Age In Ethiopia Research Articles

Spatial variation and determinants of skilled birth attendant delivery among women of reproductive age in Ethiopia: a spatial and multilevel analysis

BackgroundDelivery assisted by skilled birth attendants is essential for maternal and newborn health because most maternal and infant deaths occur during childbirth. Ethiopia continues to use skilled birth care services that are far below acceptable standards. There are also regional variations in skilled birth attendant delivery services in the country. Therefore, this study explored the spatial distribution and factors associated with the use of skilled birth attendants in Ethiopia based on nationally representative EMDHS 2019 data.MethodsThis study included a weighted sample of 5,527 women who had given birth within the 5 years prior to the survey year. ArcGIS version 10.7 was used to visualize the geographic variations, and Kulldorff’s SaTScan version 9.6 was used to identify significant purely spatial clusters. A multilevel mixed-effects logistic regression model was fitted to identify determinant factors of skilled birth attendant delivery using STATA 17.ResultsThe number of women who delivered with the assistance of skilled birth attendants was 2,740 (49.6%) and distributed non-randomly across the regions of the country. Low clustering of skilled birth attendant delivery was detected in the Afar, Amhara, Benshangul-Gumuz, Gambela, Oromia, and Somali regions, whereas high clustering was detected in the Addis Ababa, Dire Dawa, and Harari regions. Maternal education level, parity, wealth index, region, place of residence, and community poverty level were significant predictors of skilled birth attendant delivery.Conclusion and recommendationSkilled birth-assisted delivery remains below national and international acceptable standards and is associated with geographic variation across the country. If it continues at the current pace, it will be difficult to achieve national and international targets. Therefore, a geographic-specific intervention should be launched by the government and respective local administrators, supported by local research in regions with low-skilled birth attendant delivery, to tackle individual and aggregate community-level determinants.

Prevalence of and factors associated with formula feeding among mothers with infants 0-6 months of age in Ethiopia: a systematic review and meta-analysis.

Inconsistent results have been reported regarding the prevalence of and factors associated with formula feeding in Ethiopia. This study aimed to determine the pooled prevalence of and factors associated with formula feeding among mothers with infants 0-6 months of age in Ethiopia. A comprehensive systematic search was conducted across 3 databases (PubMed, EMBASE, and ScienceDirect) and the Google Scholar search engine to identify relevant studies published up to April 2, 2024. After assessing the quality of each study using the Joanna Briggs Institute Critical Appraisal Checklist for Prevalence Studies, data were independently extracted by 2 authors using pre-designed forms in an Excel spreadsheet. Any disagreements were resolved through discussion and consultation with additional authors. Statistical heterogeneity across studies was assessed using the I2 statistic. A random-effects meta-analysis was used to pool the proportions, due to high heterogeneity, while a fixed-effect meta-analysis was used to pool associated factors with low heterogeneity. A sensitivity analysis was performed to assess the potential impact of outlier studies on the overall estimates. Five studies, with a combined sample size of 2344 participants, were included. The pooled prevalence of formula feeding was 34.0% (95% CI: 23.0%, 44.0%). Factors significantly associated with formula feeding included cesarean delivery (POR [pooled odds ratio] = 4.72, 95% CI: 3.32, 6.71) compared with vaginal delivery, a positive attitude toward formula feeding (POR = 2.26, 95% CI: 1.45, 3.53) compared with a negative attitude, initiation of breastfeeding more than 1 hour after delivery (POR = 2.27, 95% CI: 1.25, 4.13) compared with initiation within 1 hour, and receiving information about formula feeding from friends or family (POR = 2.47, 95% CI: 1.46, 4.20) compared with receiving information from health-care professionals. The prevalence of formula feeding in Ethiopia is significant. Cesarean delivery, a positive attitude toward formula feeding, late initiation of breastfeeding, and receiving formula feeding-related information from friends and family were positively associated with formula feeding. Given these findings, the authors recommend that public health interventions in Ethiopia target these key determinants to decrease the high prevalence of formula feeding practices observed in the country. Strategies addressing factors such as promoting vaginal delivery, improving attitudes toward breastfeeding, encouraging early breastfeeding initiation, and limiting the influence of social networks on formula-feeding decisions may be beneficial.

