Food availability and access are strongly affected by seasonality in rural households in Ethiopia. However, relationships between household food insecurity indicators and dietary diversity and ...nutritional status of reproductive age mothers and their young children are unclear. A longitudinal study was conducted among 800 farming households in lowland and midland agro-ecological zones of rural Ethiopia in pre and post-harvest seasons. A structured interview, which included measures of three food access indicators − household food insecurity access scale (HFIAS), household dietary diversity score (HDDS) and household food consumption score (HFCS) − was conducted. Additionally, a subset of 183 households was selected for assessment of indicators of nutritional status including maternal and child dietary diversity and anthropometric measurements for children 6–23 months of age. Magnitudes of household food insecurity indices were high by international standards, particularly during the lean season (pre-harvest). Using correlation, Chi square and multivariable regression models, HFCS in both seasons was related to maternal body mass index and haemoglobin, and weight-for-length of their children. HDDS was associated in the post-harvest season with haemoglobin level of the mothers, and weight-for-length of their children. HFCS was a better predictor of nutritional status of mothers and children in both the food surplus and lean seasons, while HDDS was a better predictor of maternal and child nutritional status post-harvest. It is recommended that nutritional interventions should therefore focus on household food insecurity as well as targeting the individual nutritional status of mothers and children.
Neurological disorders are now the leading source of disability globally, and ageing is increasing the burden of neurodegenerative disorders, including Parkinson's disease. We aimed to determine the ...global burden of Parkinson's disease between 1990 and 2016 to identify trends and to enable appropriate public health, medical, and scientific responses.
Through a systematic analysis of epidemiological studies, we estimated global, regional, and country-specific prevalence and years of life lived with disability for Parkinson's disease from 1990 to 2016. We estimated the proportion of mild, moderate, and severe Parkinson's disease on the basis of studies that used the Hoehn and Yahr scale and assigned disability weights to each level. We jointly modelled prevalence and excess mortality risk in a natural history model to derive estimates of deaths due to Parkinson's disease. Death counts were multiplied by values from the Global Burden of Disease study's standard life expectancy to compute years of life lost. Disability-adjusted life-years (DALYs) were computed as the sum of years lived with disability and years of life lost. We also analysed results based on the Socio-demographic Index, a compound measure of income per capita, education, and fertility.
In 2016, 6·1 million (95% uncertainty interval UI 5·0–7·3) individuals had Parkinson's disease globally, compared with 2·5 million (2·0–3·0) in 1990. This increase was not solely due to increasing numbers of older people, because age-standardised prevalence rates increased by 21·7% (95% UI 18·1–25·3) over the same period (compared with an increase of 74·3%, 95% UI 69·2–79·6, for crude prevalence rates). Parkinson's disease caused 3·2 million (95% UI 2·6–4·0) DALYs and 211 296 deaths (95% UI 167 771–265 160) in 2016. The male-to-female ratios of age-standardised prevalence rates were similar in 2016 (1·40, 95% UI 1·36–1·43) and 1990 (1·37, 1·34–1·40). From 1990 to 2016, age-standardised prevalence, DALY rates, and death rates increased for all global burden of disease regions except for southern Latin America, eastern Europe, and Oceania. In addition, age-standardised DALY rates generally increased across the Socio-demographic Index.
Over the past generation, the global burden of Parkinson's disease has more than doubled as a result of increasing numbers of older people, with potential contributions from longer disease duration and environmental factors. Demographic and potentially other factors are poised to increase the future burden of Parkinson's disease substantially.
Bill & Melinda Gates Foundation.
Anemia is a common complication of diabetes mellitus, therefore having a major impact on the overall health and survival of diabetic patients. However, there is a paucity of evidence of anemia among ...diabetic patients in Ethiopia, particularly in Harari Region. Therefore, this study aimed to assess the magnitude of anemia and associated factors among Type 2 Diabetes Mellitus (T2DM) patients attending public hospitals in Harari Region, Eastern Ethiopia.
