Community-based Unmatched Case-control Study Research Articles

Factors affecting on compliance of childhood immunization in Ilam District of Nepal; A case-control study.

Childhood immunization is one of the most important public health interventions to reduce child morbidity and mortality. Reaching all children with full immunization services is critical to meet Nepal's commitment to Sustainable Development Goals (SDGs). This study aimed to identify factors affecting compliance with childhood immunization in children aged 16 to 36months in Nepal. A community-based unmatched case-control study was conducted with 250 (83 cases and 167 controls) respondents in the Ilam district of Nepal. Respondents were randomly selected using a multi-stage cluster sampling technique. Data were collected using a structured questionnaire and analysed using SPSS version 16 statistical software. Bivariate and multivariate logistic regression analyses were done to identify the factors influencing compliance with childhood immunization of the sampled respondents. More than two-thirds (66.8%) of the sampled children were fully immunized, and 19.3% of the children defaulted to the Measles-Rubella vaccines. Only 19.2% of the respondents had good knowledge about the type of vaccine, and more than half (59.2%) of the respondents had a positive attitude towards immunization. Multivariate logistic regression analysis revealed that lack of knowledge about vaccines (AOR=49.4, 95% CI=12.94 to 188.59), father's level of education (AOR=2.1, 95% CI=1.05 to 4.30), not getting immunization on the day of the appointment (AOR=4.8, 95% CI=2.30 to 9.89), lack of knowledge about immunization schedule (AOR=2.4, 95% CI=1.14 to 4.84), and negative attitude towards immunization (AOR=2.1, 95% CI=1.03 to 4.19) were independently impeded on compliance on the childhood immunization. Targeted intervention in health promotion activities at the household level should be promoted and integrated immunization services into the existing primary health care services.

Determinants of Podoconiosis in Bensa District, Sidama Region, Ethiopia: A case control study.

Podoconiosis is one of the neglected tropical diseases (NTD) with the greatest potential for elimination. Despite its public health importance, podoconiosis is a poorly understood disease which led to a widespread misconception about its cause, prevention, and treatment. Even though the exact global burden is still to be measured, it is estimated that at least 4 million people are affected with podoconiosis worldwide, of which more than 1.5 million people are in Ethiopia. The objective of this study was to identify the determinants of podoconiosis in Bensa District, Sidama Regional State, Ethiopia. A community-based unmatched case-control study was used to identify the determinants of podoconiosis. The sample size was estimated using the double population proportion formula. An interviewer-administered structured questionnaire was used for data collection. Blood specimens collected from cases were tested by Filariasis Test Strip to exclude lymphatic filariasis. Data were checked for completeness, coded and entered into Epi-data Version 4.6, and exported to the SPSS version 22 software. Variables with a p<0.2 in the bivariate analysis were further analyzed using multivariable binary logistic regression. Multivariable logistic regression analysis was used to examine determinants that could be associated with podoconiosis with a 95% confidence interval. A total of 459 (153 cases and 306 controls) participants were included with a response rate of 100%. Factors such as the age of participant [AOR = 0.34, 95% CI (0.13-0.87)], being female [AOR = 2.90, 95% CI (1.40-6.10)], age at which shoe wearing started [AOR = 0.7, 95% CI (0.03-0.16)], not wearing shoe daily [AOR = 2.26, 95% CI (1.05-4.86)], wearing hard plastic shoe [AOR = 3.38, 95% CI (1.31-10.89)], and family history with a similar disease (leg swelling) [AOR = 10.2, 95% CI (3.97-26.37)] were significantly associated with the occurrence of podoconiosis. The age of the participants, gender, the age at which shoe wearing started, type of shoe the participants' wear, frequency of shoe wearing, traveling barefoot, and family history with similar disease (leg swelling) were significantly associated with the occurrence of podoconiosis. Sidama regional health bureau along with non-governmental organizations working on the neglected tropical disease should plan modalities on awareness creation and comprehensive health education on shoe wearing and foot hygiene.

Factors associated with obstetric fistula among reproductive age women in Ethiopia: a community based case control study

BackgroundObstetric fistula is a major public health concerns in Ethiopia. It is the most devastating cause of all maternal morbidities.MethodData from the 2016 Ethiopian Demographic Health Survey (EDHS) was analyzed. A community-based unmatched case control study was conducted. Seventy cases and 210 non cases were selected using random number table. Data were analyzed by using STATA statistical software version 14. Multivariable logistic regression model was applied to determine the factors associated with fistula.ResultsThe majority of fistula cases were from rural residences. The multivariable statistical model showed that rural residence (Adjusted OR (AOR) = 5, 95% CI 4.26, 7.52), age at first marriage (AOR = 3.3, 95% CI 2.83, 4.60), poorest wealth index (AOR = 3.3, 95% CI 2.24, 5.01) and decision making for contraceptive use by husband alone (AOR = 1.3, 95% CI 1.124, 1.67) were factors significantly associated with obstetric fistula.ConclusionAge at first marriage, rural residence, poorest wealth index and decision making for contraceptive use by husband alone were significantly associated factors for obstetric fistula. Intervening on these factors will reduce the magnitude of obstetrics fistula. In this context there is in-need to improve on avoiding early marriage through awareness creation to the community and developing legal framework by the policymakers. Furthermore, information about the joint decision making to use contraceptives should be disseminated though mass-media and interpersonal channels.