Further analysis of determinants of Pentavalent and Measles immunizations dropouts among children under five years of age in Ethiopia from Mini-EDHS 2019

BackgroundGlobally, immunization prevents an estimated 2–3 million deaths from illnesses that can be prevented by vaccination. The predictors of Pentavalent and Measles immunization dropout were not investigated sufficiently. Therefore, this analysis was meant to determine the coverage, burden, and predictors of Pentavalent and Measles immunizations in Ethiopia.Materials and methodsThis study was a further analysis of the Mini Ethiopian Demographic Health Survey (EDHS) 2019, conducted with a nationally representative sample. In this study, immunization data was collected from a total sample of 3208 children of which 2004 (34.8%) children who received pentavalent 1 were considered for this study. Univariable, bi-variable, and multilevel mixed effect analysis was done using STATA version 17 Software. The mixed-effect model with the lowest AIC and BIC (information criteria) was chosen. A factor was designated as a significant predictor of immunization dropout if its p-value was less than 0.05 at 95% CI. The best-fitting model among the fitted models was ultimately chosen using the Akaike and Bayesian Information Criteria (AIC and BIC).ResultThe mean age of the head of the household was 37.6. The majority (68.9%) of the residents were from rural areas and of the total population, 64.9% have no formal education. Being residents of Afar increased the odds of dropping out by 3.28 (AOR = 3.28; 95% CI: 1.12, 9.56), whereas being residents of Addis Ababa reduced their odds of dropping out from prentavalent 3 by 68.1% (AOR = 0.319; 95% CI: 0.122, 0.833) compared to their Tigray counterparts. The dropout rate of Pentavalent 1 to measles 1 vaccination was 4.33 times higher among residents of Afar (AOR = 4.33; 95% CI: 1.38, 13.56). As the level of wealth increases, the quintile increases from poorer to richer compared to those in the poorest wealth quantile category, and marital status also affects the immunization dropout rate of their children.ConclusionsImmunization coverage of Ethiopian children was low and the dropout from pentavalent 1 and measles vaccination was high compared to the national and international targets to improve immunization coverage and reduce dropout. So different cost-effective interventions like Education provision for the community, decision-making facilitation, behavioral change support, and multi-system participation were required to increase vaccination coverage and reduce the vaccine dropout among children in Ethiopia.

Acceptability and factors associated with the community nutrition service for children under two years of age by mothers in the Degadamot district, west Gojjam, Ethiopia, 2023

BackgroundMalnutrition accounts for 45 percent of children under five years of age in Ethiopia and is a more common problem in rural communities. In this regard, Ethiopia has implemented the Community Based Neutrition (CBN) program at the community level to improve the nutritional status of children. Despite this, malnutrition still causes a significant rate of child morbidity and mortality. The status of the implementation of the CBN program is unknown. MethodsA single case study design was employed from March 28 to April 28, 2023. A total of 407 systematically selected mothers for exit interviews participated in the study. The data was entered into Epi-Inf version 7 and exported to STATA version 17 for analysis. Multivariate logistic regression was performed to determine the factors associated with the acceptability of mothers. Findings were presented using descriptions, tables, and graphs. ResultsAccording to the predetermined judgment parameter, the acceptability of CBN services by mothers (66.6 %). Rural residence 0.28 (AOR = 0.28, 95 % CI 0.106, 0.754), merchant 0.11 (AOR = 0.11, 95 % CI 0.036, 0.47), primary 2.5 (AOR = 2.53, 95 % CI 1.09, 5.85), secondary 3.29 (AOR = 3.29, 95 % CI 1.03, 8.43), and higher education 1.46 (AOR = 1.46, 95 % CI 1.09, 4.05) were significantly associated with acceptability. ConclusionsThe general acceptability of the mother to community nutrition services was measured fairly according to the predetermined judgment parameter. Educating mothers is an important factor in increasing service acceptability.

Incidence and risk factors of common infections among children in Wonago, southern Ethiopia: a prospective cohort study

ObjectiveThere are limited data in Ethiopia on common childhood illnesses. We aimed to measure the incidence and risk factors of common childhood illnesses in rural parts of southern Ethiopia.DesignA community-based...

