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The purpose of this study was to determine the magnitude and determinants of urban household food insecurity in East Africa.
Systematic review and meta-analysis.
Studies conducted in East Africa.
Seventeen studies (fifteen cross-sectional and two cohort) that enrolled 156 996 households. We used the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines to search electronic databases (PubMed, Cochrane Library, EMBASE, CINAHL, African Journals OnLine, Web of Science, Scopus and Google Scholar; date of last search: 10 June 2020) for studies reporting the prevalence and associated factors of urban household food insecurity.
A total of 17 studies with 156 996 households from 8 countries were used for the analysis. The pooled prevalence of urban household food insecurity in East Africa was 60·91 % (95 % CI 47·72, 74·11; I2 = 100 %; P < 0·001) where the highest (91 %) and lowest (36·5 %) was observed in Sudan and Burundi, respectively. Household head educational status (illiterate) (AOR = 2·53; 95 % CI 2·11, 2·95, I2 = 90 %; P < 0·01), female as household head (AOR = 1·45; 95 % CI 1·16, 1·75; I2 = 0·0 %; P = 0·993), large family size (AOR = 1·43; 95 % CI 1·09, 1·76, I2 = 0·0 %; P = 0·863) and poorest wealth quantile (AOR = 3·95; 95 % CI 1·93, 5·98; I2 = 57·2 %, P = 0·053) were factors which significantly increased odds of urban household food insecurity in East Africa.
The prevalence of urban household food insecurity in East Africa remains high. Therefore, policies and intervention programmes should be designed to reduce the high burden of food insecurity among urban households considering the identified factors.
To evaluate the performance of mid-upper arm circumference (MUAC) to identify thinness in the late adolescence period (aged 15–19 years) in Ethiopia.
We conducted a school-based cross-sectional study. The receiver operating characteristics curve was used to examine the validity of MUAC compared with BMI Z-score to identify adolescents with thinness (BMI Z-score <−2 sd).
Fifteen high schools (grade 9–12) located in Addis Ababa, Ethiopia.
A total of 851 adolescent (456 males and 395 females) were included in the study.
The prevalence of thinness and severe thinness among high-school adolescents in Addis Ababa was 9·5 % (95 % CI 7·7, 11·7 %). The overall AUC for MUAC against BMI Z-score <−2 SD was 0·91 (95 % CI 0·88, 0·93). The optimal MUAC cut-offs to identify thinness were 23·3 cm for males and 22·6 cm for females. These cut-off points give high sensitivity and specificity for both males (a sensitivity of 87·9 % and a specificity of 75·9 %) and females (a sensitivity of 100 % and a specificity 88·2 %).
MUAC has a comparable level of accuracy with BMI Z-score to identify thinness in adolescents aged 15–19 years. Hence, MUAC could be used as an alternative tool for surveillance and screening of thinness among adolescents aged 15–19 years. The optimum cut-off proposed by this study may incorrectly include a large number of adolescents when used in a relatively well-nourished population. In this situation, it would be necessary to choose a cut-off with greater positive predictive value.
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