Determinants of Female Genital Mutilation Among Under Five-Year Children in Motta Town, Northwest Ethiopia, 2022: Unmatched Case Control Study.

Female genital mutilation is the removal of a woman's external genitalia in whole or in part for a non-obvious medical reason. Female genital mutilation causes short- and long-term complications like bleeding, pain, infection and exposes girls to sexually transmitted diseases. The determinants of female genital mutilation among children under the age of five have received less attention. As a result, the purpose of this study was to determine the factors that influence female genital mutilation in children under the age of five. A community-based unmatched case control study design was used. The study participants were chosen using computer-generated simple random sampling technique. With a ratio of 1:4 between cases and controls, 323 participants were recruited. Data were collected using an interviewer-administered questionnaire. The association between each independent variable and the dependent variable was determined using binary logistic regression. In a multivariable analysis, variables were considered statistically significant if they had a P-value of less than 0.05 at a 95% confidence interval. In this study, mothers' circumcision status (AOR = 4.6; 95% CI: 2.29-9.25), mothers who had an unfavorable attitude (AOR = 4.15; 95% CI: 1.96-8.82), households in the poorest wealth quintile (AOR = 3.65; 95% CI: 1.2-11.54), mothers who had inadequate knowledge (AOR = 3.31; 95% CI: 1.51-7.25) and antenatal care visit of mothers (AOR = 2.46; 95% CI: 1.03-5.83) were found to be determinant factors of female genital mutilation. Mothers' circumcision status, mother's attitude, wealth quintile, knowledge of mothers, and number of antenatal care visits were factors associated with female genital mutilation. Regular awareness-building on the impacts of the practice and special attention to the mother's attitude are important to eliminate female genital mutilation.

Determinants of Stunting Children Under Five of Age During the COVID-19 in the Working Area of the Liwuto-Primary Public Health Center, Baubau City-Indonesia: A Community-Based Unmatched Case–Control Study

BACKGROUND: In Indonesia, the stunting prevalence has reached 24.4% in 2021. AIM: The study aims to examine the determinants of stunting among children under five of age during the COVID-19 pandemic in the working area of the Liwuto-Primary Public Health Center, Baubau city. METHODS: A community-based unmatched case–control study was conducted from January 10, to March 10, 2022, on a sample of 94, cases (n = 21), and controls (n = 73) of children aged 0–59 months with their respective mothers. Data were collected using a face-to-face interviewer-administered questionnaire and physical measurements standard. The data were analyzed using SPSS version 17. The variables were entered into the multivariable model using the backward stepwise regression approach. Multivariable logistic regression analysis was used to identify factors associated with stunting. Adjusted odds ratio (AOR) with a 95% confidence interval (95% CI) and p &lt; 0.05 was used to declare the significance. RESULTS: There are 22% of the stunting become in children under 5 years. Stunting children under 5 years was associated with maternal age (AOR = 5.71, 95%, CI: 1.91–17.03). While family income (AOR = 1.78, 95%, CI: 0.17–18.86), exclusive breastfeeding (AOR = 3.95, 95%, CI: 0.14–112.72), complementary feeding (AOR = 1.24, 95%, CI: 0.18–8.55), formal education (AOR = 0.74, 95%, CI: 0.36–1.53), and occupation (AOR = 2.98, 95%, CI: 0.24–36.55) were not associated with the stunting. CONCLUSION: Young mother under 30 years old was an important risk factor on the incidence of stunting in children under 5 years during the COVID-19 pandemic.

Determinants of stunting in children under five years in dibate district of Ethiopia: A case-control study