Wealth disparities in maternal health service utilization among women of reproductive age in Ethiopia: findings from the mini-EDHS 2019

BackgroundEthiopia has made strides in reducing maternal mortality, but significant discrepancies in maternal health service utilization exist across socioeconomic levels. According to studies, women from higher-income households are far more likely to use essential services such as antenatal care, delivery care, and postnatal care than poorer women. This wealth disparity is a primary contributor to persistently high maternal mortality, particularly among poor populations. The study’s goal was to assess wealth disparities in maternal health service uptake and identify contributing factors.Methods and materialsWe used the Ethiopian Mini Demographic Health Survey (EMDHS), conducted in 2019 on women aged 15–49 living in selected census areas, with a weighted sample size of 3,909. The Erreygers Concentration Index (ECI) was used to measure wealth inequalities in maternal health care, and the ECI decomposition was used to identify factors contributing to inequality in maternal health services.ResultsMaternal health service utilization was pro-rich among women in Ethiopia. The prevalence of antenatal care service (ANC), delivery, and postnatal care (PNC) service utilization showed a pro-rich distribution among Ethiopian women, with ECI = 0.115 (95% CI: 0.091–0.137), ECI = 0.223 (95% CI: 0.191–0.276), and ECI = 0.121 (95% CI: 0.041-0.200), respectively. The ECI indices were decomposed to examine the contributing factors to disparities in maternal service utilization in Ethiopia. Mother’s current age, household family size, region, birth order, and parity were contributors to maternal health service utilization.ConclusionThe ANC service, delivery service and PNC service utilization showed a pro-rich distribution among Ethiopian women. Mother’s current age, household family size, region, birth order, and parity are important contributors of maternal health service inequality. To improve access and usage among low-income women, policymakers can develop programs including increasing the number of free or subsidized services and providing transportation.

Gut microbiota patterns associated with duration of diarrhea in children under five years of age in Ethiopia

Diarrhea claims >500,000 lives annually among children under five years of age in low- and middle-income countries. Mortality due to acute diarrhea (<7 days’ duration) is decreasing, but prolonged (7-13 days) and persistent (≥14 days of duration) diarrhea remains a massive challenge. Here, we use a case-control study to decipher if fecal gut microbiota compositional differences between Ethiopian children with acute (n=554) or prolonged/persistent (n=95) diarrhea and frequency-matched non-diarrheal controls (n=663) are linked to diarrheal etiology. We show that diarrhea cases are associated with lower bacterial diversity and enriched in Escherichia spp., Campylobacter spp., and Streptococcus spp. Further, diarrhea cases are depleted in gut commensals such as Prevotella copri, Faecalibacterium prausnitzii, and Dialister succinatiphilus, with depletion being most pronounced in prolonged/persistent cases, suggesting that prolonged duration of diarrhea is accompanied by depletion of gut commensals and that re-establishing these via e.g., microbiota-directed food supplements offer a potential treatment strategy.

Spatial distribution and determinants of exclusive breastfeeding practice among mothers of children under 24 months of age in Ethiopia: spatial and multilevel analysis

BackgroundBreast milk is the first, highly valuable, and solely natural food recommended for infants in their first six months of life, which is critical for children's overall growth and development. Evidence suggests that exclusive breastfeeding differs by geographic area in Ethiopia. However, little is known regarding the geographic distribution of exclusive breastfeeding practice. Hence, this study aimed to assess exclusive breastfeeding practice, its geographic variation and associated factors among Ethiopian mothers.MethodThe study used the 2019 Ethiopian mini demographic and health survey data. All living children born 0–23 months before the survey were included. Global Moran’s I statistics on Arc-GIS and Getis Ord Gi* statistics was used to visualize the spatial pattern and hotspot and cold spot areas, respectively. Kulldorff SaTScan was used to show purely significant spatial clusters. The associated factors were identified using a multilevel mixed-effects logistic regression model. Statistically significant factors were reported using the AOR with a 95% CI and a p-value of < 5%.ResultThe coverage of exclusive breastfeeding practice in Ethiopia was 56.05% (95% CI: 53.95%, 58.10%). The spatial pattern was non-random across the country’s regions. Somalia, Gambela, Benshangul Gumuz, Dire Dawa, and Harari regions had low clustering of exclusive breastfeeding practices, whereas Amhara, Eastern SNNPR, and Central and Northern Oromia regions had high clustering. Children born through caesarean delivery [AOR = 0.36; 95% CI: 0.21, 0.63], initiated breastfeeding within the first 1 h [AOR = 0.55; 95% CI: 0.34, 0.90], after 1–24 h of delivery [AOR = 0.36; 95% CI: 0.24, 0.54], after a day [AOR = 0.04; 95% CI: 0.02, 0.08], and women residing in the pastoralist region [AOR = 0.22; 95% CI: 0.12, 0.39] or city administrations [AOR = 0.49; 95% CI: 0.27, 0.89] had lower odds of exclusive breastfeeding practice.ConclusionExclusive breastfeeding practice in Ethiopia remained low. The practice had a spatial variation across the country. Caesarean section delivery, late breastfeeding initiation, and region were statistically significant variables. Therefore, promoting timely initiation of breastfeeding and improving the utilization of maternal health services and designing special intervention strategy for women residing in city administrations and pastoralist regions of the country may increase the coverage of exclusive breastfeeding practice.

