frequency (β = 0.11; 95% CI: 0.02,
0.20), household socio-economic status (β = 0.32; 95% CI: 0.09, 0.54), maternal short stature
(β = 0.01; 95% CI: 0.01, 0.02), a ―nutrient-dense‖ dietary pattern (β = 0.10; 95% CI: 0.02,
0.18), and consumption of ―leafy local foods‖ (β = 0.07; 95% CI: 0.01, 0.12). In addition,
inadequate dietary practice (β = 0.71; 95% CI: 0.34, 1.08), household socio-economic status (β
= 0.08; 95% CI: 0.02, 0.13), and dietary information (β = 0.67; 95% CI: 0.18, 1.16) were
found to be independent predictors of the WHZ-score.
In conclusion, the findings of this Ph.D. research showed a high prevalence of undernutrition
at birth. Three distinct dietary patterns during pregnancy were identified, and these patterns
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were associated with maternal nutritional status. A low FCS during pregnancy was directly
linked to the nutritional status of the mother. Newborn undernutrition at birth was significantly
associated with maternal dietary practices during pregnancy.
Chapter 7 presents a general discussion of the findings on undernutrition at birth, along with
their implications, conclusions, and recommendations for further research
The Evaluation of Solid Waste Management practice in Sheki town, Dedo district, Oromia region, South waste Ethiopia
No full textSolid waste is defined as unwanted matter or material of any type (non-liquid), often that which is
left after useful substances or parts were removes and it ranges from house garbage to industrial
waste, which may include complex and sometimes hazardous substances. This study aimed to
evaluate solid waste management practices among households in Sheki town, Dedo district, South
waste Ethiopia. Data were collected from 97 participants selected from 2,903 households using
simple random sampling methods. Primary data were gathered through questionnaires, semi
structured interviews, and field observations targeting households, business owners, employees,
and household heads. Descriptive statistical tools, including tables, frequency distributions, and
percentages, were used to analyze the qualitative data. The study result of public awareness on
the advantage of solid waste management was 89.4%, demonstrating a strong foundational
understanding among the surveyed population. In addition to the above result, the study result
highlights that ways of removing the solid waste from house showed that :the highest participants
were use burns 57(67.1%) as disposal of solid waste collected in households and the minimum
participants were used the waste collectors and dumping along the road (3.5%) each respectively.
Based on the findings, the conclusion was proposed; that highlights both progress and ongoing
challenges in solid waste management in the study area, where 62.4% of respondents separate
their waste at home, reflecting a positive shift toward sustainability and resource recovery while
37.6% do not practice waste separation, primarily due to insufficient storage containers (50%)
and limited space or facilities for sorted waste (3.1%) underscoring the need for improved
infrastructure. Based on the finding of the study, the recommendation that proposed were:
enhancing awareness and education of society on solid waste management, providing adequate
infrastructure, strengthen waste collection systems, promoting recycling and resource recovery,
fostering community engagement, developing policy frame work, monitoring and evaluate
progress among the society in Sheki town to manage solid waste properly
Assessment of Honey Production Systems and Beekeeping Management Practices in Bita Woreda, Kaffa Zone, South Western Ethiopia
No full textBeekeeping is a vital agricultural practice in Ethiopia, contributing to household income, food
security, and environmental sustainability through pollination. Challenges such as low
productivity, pests, lack of modern equipment, and poor management hinder the sector's potential.
This study evaluates honey production systems, beekeeping practices, and managements in Bita
Woreda to identify opportunities for sustainable development. A cross-sectional study was
conducted from September 2024 to January 2025 in three kebeles (Sheda, Ona, Tageta ) using
mixed-method approaches. A multistage sampling technique was employed, selecting 150
beekeepers (traditional, transitional, and modern hive users) from those Keble through stratified
random sampling. Data were collected via questionnaires, key informant interviews, and focus
group discussions, then analyzed using descriptive statistics and thematic approaches.
The study found that 36.7% of beekeepers use transitional hives, while 33.3% and 30% rely on
traditional and modern hives, respectively. Modern hives were preferred for higher honey yields
(81.3%) and ease of harvesting (76.7%), whereas traditional hives were favored for material
availability (87.4%) and lower dependency on external inputs (87%). Annual honey production
averaged 5–8 kg per traditional hive, 6–10 kg per transitional hive, and 10–16 kg per modern
hive. Major constraints included lack of equipment (34.7%), colony shortages (28.6%), and pests
(14%). While modern hives enhance productivity, traditional systems remain important for
resource-limited beekeepers. Interventions should focus on training, pest management, and access
to modern equipment to improve yields sustainably. Strengthening market linkages and promoting
cooperative beekeeping can further enhance livelihoods and sector growth in Bita Woreda
Diversity, Distribution and Relative Abundance of Wetland Birds in Chebera Churchura National Park, Ethiopia
No full textWetlands provide critical habitats for a wide range of bird species, playing a significant role in
biodiversity conservation. This study examines the spatial distribution, relative abundance
seasonal variation, and conservation status of wetland birds in Chebera Churchura National
Park, Ethiopia. Five wetlands namely Meqa, Biqamo, Mesfine, Chefe-2, and Chefe-1 were
surveyed in this study. To identify birds along the five wetland habitats, data were collected using
direct observation on a predetermined line transect where all birds seen were recorded Data was
collected during wet seasons (June to July 2024) and dry season from February to March 2024
and November to December 2025 for a total of 40 days (10 days per month for wet and dry
season).