Chronic malnutrition is the consequence of long-term nutritional deficiency resulting in non-communicable disease and reduced productivity in later life. This situation primarily manifests through physical stunting, a term used to individuals short for their age in comparison to reference population of same age. . is defind based on the world health organization (WHO) 2006 reference population. Children whose height for age z score for height ≤ −2 SD while. is children whose z score for height > -2 SD to z score for height +2 SD. to find determinants of stunting among children aged between 6- 59 months. A community-based unmatched case-control study was conducted on 566 study participants (188 case and 378 controls) from March to May 2019. Nutritional status was determined using the WHO reference population. A structured questioner was used to collect data through interviews and anthropometric measurement. Data entry was made in Epi-data version 4.6.02, and the analysis was carried out using IBM SPSS version 26 software. Binary logistic and multivariable logistic regression was done. Multicollinearity was checked using the tolerance testand variance inflation factors. Hosmer- Lemeshow goodness of fit test was used to see model fitness. Adjusted odds ratios and 95% CI at P-values ≤ 0.05 were considered to affirm statistically significant factors. The study participants' response rate was 100% for both cases and controls. The mean age of the children was 28 ± 11.2 months for the case and 28.6 ± 6 months for control with the standard deviation. Factors significantly associated with stunting were poor household dietary diversity (AOR = 10.37, 95% CI; 5.39–19.94), middle household dietary diversity (AOR = 3.78, 95% CI; 1.38–10.38), family size ≥5 (AOR = 6.27, 95% CI; 3.37–11.66) and have no consumption of animal food source (AOR = 7.43, 95% CI; 4.3–12.8) This study relived that four variables were significantly associated with stunting. These are low household dietary diversity, medium household dietary diversity, family size, and animal source food. Based on the findings of this study, the following recommendations are made. provide health information to families regarding the importance of good household dietary diversity, provide health information to families regarding the importance of limiting family size, and provide nutritional counseling about the benefits of animal source food.

Determinants of incomplete childhood immunization among children aged 12-23 months in Dabat district, Northwest Ethiopia: Unmatched case- control study.

Despite the effort to increase access to routine immunization, majority of children in low-resource countries including Ethiopia are still either unvaccinated or under-vaccinated. In Ethiopia for the past four decades, the completion rate of routine childhood immunization remains low particularly in a rural area. In this study setting, evidence regarding the socio-economic, maternal continuum care, and caregiver characteristics effect on child immunization is limited. Hence, this study aimed to identify the determinants of incomplete vaccination among children aged 12-23 months in Dabat district, Northwest Ethiopia. A community-based unmatched case-control study design was employed among 132 cases and 262 controls. Multi-stage sampling method was used to recruit eligible study participants. Logistic regression analysis was used to identify the determinants to children's incomplete vaccination. Caregivers' attitude towards vaccine (AOR: 6.1, 95% CI 3.4 to 11.1), knowledge on the schedule of vaccination (AOR: 4, 95% CI 2.2 to 7.1), Place of delivery (AOR: 2.7, 95% CI 1.3 to 5.5), and marital status (AOR: 2.36, 95% CI 1.22 to 4.56) were statistically significant association with incomplete childhood vaccination. Home delivery, caregivers' poor knowledge on the schedule of vaccination, caregivers' negative perception towards vaccine and unmarried marital status were predictors to incomplete vaccination. Therefore, to enhance full vaccination coverage, immunization health education program needs to address vaccine related safety enquiries in a meaningful method to caregivers, in order to improve the perception of caregivers towards vaccine. Moreover, improving maternal continuum care coverage is crucial.

Determinants of postpartum depression among mothers in Debre Tabor town, North-central, Ethiopia: Community-based unmatched case-control study.

BackgroundPostpartum depression (PPD) is a non-psychotic depressive disorder of variable severity, and it can begin as early as 2 weeks after delivery and can persist indefinitely if left untreated. In Ethiopia, the prevalence of postpartum depression is high. There is a dearth of literature to determine factors associated with postpartum depression in Ethiopia, specifically in the study area.ObjectiveThis study aimed to identify factors associated with postpartum depression among mothers in Debre Tabor Town, Northcentral Ethiopia.MethodA community-based unmatched case-control study was conducted among mothers who were living in Debre Tabor Town and fulfilled the inclusion criteria. Postpartum mothers were selected using a simple random sampling technique from the listed sampling frame at the health center. Then, the sample cases and controls were interviewed until the sample size was fulfilled by using a consecutive sampling method. The data were entered into the EPI data version 4.6 and then imported and analyzed using SPSS version 25. Descriptive statistics of different variables were done by cross-tabulation. Binary logistic regression was used to assess the determinant factors with the outcome variable. A P-value of < 0.05 was considered to declare statistical significance.ResultsA total of 308 postnatal mothers living in Debre Tabor Town were included, with a 97.5% response rate. History of substance use in the previous 3 months (AOR: 6.47, 95% CI; 2.61, 15.74), current baby illness (AOR: 3.9, 95% CI; 1.5, 10.12), marital dissatisfaction (AOR: 2.41, 95% CI; 1.22, 4.75), unplanned current pregnancy (AOR: 3.46, 95% CI; 1.32, 9.12), and breastfeeding (AOR: 0.22, 95% CI; 0.09, 0.55) were independent factors that affected the occurrence of PPD.ConclusionThis study revealed that a recent history of substance use (in the past 3 months), current baby illness, marital satisfaction, unplanned current pregnancy, and breastfeeding were associated with postpartum depression. Healthcare providers working in maternal and child health clinics and health extension workers should give special attention to postpartum mothers who have had a history of substance use, current baby illness, unplanned pregnancy, non-breastfeeding mothers, and mothers with poor marital satisfaction.