Growth monitoring and promotion service utilization and its associated factors among mothers of children under two years in Ethiopia: a systematic review and meta-analysis

BackgroundGrowth monitoring and promotion (GMP) is a nutritional intervention designed to identify and address growth faltering before a child’s nutritional status deteriorates into severe malnutrition. Despite GMP being recognized as a priority in Ethiopia’s national nutrition program, there is no national aggregated figure to show the extent of GMP service utilization. Therefore, this systematic review and meta-analysis aimed to assess GMP service utilization and associated factors in Ethiopia.MethodsA systematic literature search was conducted using PubMed/MEDLINE, CINAHL, Hinari, EMBASE, Scopus, and grey literature sources like Google Scholar, WorldCat, and Institutional repository. The Joanna Briggs Institution (JBI) quality assessment tool was used to appraise the quality of the articles, and articles scoring > 50% were included in the analysis. The pooled prevalence and odds ratio of associated factors with 95%CI was computed using STATA version 16. A random-effect model was employed to estimate the effect size, and I-squared statistics and Egger’s test were used to assess heterogeneity and identify potential publication bias, respectively. Subgroup analysis was conducted with publication year, sample size, and region to identify the source of heterogeneity.ResultsNine studies with 4,768 study participants were included in this meta-analysis. The overall pooled utilization of GMP service among children under two years of age in Ethiopia was 23.21% (95% CI: 16.02, 30.41, I2 = 97.27% & P = 0.0001). Mothers who received counselling on GMP service (OR = 3.16 (95%CI: 2.49-4.00), parents who use family health card (FHC) (OR = 3.29 (95%CI: 1.49–7.28), and mother who use postnatal care (OR = 3.93 (95%CI: 2.40–6.42), and Anti natal care (OR = 3.15 (95%CI: 1.29–7.69) were the factors associated with GMP service utilization among children under two years of age.ConclusionsThe utilization of GMP services among children under the age of two in Ethiopia remains inadequate. Therefore, it is crucial to provide health education and counselling focusing on GMP to the mothers/caregivers of the child and encourage utilization of FHC. In addition, integrating GMP with other maternal health services should be promoted.

Protocol for a systematic review and meta-analysis on intention to screen for cervical cancer and predictors among women of reproductive age in Ethiopia

IntroductionThe incidence and fatality rates associated with cervical cancer are continuously decreased by cervical cancer screening. However, in underdeveloped nations such as Ethiopia, very few women have undergone cervical cancer...

Trends, spatiotemporal variation and decomposition analysis of pregnancy termination among women of reproductive age in Ethiopia: Evidence from the Ethiopian demographic and health survey, from 2000 to 2016

BackgroundPregnancy termination is a major public health problem, and complications of unsafe abortion are among the proximate and major causes of maternal mortality. Mapping the trend and spatiotemporal variation and identifying factors that are responsible for the changes in pregnancy termination help achieve the sustainable development goal of reducing maternal mortality in Ethiopia by understanding the epidemiology and regional variations. MethodsData from the 2000–2016 Ethiopian Demographic and Health Survey were analyzed with a total weighted sample of 40,983 women of reproductive age. Variables with a p-value <0.05 in a logit multivariable decomposition analysis were considered significant predictors of the decline in pregnancy termination over time. Spatial analysis was used separately for each survey to show the changes in regional disparities in pregnancy termination in Ethiopia. ResultsThe magnitude of pregnancy termination among women of reproductive age decreased by 39.5 %, from 17.7 % in 2000 to 10.7 % in 2016. The difference in the effects of literacy, working status, marital status, age at first intercourse, age at first cohabitation, knowledge about contraceptives, and knowledge of the ovulatory cycle were the significant predictors that contributed to the change in pregnancy termination over time. Significant clusters of pregnancy terminations were observed in central and northern Ethiopia (Addis Ababa, eastern Amhara, and Tigray regions). ConclusionsDespite the substantial decrease in terminated pregnancies over time in Ethiopia, the magnitude is still high. The government should focus on promoting education for girls and women, providing reproductive health education, including access to contraceptives, and raising the minimum age for girls to engage in sexual activities or marriage by implementing policies.