A hospital based cross-sectional study was conducted from February 25 to March 30, 2019. Probability proportion to size sampling, followed by simple random sampling, was utilized to select 374 T2DM patients. To collect the data, mixed methods were applied using questionnaires and checklist. Participants were tested for anemia based on World Health Organization (WHO) criteria. Data was double entered to EpiData version 3.1 and exported into Stata version 14.0 for statistical analysis. Bivariate and multivariate logistic regression models were fitted; Crude Odds Ratio (COR) and Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) were computed. Level of significance was declared at p-value less than 0.05.
The study revealed 34.8% of the participants were anemic (CI: 28.7, 40.9). Being male (AOR = 2.92, CI: 1.65, 5.17), physical inactivity (AOR = 2.58, CI: 1.50, 4.44), having nephropathy (AOR = 2.43, CI: 1.41, 4.21), poor glycemic control (AOR = 1.98, CI: 1.17, 3.34), recent history of blood loss (AOR = 4.41, CI: 1.26, 15.44) and duration of diabetes for five years and greater(AOR = 1.72, CI: 1.01, 2.96)were all significantly associated with anemia.
Anemia was a major health problem among T2DM patients in the study area. Therefore, routine screening of anemia for all T2DM patients aiding in early identification and improved management of diabetes will lead to improved quality of life in this patient population.
Introduction Dyslipidemia is a modifiable major risk factor for coronary heart disease. Although, the prevalence of dyslipidemia in high-income countries has been well documented, there is dearth of ...information about the dyslipidemia among working adults in sub-Saharan African countries including Ethiopia. Therefore, this study aimed to determine the magnitude of dyslipidemia and its associated factors among Haramaya University employees, in Eastern Ethiopia. Methods A cross-sectional study was conducted among 1,200 university employees aged 20 to 60 years. Study participants were selected using a simple random sampling method. Data were collected face-to-face interview using a semi-structured questionnaire. Dyslipidemia was defined as unhealthy levels of one or more lipid profile such as high-density lipoprotein, low-density lipoprotein, triglycerides or total cholesterol. Data were entered into Epidata version 3.1 and analyzed using STATA version 16.1 software. Modified Poisson regression with robust variance was used to estimate adjusted prevalence ratios (APR) with its 95% confidence intervals. Statistical significance was declared at P-value < 0.05. Results Of 1,164 participants, 59.6% participants had at least one lipid abnormality (i.e., 57.9% among men and 61.5% among women). Of which, 36.8% had high total cholesterol (TC), 21.6% had low high density lipoprotein cholesterol (HDL-c), 22.4% had high low density lipoprotein cholesterol (LDL-c), and 32.6% had high triglyceride (TG). We found that overweight/obesity, sedentary behavior, alcohol consumption, having hypertension and age 45 and above years were significant predictors of dyslipidemia. However, those who served fruit and vegetables more than five per day had significantly reduced prevalence ratio of dyslipidemia. Conclusions The high prevalent dyslipidemia among university employees is an important public health problem. Hence, tailored interventions to reduce overweight/obesity, hypertension, alcohol consumption and low fruit and vegetable intake have paramount importance to tackle dyslipidemia particularly among older age.
The outpatient therapeutic feeding program is one dimension of the Community Based Management of Acute Malnutrition (CMAM) that provides screening, diagnostic and treatment services for children with ...Severe Acute Malnutrition (SAM). However, little is known about the program outcomes and factors affecting time to recovery.
To determine median time of recovery and associated factors among under-five children with SAM treated at outpatient therapeutic feeding unit in Dire Dawa, Eastern Ethiopia from January 1st, 2013 to December 31st, 2016.