Determinants of Long-Acting Reversible Contraceptive Methods Utilization Among Married Women of Reproductive Age Group In Ambo Town, Oromia Region, West Ethiopia, 2016: A Case Control Study

Background: The contraceptive utilization rate in Ethiopia is approximately 29%. In contrast, only 3.7% of married women in Ethiopia use the most effective and convenient methods, i.e., long-acting contraceptive methods. This rate is approximately 3.2% in the Oromia region, the most populous region in Ethiopia. In regard to this, the current study aimed to identify determinants of long-acting reversible contraceptive method utilization among married women in Ambo town, Ethiopia. Objective: To identify determinants of long-acting reversible contraceptive method utilization among married women of reproductive age in Ambo town, 2016 Methods: A community-based unmatched case-control study was carried out in Ambo town on 420 married women of reproductive age who were randomly selected. The study population comprised users [case group; n=140] and nonusers [control group; n=280] of one of the longacting reversible methods. Multivariable logistic regression analysis was performed to determine independent predictors. Adjusted odds ratios together with their corresponding 95% CIs were calculated to assess the strength of association and declare statistical significance. Result: A total of 418 married women participated in the study, with a response rate of 99.45%. Moderate level of knowledge on long-acting reversible contraceptive methods [AOR= 8.73, 95%CI: 3.08 - 24.77], good level of knowledge [AOR=13.99, 95%CI:4.93-39.71], spousal discussion on long-acting reversible contraceptive methods [AOR=2.88, 95%CI:1.3-6.36], positive attitude toward long-acting reversible contraceptive methods [AOR=7.07, 95% CI: 3.77-13.24], women from households in the poorest wealth quintile [AOR= 6.83, 95%CI: 2.68- 17.38], women from households in the medium wealth quintile [AOR=5.83, 95%CI: 2.23- 15.23] were positive determinants, whereas intention to give birth in the future [AOR=0.09, 95% CI: 0.02- 0.36] and women’s expectations of restriction to methods use [AOR=0.2, 95% CI: 0.08- 0.48] were negative determinants of long-acting reversible contraceptive method utilization. Conclusion: Good knowledge, moderate knowledge, positive attitude, wealth index and spousal discussion were positive determinants, whereas intention to give birth in the future and woman’s expectation of restriction to method use were negative determinants of long-acting reversible contraceptive method utilization. Stakeholders should emphasize behavioral change communication to increase knowledge on long-acting reversible contraceptive methods, strengthen inter-spousal discussion and bring a positive attitude towards long-acting reversible contraceptive methods.

Scabies Outbreak Investigation and Its Risk Factors in Gumbichu District, East Shewa Zone, Central Ethiopia: Unmatched Case-Control Study

Introduction: Scabies is one of the common public health problems but neglected parasitic diseases caused by Sarcoptes scabies var hominies. Global scabies prevalence was about a 204million cases with 0.21% of total disability-adjusted life years lost. In Ethiopia, scabies is common, especially during natural or man-made disasters. This study was aimed to investigate scabies suspected outbreak and risk factors in Gumbichu District, Central Ethiopia, 2021. Methods: A community-based unmatched case-control study among 96 participants (32 cases and 64 controls) was conducted in the Gumbichu district from July 1-20/2021. Data were collected using a structured questionnaire. Line-listed data were entered into Microsoft Excel for descriptive analyses. Multivariable logistic regression analysis was computed using SPSS version 25 to identify factors associated with scabies. The odds ratio of 95% CI and a p-value less than 0.05 were used to describe the strength of the association and statistical significance. Results: A total of 1231 scabies cases line listed with overall attack rate of 16/1,000 population. The mean age was 14 years, and most affected age group was 5–14 years. Frequency of shower per month [AOR (95% CI) = 6.51(1.26-33.54)], sleeping with scabies patient [AOR (95% CI) = 10.52(3.75-29.53)], contact history [AOR (95%) = 11.44(1.72-76.22)], family size ≥5 [AOR (95% CI) = 8.63(2.42-30.84)], and sharing clothes with scabies cases [AOR (95% CI) = 14.31(3.04-67.35)] were found to be determinant factors of scabies outbreak. Conclusion: Frequency of shower per month, contact history, sleeping with scabies case, family size ≥5, and sharing clothes with scabies case were associated with a high frequency of scabies. Therefore, it is recommended to raise awareness about the transmission, prevention, and control of scabies disease.

Barriers to cleaning of shared latrines in slums of Addis Ababa, Ethiopia.