Spatial variation and determinants of traditional birth attendants utilization among women of reproductive age in Ethiopia: Spatial and multilevel analysis study.

Traditional birth attendant utilization has become a common malpractice and a leading cause of maternal morbidity and mortality in the developing world, such as Ethiopia. Therefore, this study was aimed at determining the geospatial variation and determinant factors of traditional birth attendant utilization among mothers of reproductive age in Ethiopia. The data were taken from the 2019 Ethiopian Demographic and Health Survey. Arc GIS, Excel, and STATA-14 software were used for the data analysis. The adjusted odds ratio with a 95% confidence interval was used to declare significant determinants of traditional birth attendance among mothers of reproductive age in Ethiopia. Among 5,753 mothers of reproductive age, 34.59% of them utilized traditional birth attendants in Ethiopia during the 2019 Ethiopian Demographic and Health Survey. There was a geospatial variation of traditional birth attendants among mothers of reproductive age in Ethiopia; the Global Moran's index value was 0.39 with a p-value <0.001. The significant factors associated with traditional birth attendant utilization were the age of mothers; higher odds were observed among older mothers aged 35-49 years (AOR = 1.31; 95% CI (1.04-1.63)); educational level of mothers (AOR = 3.04; 95% CI (2.13-4.33)); higher odds were observed in uneducated mothers, wealth index (AOR = 2.76; 95% CI (1.83-4.19)); higher odds were observed among the poorer and poorest households, place of residence (AOR = 5.69; 95% CI (3.35-9.67)); and the regions; the highest odds were observed in Somali (AOR = 12.1; 95% CI (4.99-25.68)) and Afar (AOR = 7.13; 95% CI (2.37-21.38)). The utilization of traditional birth attendants among reproductive-age mothers became a major public health concern, and the distribution showed geo-spatial variations among the regions of the country. We recommend taking appropriate measures to alleviate the current problem by improving access to maternal healthcare services.

Mortality of neonates born to mothers of extreme reproductive age in Ethiopia; multilevel mixed effect analysis of Ethiopian demographic and health survey data of 2016.

Neonatal mortality is still a major public health problem in middle- and low-income countries like Ethiopia. Despite strategies and efforts made to reduce neonatal death, the mortality rate declines at a slower pace in the country. Though there are studies conducted on neonatal mortality and its determinants, our searches of the literature have found no study on the extent of mortality of neonates born to mothers of extreme reproductive age in the study area. Therefore, this study aimed to assess the magnitude and factors associated with the mortality of neonates born to mothers of extreme reproductive age in Ethiopia. Secondary data analysis was conducted using 2016 Ethiopian Demographic and Health Survey data. The final study contained an overall weighted sample of 2,269 live births. To determine the significant factors in newborn deaths, a multilevel binary logistic regression was fitted. For measuring the clustering impact, the intra-cluster correlation coefficient, median odds ratio, proportional change in variance, and deviation were employed for model comparison. The adjusted odds ratio with a 95% confidence interval was presented in the multivariable multilevel logistic regression analysis to identify statistically significant factors in neonatal mortality. A P-value of less than 0.05 was declared statistically significant. The neonatal mortality rate of babies born to extreme aged reproductive women in Ethiopia was 34 (95% Cl, 22.2%-42.23%) per 1,000 live birth. Being twin pregnancy (AOR = 10; 95% Cl: 8.61-20.21), being from pastoralist region (AOR = 3.9; 95% Cl: 1.71-8.09), having larger baby size (AOR = 2.93; 95% Cl: 1.4-9.12) increase the odds of neonatal mortality. On the other hand, individual level media exposure (AOR = 0.3; 95% Cl: 0.09-0.91) and community level media exposure (AOR = 0.24; 95% Cl: 0.07-0.83), being term gestation (AOR = 0.14; 95% Cl: 0.01-0.81) decreases the odds of neonatal mortality born to mothers of extreme reproductive age. Ethiopia had a greater rate of neonatal death among babies born at the extremes of reproductive age than overall reproductive life. Multiple pregnancies, larger baby sizes, emerging regions, term gestation, and media exposure were found to be significant factors associated with the mortality of neonates born to mothers of extreme reproductive age. Therefore, the concerned bodies should give emphasis to mothers giving birth before the age of 20 and above 35, access to media, healthy pregnancy, and special attention to pastoralists to reduce the burden of neonatal mortality.

Pregnancy and associated factors among teenage females in Hula District, Sidama region, Ethiopia: a community-based cross-sectional study.

