Data was collected from 300 students; 232(77.3%) were from public schools. One hundred fifty nine (53%) of children were females. Two hundred ninety nine (99.7%) of the students were Amhara in ethnicity. Religion wise, 296(98.7%) of them were Orthodox Christianity followers. From a total, 130(43.3%) of them were in birth order of 2– 3. The mean age ± standard deviation (SD) of children was 9.9867 ± 1.47663 months.
Regarding to family size, 220 (73.3%) of children live in a family size of 5 and above. Two hundred nine(69.7%) of children live with both mother and father and about 83(27.7%) mothers of school age children cannot read and write as shown in the table below (Table 1).
Table 1
Socio-demographic and socio economic status of School Age Children aged 6–12 Years in Debre Tabor Town elementary Schools, South Gondar, Ethiopia, 2018 (n = 300).
Variables
|
|
Frequency
|
Percentage
|
Age of the student
|
6
|
1
|
.3
|
7
|
16
|
5.3
|
8
|
45
|
15.0
|
9
|
32
|
10.7
|
10
|
91
|
30.3
|
11
|
60
|
20.0
|
12
|
55
|
18.3
|
Birth order
|
1
|
99
|
33.0
|
2–3
|
130
|
43.3
|
4–5
|
47
|
15.7
|
6 and above
|
24
|
8.0
|
Educational status of the mother
|
cannot read and write
|
83
|
27.7
|
can read and write
|
28
|
9.3
|
grade 1–4
|
26
|
8.7
|
grade 5–8
|
59
|
19.7
|
grade 9–12
|
39
|
13.0
|
above12
|
65
|
21.7
|
Occupation of mothers
|
house wife
|
139
|
46.3
|
Farmer
|
4
|
1.3
|
Merchant
|
53
|
17.7
|
government employee
|
71
|
23.7
|
daily labourers
|
29
|
9.7
|
Others
|
4
|
1.3
|
Age of the mother/caregivers
|
below 25
|
7
|
2.3
|
25–29
|
39
|
13.0
|
30–34
|
92
|
30.7
|
35–39
|
90
|
30.0
|
40–44
|
33
|
11.0
|
45–49
|
17
|
5.7
|
50–54
|
11
|
3.7
|
55 and above
|
7
|
2.3
|
Educational status of the father
|
cannot read and write
|
34
|
11.3
|
read and write
|
39
|
13.0
|
1–4
|
19
|
6.3
|
5–8
|
57
|
19.0
|
9–12
|
42
|
14.0
|
12 and above
|
87
|
29.0
|
Monthly income
|
< 1500
|
68
|
22.7
|
1500–3000
|
126
|
42.0
|
> 3000
|
105
|
35.0
|
Dietary habit and water sources of households of school age children
Regarding to dietary habit, the staple food among 268(89.3%) of households was Teff and 278(92.7%) of children were never been hungry in the past one month. One hundred sixty three (54.3%) of children ate three times per day. And 144(48%) of children ate breakfast always; 129 (43%) of them ate some times; 26(8.7%) eat rarely and1 (0.3%) almost never ate breakfast. One hundred forty two (47.3%) children eat fruits once per week and 104(34.7%) of children never consumed milk or milk product (Table 2).
Of all household food sources, 271(90.3%) of them were got by purchasing from market; 14(4.7%) from their own product; 12(4%) both from their own product and purchasing and 2 (0.7%) get from aid. Two hundred eighty eight (96%) of them were had a latrine at their home. from the total, 267(89%) of households do not treat drinking water and from these, the source of drinking water for 258 (86%) of households were tap water.
Table 2
Dietary habits of school age children Aged 6–12 years in Debre Tabortown elementary schools, South Gondar, Ethiopia, 2018(n = 300).