Shared latrines and other shared sanitation facilities are vital for communities that lack private latrines. However, the cleanliness of shared latrines continues to be a problem in sub-Saharan Africa, including slums of Addis Ababa, Ethiopia. Investigating the barriers to cleaning of shared latrines may inform the future strengthening of comprehensive sanitation programs in slums of Addis Ababa, Ethiopia. Thus, a community-based unmatched case-control study was conducted among 100 case and 200 control households that were users of shared latrines from September to November 2017 in a slum district in Addis Ababa. Cases were those who had not cleaned their shared latrines and controls were those who had cleaned their shared latrines at least once during the week prior to data collection. Data were collected using a structured questionnaire and an on-the-spot-observational checklist and analyzed using bivariate (crude odds ratio [COD]) and multivariable (adjusted odds ratio [AOR]) unconditional logistic regression model. Variables having a p-value of less than 0.25 from the bivariate logistic regression analysis were retained into multivariable analysis. From the multivariable analysis, variables with p<0.05 were declared as factors significantly associated with barriers to cleaning of shared latrines. We found that about half 99 (49.5%) of shared latrines used by cases and almost one-third 32 (32.0%) of the shared latrines used by controls had visible cracks and spaces in the floor and slabs. The barriers to cleaning of shared latrines were found to be monthly household income of less than $55.60 USD (AOR = 1.80; 95%CI: 1.2-3.10), users feeling a lack of privacy during latrine use (AOR = 2.95; 95% CI: 1.60-5.43), no locking latch on the latrine door (AOR = 4.60; 95% CI: 2.43-8.79), inadequate ventilation of latrine (AOR: 4.88; 95% CI: 2.44-9.63), lack of regular monitoring of latrine by health extension workers (AOR = 2.86; 95%CI: 1.32-6.21) and a lack of enough water at home for cleaning the latrine (AOR = 4.91; 95% CI: 1.07-9.48). This study found several barriers to cleaning of shared latrines in slums of Addis Ababa. We recommend that stakeholders promote cleaning of shared latrines by designing programs to improve latrine privacy by adding or modifying the superstructure and including a door with locking latch, to make adjustments to the structure for better ventilation, to ensure regular monitoring of latrines by health extension workers and to make enough water consistently available for regular latrine cleaning.

Determinants of long-acting reversible contraceptive use among women in Jawi woreda, North West Ethiopia: A case-control study.

Objectives:The utilization of long-acting reversible contraceptive methods is one of the key factors in protecting women and couples against unwanted pregnancies. The study aimed to assess the determinants of long-acting reversible contraceptive use among women in Northwest Ethiopia.Methods:A community-based unmatched case-control study was conducted from 1 February to 8 March 2017 in Northwest Ethiopia. The cases were women who used long-acting reversible contraceptive methods, and the controls were women who used short-acting contraceptives. Both of them were selected using a systematic sampling method. An interviewer-administered questionnaire was used to collect the data. Epi info and SPSS version 23 were used for data entry and analysis, respectively. Descriptive statistics and association measures were done and presented in texts, tables, and figures.Results:A total of 882 women were interviewed, with a response rate of 99.3%. Women who were between 15 and 24 years old were two times more likely to use long-acting reversible contraceptive methods than those whose age was ⩾35 (adjusted odds ratio = 2, 95% confidence interval: (1.20, 3.50)). A good level of knowledge about long-acting reversible contraceptive methods (adjusted odds ratio = 11.6, 95% confidence interval: (5.42, 24.80)), a negative attitude toward long-acting reversible contraceptive methods (adjusted odds ratio = 0.31, 95% confidence interval: (0.21, 0.46)), membership in the health development army (adjusted odds ratio = 2.8, 95% confidence interval: (2.12, 3.78)), no discussion with a partner about long-acting reversible contraceptive methods (adjusted odds ratio = 2.3, 95% confidence interval: (1.54, 3.49)), and more than 2 years of desire to wait before another pregnancy (adjusted odds ratio = 23.7, 95% confidence interval: (11.63, 48.55)) were determinants of long-acting reversible contraceptive methods use.Conclusion:This study revealed that attitude toward long-acting reversible contraceptive method use, being a member of the women’s health development army, and the desire to space children were determinants of long-acting reversible contraceptive method use. More actions should be taken to increase the utilization of long-acting reversible contraceptive methods by promoting discussion between partners about modern contraceptives and increasing women’s participation in being a member of the health development army.