Teenage pregnancy causes serious health, social, and economic consequences, with 95% occurring in developing countries. A significant number of girls start childbearing at an early age in Ethiopia, which contributes to high infant and maternal morbidity and mortality. However, the information on teenage pregnancy and related variables is limited in the study area. To assess the prevalence of teenage pregnancy and its associated factors among teenage females in the Hula District, Sidama, Ethiopia. A community-based cross-sectional study was employed among 518 teenagers, randomly selected between 15 February and 15 March 2023. An interviewer-administered questionnaire was used for data collection. Bivariate and multivariate logistic regression analyses were applied to assess the relationship under study. Living in rural areas compared to urban [adjusted odds ratio (AOR) = 3.90; 95% confidence interval (CI): 1.30-11.3], lack of awareness about family planning methods (AOR = 5.90; 95% CI: 1.60-22.24), unfamiliarity with the availability of family planning services (AOR = 3.20; 95% CI: 1.08-9.24), and inadequate communication about sexual issues with parents (AOR = 3.61; 95% CI: 1.14-11.56) were independently associated with teenage pregnancy. The prevalence of teenage pregnancies in the Hula District was high. Factors such as residing in rural areas, limited access to information on family planning methods and services, as well as a lack of open discussions about sexual health were associated with teenage pregnancy.

Prevalence of anemia and its associated factors among children aged 6–23 months, in Ethiopia: a systematic review and meta analysis

IntroductionDespite several strategies exist for anemia prevention and control, it has been the major public health important problem in the world. Numerous immediate and long-term health issues were reported in children who have history of anemia including decreased work productivity in adult hood period. Although analyzing data on burden and risk factors of anemia are the recommended action areas of World Health Organization framework for accelerating anemia reduction, the aggregated national burden and contributors of anemia in Ethiopia has not been determined so far. There for, this systematic and meta-analysis study is aimed to assess the pooled prevalence and associated factors of anemia among children aged 6–23 months in Ethiopia.MethodsThe electronic databases including PubMed, Scopus, EMBASE, Web of Science, Science Direct, Google scholar and institutional repositories were searched using search terms. The studies that reported the prevalence and/or risk factors of anemia in children 6–23 months of age were included. The JBI quality assessment tool was used to evaluate the quality of each study. The data was extracted with Microsoft Excel, 2019 and analyzed with STATA 17.0 statistical software. A random effect model was used to estimate the pooled prevalence of anemia and its associated factors. The Cochrane Q-test statistics and I2 test were used to measure heterogeneity between the included studies. Furthermore, publication bias was examined using the funnel plot graph and statistical tests (Egger’s and begg tests). Outliers also visualized using Galbraith plot. When necessary, sensitivity analysis was also employed to detect small study effect.ResultTen studies with a total population of 14, 733 were included for analysis. The pooled prevalence of anemia among children aged 6–23 months of age in Ethiopia was found to be 57.76% (95%CI; 51.61–63.91; I2 = 97.192%; p < 0.001). Having history of diarrhea AOR = 2.44 (95%CI: 1.03–3.85), being stunted AOR = 2.00 (95%CI: 1.38–2.61), living in food insecure house hold AOR = 2.08 (95%CI: 1.10–3.07), consuming less diversified food AOR = 2.73 (95%CI: 2.06–3.39) and being 6–11 months of age AOR = 1.59 (95%CI: 1.23–1.95) were associated with anemia.Conclusion and recommendationThe prevalence of anemia is in the range of severe public health problem among children aged 6–23 months in Ethiopia. Diarrhea, stunting, house hold food insecurity, dietary diversity, and age were the predictors of anemia. Further, prospective cohort and random controlled trial studies are recommended. Further, random controlled trial especially effectiveness of nutritional education interventions trial is important. To reduce prevalence of anemia, strengthening diarrhea reduction program, securing household food insecurity, preventing stunting, giving special attention for infants age 6–11 months and encouraging food diversification are important.

Factors affecting utilization of modern contraceptive methods among women of reproductive age in Ethiopia.