Variables
|
|
Frequency
|
Percentage
|
Meal frequency
|
Once
|
3
|
1.0
|
Twice
|
24
|
8.0
|
Three
|
163
|
54.3
|
4 and above
|
110
|
36.7
|
Fruit eating frequency
|
not at all
|
55
|
18.3
|
Once
|
142
|
47.3
|
Twice
|
63
|
21.0
|
≥Three
|
40
|
13.3
|
Milk consumption
|
Never
|
104
|
34.7
|
Sometimes
|
95
|
31.7
|
Most of the days
|
35
|
11.7
|
Always
|
66
|
22.0
|
Sanitation and Hygienic practice
Concerning to hand washing habit 236(78.7%) of school age children always wash their hands before eating. From all children, 203(67.7%) of them were using soap sometimes. One hundred fifty three (51%) children wash unpeeled fruits sometimes before eating (Table 3)
Table 3
Sanitation and hygiene status of school age children aged 6–12 Years in Debre Tabor town elementary schools, South Gondar, Ethiopia (n = 300)
Variables
|
Frequency
|
Percentage
|
Waste disposal system
|
Collection by municipality
|
50
|
16.7
|
Burial
|
80
|
26.7
|
private collector
|
24
|
8.0
|
thrown on the road or free space
|
20
|
6.7
|
collected in the compound
|
5
|
1.7
|
thrown on the farm place
|
5
|
1.7
|
Burned
|
114
|
38.0
|
Others
|
2
|
.7
|
Hand washing habit
|
Never
|
3
|
1.0
|
Rarely
|
4
|
1.3
|
some times
|
28
|
9.3
|
Most of the days
|
29
|
9.7
|
Always
|
236
|
78.7
|
Soap usage while hand washing
|
Never
|
18
|
6.0
|
Rarely
|
29
|
9.7
|
Sometimes
|
203
|
67.7
|
Most of the days
|
16
|
5.3
|
Always
|
34
|
11.3
|
Washing unpeeled fruits
|
Never
|
26
|
8.7
|
Sometimes
|
153
|
51.0
|
Most of the days
|
24
|
8.0
|
Always
|
97
|
32.3
|
Fifty eight (19.3/%) of children have been sick in the past two weeks prior to data collection. The cause of sickness was stomach ache 25(27.6%) followed by common cold 12(20.7%).
Nutritional status
The mean ± standard deviation (SD) of height of children was 132.915 ± 9.824 cm and the mean ± standard deviation (SD) of weight of children was 27.65 ± 5.785 Kg .In this study, 21(11.4%, 95% CI, 6.8–15.9) of children aged 6–10 years were under weight. Thirty three (11%, 95% CI, 7.3–15) of all children were stunted; 19(6.3%, 95% CI: 3.5, 9.3) of children were wasted. Over all, the likely to have severe form of malnutrition was rare among these age groups in the study area.
Factors associated with under nutrition.
Factors associated with underweight
In the bi-variable analysis sex of the student, educational status of their fathers, breakfast eating habit, milk consumption, treating water and sickness in the past two weeks were associated with underweight. All these variables were fitted into multivariable logistic regression analysis. Then, educational status of the father, children’s breakfast eating habit, consumption of milk, and having sickness in the past 2 weeks were significant variables.
Here, educational status of a father being grade 9–12 was protective factor for not to be underweight as compared to fathers who cannot read and write (AOR = 0.09; 95%CI, 0.01–0.94). Students who rarely ate their breakfast were more likely to be underweight than those who eat breakfast always (AOR = 7.94;95%CI, 4.82–14.80).Those who never consumed milk or milk products were more likely to be underweight as compared to those who consumed always (AOR = 5.46; 95% CI, 4.02–6.90).In addition, those who were sick two weeks before data collection were more likely to be underweight than their counterparts (AOR = 7.3; 95%CI, 2.8–14.4) (Table 4).
Table 4
Factors associated with underweight among School Age Children Aged 6–12 Years in Debre Tabor town elementary Schools, South Gondar, Ethiopia
Variables
|
COR(95%CI)
|
AOR(95% C.I)
|
P value
|
Educational status of the father
|
Cannot read and write
|
|
|
|
read and write
|
0.43(0.07–2.80)
|
0.3(0.24–8.31)
|
.357
|
1–4
|
0.75(0.12–4.75)
|
0.22 (.02 -2.39)
|
.214
|
5–8
|
0.38(0.03–4.12)
|
0.24( 0.01–9.07)
|
.441
|
9–12
|
0.22(0.05–0.97)
|
0.09 (.01 -0.95)
|
.045
|
12 and above
|
0.41(0.08–2.19)
|
0.45(0 .04- 4.76)
|
.506
|
Sex of the student
|
Male
|
|
|
|
Female
|
0.45(0.17–1.18)
|
1.30 (0.31–5.53)
|
.720
|
Breakfast eating habit
|
Rarely
|
12.60(3.14–50.02)
|
7.94( 4.82–14.80)
|
.002
|
Some times
|
10.44(2.99–36.01)
|
13.40( 1.70- 15.38)
|
.014
|
Always
|
|
|
|
Milk consumption
|
never
|
13.11(2.90-16.78)
|
5.46 (4.03–6.96)
|
.002
|
Some times
|
13.30(1.69–15.39)
|
5.85( 2.26–9.31)
|
.013
|
Most of the days
|
63.21(0.01–71.24)
|
16(0.01–22.86)
|
.998
|
Always
|
|
|
|
Water treatment
|
yes
|
|
|
|
no
|
0.32(0.10–1.01)
|
7.44( 0.71–77.97)
|
.094
|
Sickness in the past two weeks
|
Yes
|
13.50(11.01–23.54
|
7.32 (2.87–14.41)
|
.002
|
no
|
|
|
|
Factors associated with stunting
Variables having a p value of < 0.2 in the bivariable analysis are eating frequency per day, milk consumption habit, soap usage for hand washing and washing of unpeeled fruits before eating. In multivariable analysis those who never consume milk or milk products are more likely to be stunted than those who consumed always (AOR = 6.5; 95%CI ,1.7–23) and those who never use soap for hand washing are more likely to be stunted than those who used soap always (AOR = 4.5; 95%CI, 1.7–12).