Determinants of diarrheal diseases among under five children in Jimma Geneti District, Oromia region, Ethiopia, 2020: a case-control study

BackgroundGlobally, in 2017, there were nearly 1.7 billion cases of childhood diarrheal diseases, and it is the second most important cause of morbidity and mortality among under-five children in low-income countries, including Ethiopia. Sanitary conditions, poor housing, an unsanitary environment, insufficient safe water supply, cohabitation with domestic animals that may carry human pathogens, and a lack of food storage facilities, in combination with socioeconomic and behavioral factors, are common causes of diarrhea disease and have had a significant impact on diarrhea incidence in the majority of developing countries.MethodsA community-based unmatched case-control study was conducted on 407 systematically sampled under-five children of Jimma Geneti District (135 with diarrhea and 272 without diarrhea) from May 01 to 30, 2020. Data was collected using an interview administered questionnaire and observational checklist adapted from the WHO/UNICEF core questionnaire and other related literature. Descriptive, bivariate, and multivariate binary logistic regression analyses were done by using SPSS version 20.0.ResultSociodemographic determinants such as being a child of 12–23 months of age (AOR 3.3, 95% CI 1.68–6.46; P < 0.05) and mothers’/caregivers’ history of diarrheal diseases (AOR 7.38, 95% CI 3.12–17.44; P < 0.05) were significantly associated with diarrheal diseases among under-five children. Environmental and behavioral factors such as lack of a hand-washing facility near a latrine (AOR 5.22, 95% CI 3.94–26.49; P < 0.05), a lack of hand-washing practice at critical times (AOR 10.6, 95% CI 3.74–29.81; P < 0.05), improper domestic solid waste disposal (AOR 2.68, 95% CI 1.39–5.18; P < 0.05), and not being vaccinated against rotavirus (AOR 2.45, 95% CI 1.25–4.81; P < 0,05) were found important determinants of diarrheal diseases among under-five children.ConclusionThe unavailability of a hand-washing facility nearby latrine, mothers’/caregivers’ history of the last 2 weeks’ diarrheal diseases, improper latrine utilization, lack of hand-washing practice at critical times, improper solid waste disposal practices, and rotavirus vaccination status were the determinants of diarrheal diseases among under-five children identified in this study. Thus, promoting the provision of continuous and modified health information programs for households on the importance of sanitation, personal hygiene, and vaccination against rotavirus is fundamental to decreasing the burden of diarrheal disease among under-five children.

Predictors of Partial Immunization Among Children Aged 12-23 Months in Yirga Cheffe District, South Ethiopia - A Community-Based Unmatched Case-Control Study.

BackgroundUniversal age-specific immunization is one of the areas where preventive public health policy has become successful. Despite the increase in global immunization coverage, however, many children around the world, especially in developing countries, are still left unvaccinated. The study aimed at assessing the determinants of partial immunization among children 12–23 months of age in Yirga Cheffe, Gedeo, Ethiopia.MethodologyA community-based unmatched case-control study design was conducted. Using a simple random sampling technique, 328 samples (164 cases and 164 controls) were selected. Index case was defined as a child aged 12 to 23 months who missed at least one dose of vaccine from the scheduled dose. The odds ratio (OR) and 95% confidence interval (CI) were used to calculate the association, and the level of significance was set at p 0.05.The ResultThe study showed that 40% of children were fully vaccinated, and the prevalence of those with partial vaccination was 46%. The likelihood of having incomplete vaccination was 45% higher in children whose mothers had no antenatal coverage (ANC) visit during pregnancy [OR=0.55, (95% CI; 0.297, 1.035)]. Lack of knowledge about the schedule of the vaccination has negatively affected the success of full vaccination (OR=2.3; 95% CI=1.01, 5.56).ConclusionThe study revealed that significant numbers of children are not fully vaccinated. Despite appreciable efforts by the Federal Ministry of Health to improve complete immunization coverage, there are still bottlenecks that need to be tackled in enhancing coverage. We recommend the expansion of ANC and providing education on vaccination schedule and importance to minimize the burden of partial vaccinations and its sequelae.

Determinants of short birth interval among women in South Gondar, Ethiopia: community-based unmatched case-control study

BackgroundThe effect of short birth interval on socio-economic, negative maternal and child health outcomes remains common in developing countries. This study aimed to assess determinants of short birth interval among reproductive age women, who gave birth in health institution for last six-month in South Gondar, Ethiopia 2019.MethodsCommunity-based unmatched case control study design was conducted from February 1 to March 30, 2019. Sample size of 150 was included by simple random sampling technique. The data was collected by semi-structured and pre-tested face to face interviewer-administered questionnaire from selected respondent. The collected data was entered with Epi-Data version 3.1 and analyzed by using SPSS version 23 software. Bivariate and multivariable analyses were used to examine the association. Odds ratio, 95% CI and P-value < 0.05 were used to determine the statistical association.ResultThe mean age of the respondents was 32.42 (SD ± 5.14) and 35.12 (SD ± 5.86) for cases and controls, respectively. Mothers not used contraceptives (AOR = 6.29, 95% CI (1.95, 20.24)), participants who had ≤2 alive children (AOR = 5.57, 95% CI (1.47, 21.13)), mothers who breast fed less than 24 months (AOR = 3.42, 95% CI (1.38, 8.46)), husband decision on contraceptives utilization (AOR = 2.69,95% CI (1.05,6.88)) and mothers who did not have history of antenatal care follow up (AOR = 3.52, 95% CI (1.27, 9.75)) were associated with short birth interval.ConclusionThe optimum birth spacing plays a vital role in decreasing fertility and the morbidity and mortality of mothers and children. Thus, providing health information on the benefit of breast feeding, follow-up of antenatal care during pregnancy, use of contraceptives after delivery and encouraging mothers to make decisions about their own health and use of contraceptives to optimize birth spacing for rural communities.