Modern contraceptive use is important for improving health and socioeconomic outcomes, but Ethiopia is among the lowest-using countries. Therefore, this study aimed to determine factors affecting modern contraceptive use among women of reproductive age in Ethiopia. This population-based cross-sectional study used data obtained from the 2019 Ethiopia Mini Demographic and Health Survey (EMDHS). A total of 8,885 reproductive-age women were included in the analysis. A weighted generalized estimating equation approach was used to account for the clustering and weighting effects in the assessment of associations between modern contraceptive usage and socioeconomic and demographic variables. Modern contraceptive use among women of reproductive age in Ethiopia is low (28%). Prevalence is highest among women aged 25-34 (40.11%), with higher education (30.97%), who are Orthodox Christians (31.67%), married (40.40%), middle wealth index (31.70%), female-headed households (31.42%), with 1-3 living children (44.85%), who headed by under 31 years old (40.07%), and in the Amhara region (34.45%). In the generalized estimating equation analysis, women aged 35-44 and over 45, Muslims, households heads aged 41-50 and over 50, and in female-headed households were less likely to use modern contraceptives, while women with primary, secondary, and higher education, married, middle and rich wealth index, and with 1-3 and more living children were more likely to use modern contraceptive than their counterparts (reference group) and were statistically significant. Modern contraceptive use is notably low among women of reproductive age in Ethiopia. Factors such as age, women's educational level, religion, marital status, number of living children, wealth status, gender and age of household head, and region were identified as significant factors associated with modern contraceptive use. Therefore, to increase modern contraceptive use, governmental and non-governmental organizations should invest in women's education and financial empowerment and raise awareness about the benefits of modern contraceptives, especially among older, unmarried, financially poor, elderly-led households, with few living children, and uneducated women.

Epidemiological profiles and causes of sudden deaths of various ages in Ethiopia: an autopsy-based study

Background Sudden death is an important global public health issue. An autopsy is an important source of epidemiological data, as the considerable causes of sudden death remain hermetic until postmortem examination. This study is devoted to evaluating the sociodemographic, behavioral, clinical and pathological characteristics of sudden deaths of various ages in Ethiopia. Methods This is an observational, prospective, descriptive study that included all sudden deaths observed over 1 year at St. Paul’s Hospital and Millennium Medical College, Addis Ababa, Ethiopia. Results Sudden death (n = 568) accounted for 11.5% of all autopsied cases. There were 482 males and 86 females (M:F ratio of 5.6:1) and a mean age of 44.81±17.349. The peak age group was the fourth and fifth decades, accounting for 43.9% of the cases. Chronic substance abuse and a history of prior illness were declared in 40.1% and 38% of victims of sudden death, respectively. Cardiovascular (36.1%), respiratory (32.6%), and gastrointestinal system (19.5%) pathologies were the most common causes. The leading underlying causes of sudden death were ischemic heart disease and pneumonia. Most (86.6%) sudden deaths occurred outside of a hospital setting. Conclusions Most of the causes of sudden death in Ethiopia can be prevented and treated. The majority of sudden deaths are silent without preexisting symptoms. Therefore, it is vital to develop public health measures that will help educate the community about the importance of recognizing the manifestation of various clinical conditions and the need to seek immediate clinical help. Furthermore, efforts should be made to make healthcare facilities accessible and affordable with adequate diagnostic and management capacity. Documentation of autopsy-based data could provide important epidemiological information to guide medical services, prevention efforts, and control measures.

Pulmonary tuberculosis case notification and burden of drug resistance among children under 15 years of age in Ethiopia: sub-analysis from third-round drug resistance tuberculosis survey

IntroductionData on the burden of bacteriologically confirmed childhood Tuberculosis (PTB) and drug-resistant TB in Ethiopia is limited due to difficulties related to its diagnosis in this population. Therefore, this study aimed to assess bacteriologically confirmed childhood PTB Case Notification Rates (CNRs) and the burden of Drug Resistant-Tuberculosis among children in Ethiopia.MethodRetrospective secondary clinical and laboratory data were obtained from 3rd round national DR-TB survey which was conducted between August 2017 and January 2019. We used IBM SPSS 24 for sub-analysis of 3rd round Drug Resistant-Tuberculosis data. Descriptive statistics were used in computing the association between the sociodemographic characteristics and PTB CNRs, and the strength of the associations was determined using binary logistic regression with Odds ratios (OR) with a 95% confidence interval (CI).ResultOverall, 102 bacteriologically confirmed childhood PTB cases were identified with a median age of 12 (range 1–14) years. Of these, 54 (52.9%) were females and 81 (79.4%) lived in rural areas. HIV-TB co-infection cases were 5/102 (4.3%) and the majority (98%) of cases were newly diagnosed children. Nationally, the incidence of bacteriologically confirmed childhood PTB was calculated to be 5.1 per 100,000 children. The burden of Drug Resistant-Tuberculosis to at least one of the five first-line anti-TB drugs tested was five (6.5%) cases and one (1.3%) was found to be a Multi-drug resistant tuberculosis case. Drug-resistant tuberculosis was significantly associated with the age group 10–14 years (P = 0.002; [AOR] 29.76; [95% CI, 3.51-252.64]) and children living in urban areas (P = 0.027; [AOR] 5.76; 95% CI, 1.22–27.09).ConclusionBacteriologically confirmed childhood PTB cases increased as the age of the children increased. Most of the bacteriologically confirmed childhood PTB and the identified drug Resistant-Tuberculosis cases were new cases. Also, rural children were more affected by TB than their urban, counterparts Drug Resistant-Tuberculosis was higher in urban resident children.