A total of 30 bird species from 13 families were recorded from selected site, with significant
seasonal fluctuations in abundance. The Shannon Diversity Index increased slightly during the
wet season, with Meqa Wetland rising from 3.17 to 3.30, reflecting higher species diversity.
Mean bird abundance also varied significantly, with Meqa Wetland increasing from 7.667
individuals per species in the dry season to 12.167 in the wet season, while Chefe-1 wetland
declined from 5.300 to 3.033. Bird populations increased markedly during the wet season, with
Meqa Wetland rising from 230 to 365 individuals and Biqamo Wetland from 225 to 273, driven
by improved food availability and nesting conditions. In contrast, Chefe-1 wetland showed a
sharp decline from 159 individuals in the dry season to 91 in the wet season, likely due to
localized habitat disturbances. Two Near Threatened species, the migratory Curlew Sandpiper
(Calidris ferruginea) and the near endemic Wattled Ibis (Bostrychia carunculata), were
identified, underscoring the need for targeted conservation efforts. These findings highlight the
ecological importance of wetlands for both resident and migratory birds, emphasizing the need
for habitat protection, community-based conservation, and long-term monitoring to address
threats such as habitat degradation and climate change. The study provides critical insights for
wetland management and avian biodiversity conservation in the study area
Early childhood growth, cognitive function and school achievement in late childhood
No full textBackground: Children in lower- and middle-income countries often do not achieve their full
developmental potential and tend to have lower academic performance compared to those in high
income countries. Early childhood growth is linked with cognitive function or school achievement.
This evidences mainly examine early childhood growth using height/length or stunting at specific
points in time, but this approach fails to capture the dynamic nature of early childhood linear
growth. Additionally, the relationship of fat mass (FM) and fat-free mass (FFM) with cognitive
function during late childhood remains underexplored. Thus, this PhD study aims to examine the
association of early childhood linear growth velocities and trajectories with cognitive function and
school achievement. Furthermore, this study also aims to examine the association of FM and FFM
accretion during early childhood with and cognitive function in late childhood.
Methods: The papers presented in this thesis are based on data from the Infant Anthropometry
and Body Composition birth cohort, which enrolled term newborns and invited them for 14 visits
from birth to 10 years of age. Length/height and body composition data were collected during
these visits, except for body composition between 6 months and 4 years. The outcome variables
were school achievement and cognitive function, measured at the 10-year follow-up. School
achievement was assessed using two markers: Math, English, and Science (MES) combined
scores, and grade-for-age. Cognitive function was measured using the Peabody Picture Vocabulary
Test (PPVT). Advanced modeling techniques -linear spline mixed-effect model and latent class
trajectory analysis- were used to model early childhood growth. Regression analyses assessed
associations of early childhood growth with cognitive function, MES scores and grade-for-age.
Result: At the 10-year follow-up, 355 children were participated: 318 completed the PPVT test,
343 provided grade data, and 276 had MES scores. A 1 SD (standard deviation) increase in birth
length was associated with 1.42 (95% CI: 0.99, 2.03) higher odds of achieving a high MES
combined score, while a 1 SD increase in birth FFM was associated with a 0.14 SD (95% CI: 0.01,
0.28) higher PPVT. Postnatal FFM accretion from 0-3 and 3-6 months were associated with PPVT,
(β = 0.50 (95% CI: 0.08, 0.93)) and (β = -0.48 (95% CI: -0.90, -0.07)), respectively. Additionally,
linear growth velocity from 6-24 months was associated with appropriate grade-for-age, adjusted
odds ratio (aOR) = 1.66 (95% CI: 1.14, 2.43). Four distinct height-for-age z score (HAZ)
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trajectories were identified, with dynamic growth observed through 6 months and continuing until
2 years. Only the rising trajectory, which constitute 8.6% of the population, showed a HAZ
trajectory above, but close to the WHO child growth standard median value. Furthermore, only
this trajectory showed a positive association with cognitive function, the MES combined score,
and grade-for-age, compared to the increasing-decreasing trajectory (β = 0.12 (95% CI: -0.24,
0.47), β = 4.54 (95% CI: -0.45, 9.55), aOR = 2.40 895% CI: 1.12, 5.15), respectively). Stunting at
ages 4 and 6 were negatively associated with MES combined scores (aOR = 0.43 (95% CI: 0.20,
0.93) and aOR = 0.31 (95% CI: 0.11, 0.89), respectively). Stunting at age 2 was also inversely
associated with appropriate grade-for-age, aOR = 0.39 (95% CI: 0.18, 0.88).
Conclusion: Dynamic growth was observed during the first two years. The vast majority of
children were shorter than the WHO child growth standards. Birth length and FFM at birth were
positively associated with MES combined score and cognitive function, respectively. Furthermore,
higher linear growth velocity from 6-24 months was associated with greater odds of being in the
appropriate grade-for-age, while stunting after 2 years was negatively associated with school
achievement. FFM from birth to 3 months and from 3-6 months showed opposite associations with
cognitive function. This study underscores the importance of prenatal growth and early growth up
to the age 2 years, for better cognitive function and school achievement. Therefore, programs
aimed at improving cognitive function and school achievement should also focus on supporting
child growth during these crucial periods