Paederus Dermatitis Outbreak in Addis Ababa, Ethiopia: A Case-Control Study.

Background Paederus dermatitis is an irritant contact dermatitis caused by crushing insects of the genus Paederus, which releases a vesicant toxin called pederin. On July 28, 2018, the district health office received a report of cases with erythema, itching, and burning after contact with the Paederus insect. In response, we investigated the outbreak intending to describe, confirm, and identify the risk factors associated with the country's first reported outbreak. Methods A community-based unmatched case-control study was conducted from August 10 to 22, 2018. Two hundred twenty-five (75 cases and 150 controls) study participants were involved in the study. Cases were defined as Bole subcity residents who had acute contact dermatitis after contact with the insect, while controls were persons who did not have contact with the insect. Cases were recruited consecutively as they present, whereas controls were selected by the neighborhood sampling method. An interviewer-administered questionnaire was used for the data collection, and multiple logistic regression was applied to determine the independent risk factors. The results were expressed as adjusted odds ratios (AORs) and 95% confidence intervals (CIs). Results A total of 122 cases were reported from the three districts of the subcity. The mean age of cases and controls was 23.6 (SD ± 16.4) and 29.4 (SD ± 10.9) years, respectively. Multivariate analysis showed that the presence of outdoor light (AOR = 5.1; 95% CI (2.5, 10.9), presence of rotten leaves (AOR = 6.4; 95% CI (2.9, 15.7)), sleeping on the floor (AOR = 6.1; 95% CI (2.5, 15.7)), wearing protective clothing (AOR = 0.2; 95% CI (0.1, 0.4)), and use of insect repellant (AOR = 0.1; 95% CI (0.0, 0.4)) were significantly associated with Paederus dermatitis outbreak. Conclusion The investigation identified exposure to artificial light and the presence of rotten leaves around the residential area as important factors leading to an increase in the odds of Paederus dermatitis. In contrast, the use of insect repellant and wearing protective clothing were shown to provide protection. The investigation determined that reducing burning outdoor lights, cleaning excess vegetation, avoiding sleeping on the floor, using insect repellants, and wearing protective clothing can reduce the risk of contracting Paederus dermatitis.

An epidemiological investigation of the 2019 suspected pertussis outbreak in northwestern Nigeria.

Introduction:In 2019, we investigated the profile of the cases and controls and the determinants of pertussis transmission in Kebbi State, Northwestern Nigeria, to inform better immunization and surveillance strategies.Methods:Community-based unmatched case–control study and review of the 2019 pertussis routine surveillance data in the affected settlements in the state were conducted. A total of 52 suspected cases of pertussis and 107 control from two local government areas in Kebbi State were recruited. Data were analyzed using descriptive and inferential statistics.Results:The highest attack rate was observed among between 1- and 4-year age group followed by children less than 1-year old, and the least attack rate was among those above 15 years. The overall attack rate and the case fatality rate were 2.10% and 0.10%, respectively. A higher attack rate was observed among women, whereas the case fatality rate was more among males. From the community survey, we observed that the cases were less likely to have pertussis vaccination history (adjusted odds ratio = 0.28, 95% confidence interval = 0.11–0.74) compared with the controls. Knowing pertussis prevention methods were found protective for pertussis transmission (adjusted odds ratio = 0.14, 95% confidence interval = 0.04–0.45).Conclusion:This study showed the vulnerability of children under 5 years, especially under 1 year, to vaccine-preventable diseases in rural populations, where “real” immunization coverage is sub-optimal, and the dominant socio-demographic factors are supportive of disease transmission. We found immunization and knowledge of the preventive measures to be protective against pertussis outbreaks. Therefore, routine immunization services must be intensified to improve coverage and prevent future pertussis outbreak(s).

Determinants of short birth interval among ever married reproductive age women living in Jigjiga, Eastern Ethiopia 2020 (unmatched case-control study).