Table 5
Factors associated with stunting among School Age Children Aged 6–12 Years in Debre Tabor town elementary Schools, South Gondar, Ethiopia
|
|
COR (95% CI)
|
AOR(
95% C.I.)
|
|
Meal frequency per day
|
Once
|
3.5(0.24–5.14)
|
4.65(0.25–16.14)
|
.302
|
Twice
|
3.57(0.31–4.13
|
4.33( 0.32–9.65)
|
.273
|
Three times
|
5.6(0.46–8.04)
|
6.456(0 .45- 13.66 )
|
.172
|
>=4 times
|
|
|
|
Milk consumption habit
|
Never
|
5.99(3.69–11.65)
|
6.49 (1.76- 23.945)
|
.005
|
Some times
|
1.17(0.39–3.45)
|
1.23 ( 0.36–4.19)
|
.736
|
Most of the days
|
1.42(0.57–3.49)
|
1.63 (.613 − 4.31)
|
.329
|
Always
|
|
|
|
How often you use soap during hand washing
|
Never
|
6.12(0.71–28.50)
|
4.546 ( 1.70- 12.14)
|
.003
|
Occasionally
|
10.08(9.21–25.65)
|
20.40 ( 2.06–28.24)
|
.010
|
Sometimes
|
3.29(1.35–5.67)
|
7.826 ( 0.812–75.48 )
|
.075
|
Most of the time
|
2.52(0.48–10.33)
|
3.326 ( 0.560–19.76)
|
.186
|
Always
|
|
|
|
Washing of unpeeled fruits
|
Never
|
2.8(0.35–5.41)
|
0.299 ( .033- 2.681)
|
.281
|
Occasionally
|
3.42(0.36–8.7)
|
4.16 (0.512–16.71)
|
0.26
|
Some times
|
0.15(0.02–1.41)
|
0.13 ( 0.01–1.38)
|
0.091
|
Most of the time
|
0.35(0.042–2.85)
|
0.38 ( 0.04–3.53)
|
0.398
|
Always
|
|
|
|
Factors associated with low BAZ
In the bivariate analysis fruit eating frequency per week, milk consumption habit, and sickness in the past two weeks were associated with low BAZ or wasting. Finally in the multivariable analysis those who never consumed milk were more likely to be wasted than who consumed always, and sickness in the past two weeks is significantly associated with low BAZ (Table 6)
Table 6
Factors associated with wasting among School Age Children Aged 6–12 Years in Debre Tabor Town 6lementary Schools, South Gondar, Ethiopia
|
|
COR(95% CI)
|
AOR (95% C.I.)
|
P- value
|
Milk consumption habit
|
always
|
|
|
|
Most of the days
|
2.73(0.74–10.1)
|
2.39 ( 0.455–12.49)
|
.304
|
Some times
|
2.15(0.46(10.12
|
2.26 ( 0.35–14.47)
|
.391
|
never
|
6.06(1.35–8.55)
|
9.02 ( 1.56–51.98)
|
.014
|
Fruit eating pattern per week
|
never
|
|
|
.
|
once
|
0.44(0.045–4.43)
|
.591 ( .044–8.009)
|
.693
|
twice
|
(0.37-0.04-3.08)
|
.226 ( .023- 2.256)
|
.205
|
Three and above
|
0.19(0.24–2.10)
|
.213 ( .019- 2.443)
|
.214
|
Sickness in the past two weeks
|
yes
|
8.4(4.01–12.32)
|
6 .93( 4.12–10.06)
|
.000
|
No
|
|
|
|