Pragmatic cluster-randomized trial of home-based preventive treatment for TB in Ethiopia and South Africa (CHIP-TB)

BackgroundEach year, 1 million children develop TB resulting in over 200,000 child deaths. TB preventive treatment (TPT) is highly effective in preventing TB but remains poorly implemented for household child contacts. Home-based child contact management and TPT services may improve access to care. In this study, we aim to evaluate the effectiveness and cost-effectiveness of home-based contact management with TPT initiation in two TB high-burden African countries, Ethiopia and South Africa.MethodsThis pragmatic cluster randomized trial compares home-based versus facility-based care delivery models for contact management. Thirty-six clinics with decentralized TB services (18 in Ethiopia and 18 in South Africa) were randomized in a 1:1 ratio to conduct either home-based or facility-based contact management. The study will attempt to enroll all eligible close child contacts of infectious drug-sensitive TB index patients diagnosed and treated for TB by one of the study clinics. Child TB contact management, including contact tracing, child evaluation, and TPT initiation and follow-up, will take place in the child’s home for the intervention arm and at the clinic for the control arm. The primary outcome is the cluster-level ratio of the number of household child contacts less than 15 years of age in Ethiopia and less than 5 years of age in South Africa initiated on TPT per index patient, comparing the intervention to the control arm. Secondary outcomes include child contact identification and the TB prevention continuum of care. Other implementation outcomes include acceptability, feasibility, fidelity, cost, and cost-effectiveness of the intervention.DiscussionThis implementation research trial will determine whether home-based contact management identifies and initiates more household child contacts on TPT than facility-based contact management.Trial registrationNCT04369326. Registered on April 30, 2020.

Modern contraceptive use and associated factors among reproductive-age women in Ethiopia: multilevel analysis evidence from 2019 Ethiopia mini demographic and health survey

Background Despite the high fertility and population growth rates, the use of modern contraceptives remains low in low- and middle-income countries. Different pocket-sized studies on the use of modern contraceptive methods conducted in various parts of Ethiopia have been extremely varied and ambiguous. Therefore, this study aimed to assess modern contraceptive use and its associated factors in women of reproductive age in Ethiopia. Methods Cross-sectional data from the Ethiopia Interim Demographic Health Survey (EMDHS) 2019 in a stratified, two-stage, and cluster sampling study. Multilevel binary logistic regression analysis was used to fit the associated factors. The interclass correlation (ICC), median odds ratio (MOR), proportional change variance (PVC), and deviance were used for model comparison and fitness. The adjusted odds ratio (AOR) with 95% confidence interval (CI) was used to identify the significant factors of modern contraceptive use. Result The multilevel analysis demonstrated that Orthodox religion [AOR = 1.7; 95%CI: 1.4–2.10] protestant religion [AOR = 1.2; 95%CI: 0.93–1.62], married [AOR = 4.2; 95%CI: 1.93–9.07], primary education [AOR = 1.5; 95%CI: 1.26–1.76], secondary education [AOR = 1.36; 95%CI: 1.04–1.77 [AOR = 1.89; 95%CI: 1.37–2.61], middle [AOR = 1.4; 95%CI: 1.14–1.73], rich [AOR = 1.3; 95%CI: 1.06–2.68] were positively associated with modern contraceptive utilization, while the age group of 40–49 [AOR = 0.45, 95% CI: 0.34–0.58], and high community poverty [AOR = 0.62; 95%CI: 0.46–0.83] were negatively associated with modern contraceptive utilization. Conclusion The prevalence of modern contraception in Ethiopia remains low. Maternal age, religion, maternal education, marital status, wealth index, region, and community poverty were significant predictors of modern contraceptive utilization in Ethiopia. Governments and non-governmental organizations should expand their public health programs to poorer communities to increase the use of modern contraception in the country.