Objectives:A short birth interval is a universal public health problem resulting in adverse maternal, neonatal, and child outcomes. Therefore, the aim of this study was to identify determinants of short birth interval among ever married reproductive age mothers who live in Jigjiga city administration, Eastern Ethiopia, 2020.Methods:A community-based unmatched case–control study was used among 194 cases and 194 controls in Jigjiga city administration from September to December 2020. Cases were women with short birth interval (less than 3 years) and controls were women with optimum birth interval (3–5 years). Simple random sampling technique was employed to select cases and controls. Data were entered into Epi data version 4.2 and analysis with SPSS version 22. Binary logistic regression with 95% confidence interval at p < 0.05 is used to declare significantly associated predictors of short birth interval.Result:This study reported that women who have not attended formal education (adjusted odds ratio = 5.28, 95% confidence interval: (2.25–12.36)), attended primary education (adjusted odds ratio = 2.79, 95% confidence interval: (1.46–5.34)), women who married to a polygamous husband (adjusted odds ratio = 3.69, 95% confidence interval: (1.80–7.58)), having a history of neonatal death (adjusted odds ratio = 2.15, 95% confidence interval: (1.07–4.32)), preceding child being female (adjusted odds ratio = 3.69, 95% confidence interval: (2.02–6.72)), and never used contraceptive methods (adjusted odds ratio = 3.69, 95% confidence interval: (2.02–6.72)) were identified as determinants of the short birth interval.Conclusion:Short birth intervals were associated with educational level of the women, sex of the baby, husband marriage types, history of neonatal death, and contraceptive utilization. Strategy should be engaged to enhance women education, contraceptive uses, and to decrease neonatal death.

Expanding Maternity Waiting Homes as an Approach to Improve Institutional Delivery in Southwest Ethiopia: A Community-Based Case-Control Study.

With the promising efforts in increasing institutional delivery yet, maternal and child mortality is high in Ethiopia. One of the strategies used to minimize this problem was the introduction of Maternity Waiting Homes (MWH). MWHs are residential facilities for pregnant women near a qualified medical facility. The introduction of MWHs has improved institutional delivery in many countries. In Ethiopia however, the contribution of MWHs was rarely studied. To fill this gap, we have conducted a community-based unmatched case-control study from March 1 to April 20, 2016, in Southwestern Ethiopia. Mothers who delivered at a health facility within 1 year were considered as cases while mothers delivered at home were controls. We used simple random sampling to identify study participants from the pool of cases and controls who were identified by census. Data were analyzed using SPSS Version 20. Binary logistic regression was used to identify significant predictors. A total of 140 cases and 273 controls were included in the study. Among the case, 86 (61.4%) used MWHs during their last delivery. Variables like educational status of the mothers [AOR = 2.96, 95% CI: 1.41, 6.23], educational status of the husband [AOR = 5.19, 95% CI: 1.52, 17.76], and having antenatal care follow up [AOR = 3.22, 95% CI: 1.59, 6.54]. This study remarks, accessing MWHs, creating better awareness in utilizing them, and practicing antenatal follow-up have a crucial role in improving institutional delivery. Therefore, strengthening the existing and establishing new MWHs to deliver quality services is a good strategy in reducing home delivery.

Determinants of Stunting among Children Aged 6-23 Months of Age in Pastoral Community, Afar Region, Ethiopia: Unmatched Case-Control Study

Background: Globally, stunting is a public health concern, more of in developing counties, including Ethiopia. Once occurred, in the first two years of life, it is irreversible and has long-lasting harmful consequences. Exploring the determinants has pivotal importance for evidence-based interventions. Therefore, the rationale of this study was to identify determinants of stunting among children aged 6-23 months in the pastoralist community, Afar region, Ethiopia. Method: A community-based unmatched case-control study was conducted among 381 (cases=126, controls 255) study participants from February 15/2017 to March 30/2017. Cases and controls were identified consecutively using the world health organization growth monitoring chart. Data was collected by interviewer-administered questionnaires and anthropometric measurements. Statistical significance was declared at p-value &lt; 0.05 in the final multivariable logistic regression model. Result: Maternal education (AOR:0.34, 95% CI: 0.16, 0.77), maternal under-nutrition (AOR:2.91, 95% CI:1.51, 5.60), number of under-five children within the household (AOR:2.66, 95% CI: 1.38, 5.10), latrine ownership (AOR:0.28, 95% CI:0.15, 0.55), minimum Dietary Diversity score of children (AOR:0.41, 95% CI:0.22, 0.75), child age (AOR:1.76, 95% CI:1.01, 3.09), colostrum intake (AOR:3.03, 95%CI:1.62, 5.66), and exclusively breastfeed for the first six months (AOR:3.20, 95% CI:1.72,5.95) were found to be determinants of stunting. Conclusion: This study found that determinants of childhood stunting are multifactorial. Maternal, household and child-related characteristics are associated with childhood stunting. Therefore, to improve childhood nutritional status, inter-sectoral collaboration and commitment are vital.