A facility-based retrospective cohort study supplemented with qualitative inquiry was conducted to analyze the records of 713 under-5 children with SAM that were randomly selected from four health centers and one hospital in Dire Dawa. In-depth interviews were conducted with five health professionals. Data was collected from the nutrition registration log book by using structured check lists. The collected data were entered into EPI-data version 3.1 software and exported to SPSS version 23 for analysis using Kaplan Meir and Cox proportional hazard regression.
The overall recovery rate was 569 (79.8%). Eighty (11.2%) defaulted, 27 (3.8%) were non-responders, 4 (0.6%) died and 15 (2.1%) were transferred-out. The median recovery time was 8.7 weeks (IQR: 5.0-14 weeks). Children with an admission weight of ≥7kg (AHR = 1.73, 95% CI: (1.41-2.14), children who were dewormed (AHR = 1.44, 95% CI: (1.01-2.06) and children with weight gain of ≥8g/kg/day (AHR = 5.76, 95% CI: (4.51-7.38) had higher probability of recovering faster. However, marasmic children stayed longer in treatment (AHR = 0.51, 95% CI: (0.37-0.71) and a low Plumpy Nut consumption rate (g/day) (AHR = 0.79) was associated with longer time of stay on treatment.
The recovery rate was within the level specified in the Sphere International standards which is >75%. A higher weight at admission, taking deworming and a steady weight gain were positively associated with a fast recovery time. Appropriate nutritional therapy and management of SAM as per the national protocol will be helpful to overcome lower weight gain and higher length of stay on treatment.
The disease burden and mortality related to Non-communicable Diseases (NCD) increased in the last couple of decades in Ethiopia. As a result, an estimated 300,000 deaths per annum were due to NCD. ...According to a World Health Organization report, 39% of the total deaths in Ethiopia were attributable to NCD. Rapid urbanization characterized by unhealthy lifestyles such as tobacco and/or alcohol use, physical inactivity, low fruits and vegetable consumption, and overweight drive the rising burden of NCD. However, studies on risk factors for NCD and associated variables are limited among working adults in Eastern Ethiopia. Therefore, this study aimed to examine the magnitude of the risk factors of NCD and associated factors among working adults in Eastern Ethiopia.
A cross-sectional study was carried out among 1,200 working adults in Eastern Ethiopia that were selected using a simple random sampling technique from December 2018 to February 2019. Data were collected following the World Health Organization Stepwise Approach to NCD Risk Factor Surveillance (WHO STEP) instruments translated into the local language. A total of five risk factors were included in the study. The Negative Binomial Regression Model was used to determine the association between NCD risk factor scores and other independent variables. Adjusted incidence rate ratio (AIRR) with a 95% Confidence Interval (CI) was used to report the findings while the association was declared significant at a p-value of less than 0.05. STATA version 16.1 was used for data clearing, validating and statistical analysis.
Totally, 1,164 (97% response rate) participants were employed for analysis. Overall, 95.8% (95% CI: 94.4-96.7%) of the participants had at least one of the five risk factors of NCD. Furthermore, the proportion of participants that had all NCD risk factors was 0.3%. Among the participants, 47.5% were alcohol drinkers, 5.1% were current smokers, 35.5% were overweight, 49.1% exercise low physical activity, and 95% had less than five portions of fruits and vegetables intake per day. Higher risk factor scores were associated with those of advanced age (AIRR = 1.24; 95% CI: 1.01-1.53 in 35-44 age group and AIRR = 1.28; 95% CI: 1.01-1.62 in 45-54 age group), and the ones who are higher educational level (AIRR = 1.23; 95% CI: 1.07-1.43 for those who have completed secondary school and AIRR = 1.29; 95% CI: 1.11-1.50 for those who have completed college education).
The overwhelming majority (95.8%) of the participants had at least one risk factor for non-communicable diseases. The risk score of non-communicable diseases was higher among those with advanced age and who completed secondary and above levels of education. In a nutshell, the finding shows the need for lifestyle modification and comprehensive non-communicable diseases prevention programs for working adults in Eastern Ethiopia.
