title: Seasonal variation in nutritional status and anemia among lactating mothers in two agro-ecological zones of rural Ethiopia: A longitudinal study.
abstract: OBJECTIVE
  The aim of this study was to determine seasonal and agro-ecological variations in nutritional status, anemia, and associated factors among lactating women in rural Ethiopia.
  
  
  METHODS
  We conducted a longitudinal study with 216 mothers in pre- and postharvest seasons in two agro-ecological zones of rural Ethiopia. We conducted interviews using a structured questionnaire, anthropometric measurements, and blood tests for anemia. We used multivariable linear regression models to identify independent predictors.
  
  
  RESULTS
  The prevalence of anemia increased from postharvest (21.8%) to preharvest seasons (40.9%). Increases were from 8.6% to 34.4% in midland and from 34.2% to 46.3% in lowland agro-ecological zones. Of the mothers, 15% were anemic during both seasons. The prevalence of undernutrition, assessed using body mass index (BMI) < 18.5 kg/m(2), increased from 41.7% to 54.7% between the two seasons. Prevalence of maternal mid upper arm circumferences <22 cm also increased from 43.1% to 55.2% during the preharvest season. The seasonal effect was generally more pronounced in the midland community for all forms of malnutrition. Predictors of anemia were high parity of mother and low dietary diversity. Parity, number of children under the age of 5 y, and regional variation were predictors of low BMI among lactating mothers.
  
  
  CONCLUSIONS
  The magnitude of malnutrition and anemia was significantly influenced by variations in season and agro-ecological zones. Interventions focused on agro-ecology and seasonal variation should be considered in addition to current strategies to alleviate malnutrition in lactating mothers.
authors.affiliation: Haramaya University, College of Health and Medical Science, Harar, Ethiopia; School of Food and Nutritional Sciences, University College Cork, Cork, Ireland.
authors.forename: Kedir Teji
authors.initials: KT
authors.lastname: Roba
authors.affiliation: School of Food and Nutritional Sciences, University College Cork, Cork, Ireland.
authors.forename: Thomas P
authors.initials: TP
authors.lastname: O'Connor
authors.affiliation: Department of Population and Family Health, College of Public Health and Medical Sciences, Jimma University, Jimma, Ethiopia.
authors.forename: Tefera
authors.initials: T
authors.lastname: Belachew
authors.affiliation: School of Food and Nutritional Sciences, University College Cork, Cork, Ireland. Electronic address: Nob@ucc.ie.
authors.forename: Nora M
authors.initials: NM
authors.lastname: O'Brien
mesh_terms: D000328:Adult; D000740:Anemia / Q000453:epidemiology* / Q000503:physiopathology; D000886:Anthropometry; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D006801:Humans; D007774:Lactation; D016014:Linear Models; D008137:Longitudinal Studies; D009035:Mothers; D015999:Multivariate Analysis; D009752:Nutritional Status; D010298:Parity; D011247:Pregnancy; D015995:Prevalence; D012424:Rural Population; D012621:Seasons; D012959:Socioeconomic Factors
keywords: Anemia; BMI; Lowland; Midland; Postharvest; Preharvest