Despite having a high fertility rate, low-resource countries are also home to couples with infertility problems. Although many couples are suffering from the psychological impacts of infertility, its ...level and determinants are not adequately known. The main objective of this study is to assess the prevalence and factors associated with infertility among couples in Ethiopia using the 2016 Ethiopian Demographic and Health Survey (EDHS) data. The study employed a cross-sectional study design extracting variables from the 2016 EDHS. The study included all married or cohabitating women aged 15 to 49 years in the Couples Recode (CR) file data set. Weighted samples of 6141 respondents were analyzed. We used Stata 14 software for analyzing the data. The association of selected independent variables with primary, secondary, and total infertility was analyzed using a logistic regression model. We presented the results using an adjusted odds ratio (AOR) with a 95% confidence interval (CI) and a p-value <0.05 as a cut-off point for declaring statistical significance. The prevalence of infertility in the past 12 months was 24.2% (95% CI: 23.1-25.3%), of which the majority (90.7%) was secondary infertility. Greater than 35 years of age (AOR = 2.45, 95% CI (1.58-3.79)), rural residence (AOR = 1.06, 95% CI (1.01-1.39)), smoking (AOR = 2.29, 95% CI (1.39-3.77)), and <18.5 Body Mass Index (BMI) (AOR = 1.71, 95% CI (1.43-2.04)) were significantly associated with infertility. Conversely, infertility was less likely among women with formal education and better wealth index. Primary infertility was significantly higher among women whose partners drink alcohol (AOR = 1.55; 95% CI 1.06-2.28)) and chew khat (AOR = 1.62; 95% CI (1.12-2.36)). Secondary infertility was significantly higher among women with 30 BMI (AOR = 1.54; 95% CI 1.01-2.35)), and <15 years of age at first birth (AOR = 1.40; 95% CI 1.15-1.69)). More than one in five couples in Ethiopia has an infertility problem. Both male and female-related factors are associated with infertility. Primary infertility was significantly higher among women whose partner chews khat and drinks alcohol. Secondary infertility was significantly associated with being underweight, obese, smoking, and young age at first birth. Hence, taking action on preventable factors is the most critical treatment approach and will improve the health status of the couples in other ways.
The coronavirus disease 2019 (COVID-19) has emerged as a global health and economic security threat with staggering cumulative incidence worldwide. Given the severity of projections, hospitals across ...the globe are creating additional critical care surge capacity and limiting patient routine access to care for other diseases like tuberculosis (TB). The outbreak fuels panic in sub-Saharan Africa where the healthcare system is fragile in withstanding the disease. Here, we looked over the COVID-19 containment measures in Ethiopia in context from reliable sources and put forth recommendations that leverage the health system response to COVID-19 and TB.
Ethiopia shares a major proportion of the global burden of infectious diseases, while the patterns of COVID-19 are still at an earlier stage of the epidemiology curve. The Ethiopian government exerted tremendous efforts to curb the disease. It limited public gatherings, ordered school closures, directed high-risk civil servants to work from home, and closed borders. It suspended flights to 120 countries and restricted mass transports. It declared a five-month national state of emergency and granted a pardon for 20 402 prisoners. It officially postponed parliamentary and presidential elections. It launched the 'PM Abiy-Jack Ma initiative', which supports African countries with COVID-19 diagnostics and infection prevention and control commodities. It expanded its COVID-19 testing capacity to 38 countrywide laboratories. Many institutions are made available to provide clinical care and quarantine. However, the outbreak still has the potential for greater loss of life in Ethiopia if the community is unable to shape the regular behavioral and sociocultural norms that would facilitate the spread of the disease. The government needs to keep cautious that irregular migrants would fuel the disease. A robust testing capacity is needed to figure out the actual status of the disease. The pandemic has reduced TB care and research activities significantly and these need due attention.
Ethiopia took several steps to detect, manage, and control COVID-19. More efforts are needed to increase testing capacity and bring about behavioral changes in the community. The country needs to put in place alternative options to mitigate interruptions of essential healthcare services and scientific researches of significant impact.
ObjectiveInvestigate the association between the dietary diversity of preschool children and proximate factors including household food insecurity, maternal food choice, preferences, khat use, and ...levels of depressive symptoms.DesignCross-sectional survey of randomly selected households.SettingHaramaya Health and Demographic Surveillance site in Eastern Ethiopia, predominantly smallholder farming households.Participants678 preschool children (24–59 months) and their mothers.MethodsThe key outcome, the adequacy of dietary diversity of preschool children, was calculated using a 24-hour parental dietary recall. Binary logistic regression was then used to identify maternal and household factors associated with dietary adequacy versus inadequacy.ResultsThe majority (80.53%) of surveyed children had low dietary diversity (mean Dietary Diversity (MDD)) score of 3.06±1.70 on a 7-point scale). Approximately 80% of households exhibited food insecurity. Households with greater food security (adjusted OR (AOR)=1.96, 95% CI 1.19 to 3.23), healthier maternal food choice (AOR=2.19, 95% CI 1.12 to 4.31) and broader maternal food preferences (AOR=4.95, 95% CI 1.11 to 21.95) were all associated with higher dietary diversity of their preschool children (p≤0.05). Other covariates associated with adequate child dietary diversity included improved household drinking water sources (AOR=1.84, 95% CI 1.16 to 2.92) and family planning use (AOR=1.69, 95% CI 1.00 to 2.86). Despite predictions, however, maternal depression and khat consumption were not identified as factors.ConclusionsThe dietary diversity of preschool children is extremely low—a pattern observed in both food-secure and food-insecure households. Key factors include maternal selection of food for convenience and ease, preferences that do not include animal protein or healthier food choices, and lack of access to improved drinking water sources. Interventions around maternal food choice and preferences could improve preschool children’s nutritional health.
Background:
One of the primary reasons for an increase in cesarean sections is obstetricians’ uncertainty about labor trial safety following a previous cesarean section. The success rate of vaginal ...birth after cesarean section with a single cesarean scar is greater than 50%. However, to the best of our knowledge, there is a scarcity of information on the determinants of vaginal birth after cesarean delivery in the study area. As a result, the purpose of this study was to identify predictors of successful vaginal birth after cesarean delivery in public hospitals in Eastern Ethiopia.
Methods:
A nested case–control study design was used within a prospective follow-up study conducted from June to October 2020. A total of 220 women who tried vaginal birth after cesarean delivery was included, 110 cases and 110 controls. Cases were women with one previous cesarean section scar and successfully proceed with vaginal delivery. The controls were those with an earlier cesarean section scar and delivered by emergency cesarean section after trial of labor. A pre-tested structured questionnaire was used to gather the information. Multiple logistic regression is used to identify the determinants for the success of vaginal birth after cesarean section; odds ratio with its 95% CI are used to report the findings.
Results:
We found that living in rural areas (AOR = 2.28; 95% CI (1.85, 12.41)), having a current antenatal care follow-up (AOR = 3.20; 95% CI (1.15, 8.87)) and partograph monitoring of labor (AOR = 4.26; 95% CI (1.90, 9.57)) had a positive association with successful vaginal birth after cesarean section. In contrast, the presence of meconium-stained amniotic liquor (AOR = 0.10; 95% CI (0.01, 0.75)) and history of stillbirth (AOR = 0.07; 95% CI (0.02, 0.53)) reducing the chance of success of the trial.
Conclusion:
Past obstetric history, such as stillbirth, history of labor trial after primary cesarean section, and prior vaginal birth, were significant predictors for achieving vaginal birth after cesarean section. Antenatal care visit, and partograph follow-up were the current obstetric characteristics positively associated with the trial of labor.
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