Disorders In Ethiopia Research Articles

Primary health care nurses attitude towards people with severe mental disorders in Addis Ababa, Ethiopia: a cross sectional study

BackgroundNegative attitude and discriminatory behavior of health professionals constitute a major obstacle in psychiatric care and have been pointed out as a key issue in working with mental illness. Understanding about the attitude of nurses is crucial for quality and holistic care of psychiatric services and essential for the successful integration of mental health into primary health care. However, there is a paucity of study to examine the attitude of primary health care nurses towards severe mental disorder in Ethiopia. Therefore, this study aimed to assess the attitude of primary health care nurses and its associated factors towards people with severe mental illness in Addis Ababa.MethodsInstitutional based cross-sectional study was conducted among nurses working at primary health care in Addis Ababa from May to June, 2018. Multistage sampling technique was used to select 634 participants. A structured self-administered questionnaire was used. Data were coded and entered into EPIDATA 3.1 and exported to SPSS version 20 for analysis. Bivariate and multivariate binary logistic regression analysis was used to identify factors associated with attitudes of nurses in primary health care. The level of significance was declared at P-value < 0.05 with 95% confidence interval.ResultsA total of 610 respondents were included in the study with a response rate of 96.2%. The mean age of participants was 28.6 ± 5.9 (SD) years and the prevalence of negative attitude was 48.2%. Multiple logistic regression models revealed that respondents who have diploma [AOR = 3.09, CI (1.20–7.95)], work experience of < 5 years [AOR = 4.49, CI (2.37–8.49)], respondents who didn’t took mh-Gap training [AOR = 4.92, CI (3.05–7.95)] and poor knowledge about mental illness [AOR = 2.84, CI (1.82–4.44) were associated with negative attitude towards people with severe mental illness.ConclusionNearly half of the participants have negative attitude towards people with severe mental disorders. Therefore, evidence based and contextualized models are warranted to mitigate negative attitudes of primary health care nurses.

Moving towards universal health coverage for mental disorders in Ethiopia

BackgroundPeople with mental disorders in low-income countries are at risk of being left behind during efforts to expand universal health coverage.AimsTo propose context-relevant strategies for moving towards universal health coverage for people with mental disorders in Ethiopia.MethodsWe conducted a situational analysis to inform a SWOT analysis of coverage of mental health services and financial risk protection, health system characteristics and the macroeconomic and fiscal environment. In-depth interviews were conducted with five national experts on health financing and equity and analysed using a thematic approach. Findings from the situation analysis and qualitative study were used to develop recommended strategies for adequate, fair and sustainable financing of mental health care in Ethiopia.ResultsOpportunities for improved financing of mental health care identified from the situation analysis included: a significant mental health burden with evidence from strong local epidemiological data; political commitment to address that burden; a health system with mechanisms for integrating mental health into primary care; and a favourable macro-fiscal environment for investment in human capabilities. Balanced against this were constraints of low current general government health expenditure, low numbers of mental health specialists, weak capacity to plan and implement mental health programmes and low population demand for mental health care. All key informants referred to the under-investment in mental health care in Ethiopia. Respondents emphasised opportunities afforded by positive rates of economic growth in the country and the expansion of community-based health insurance, as well as the need to ensure full implementation of existing task-sharing programmes for mental health care, integrate mental health into other priority programmes and strengthen advocacy to ensure mental health is given due attention.ConclusionExpansion of public health insurance, leveraging resources from high-priority SDG-related programmes and implementing existing plans to support task-shared mental health care are key steps towards universal health coverage for mental disorders in Ethiopia. However, external donors also need to deliver on commitments to include mental health within development funding. Future researchers and planners can apply this approach to other countries of sub-Saharan Africa and identify common strategies for sustainable and equitable financing of mental health care.

Trauma exposure, depression, suicidal ideation, and alcohol use in people with severe mental disorder in Ethiopia.

To investigate exposure to traumatic and stressful events and their association with depression, suicidal ideation, and alcohol abuse in people with severe mental disorder (SMD) in Ethiopia. As part of the Programme for Improving Mental health carE, 300 people with SMD (84% primary psychosis, 11% bipolar disorder, and 16% depression with psychotic features) in a rural district were identified by psychiatric nurses. A cross-sectional assessment included clinical characteristics, experience of being restrained, exposure to stressful events as measured by an adapted version of the List of Threatening Experiences scale, traumatic events as measured by endorsement of 13 locally relevant potentially traumatic events that occurred since the onset of the participant's mental illness, depression symptoms measured by the Patient Health Questionnaire, the Suicidal Behavior Module of the Composite International Diagnostic Interview, and hazardous drinkingwhich was calculated as a sum score of eight or higher on the Alcohol Use Disorders Identification Test. Almost half of participants reported being restrained since becoming ill, which was associated with more suicidal ideation and less hazardous drinking. More than one-third experienced traumatic events since becoming ill, including being assaulted, beaten, or raped. Exposure to traumatic events was associated with hazardous drinking. In this rural Ethiopian setting, people with SMD experienced high levels of traumatic and stressful events which were associated with co-morbid conditions. Greater attention needs to be given to trauma prevention and integration of treatment for trauma sequelae in efforts to expand integrated mental health care.

Factors associated with pelvic floor disorders in Kersa District, eastern Ethiopia: a community-based study

Pelvic floor disorders, which diminish the quality of life, disproportionally affect women in developing countries. However, there is a knowledge gap in the understanding of the factors associated with the problem in many countries including Ethiopia. Therefore, we aimed to assess the factors associated with pelvic floor disorders in Ethiopia. A community-based cross-sectional study was conducted among 3432 ever-married women selected through a stratified multistage sampling procedure from the Kersa Health and Demography Surveillance System. Data were collected using structured questionnaires through face-to-face interviews. A Poisson regression model with robust variance estimation was used to investigate the association of the independent variable with pelvic floor disorder. The results are reported in adjusted prevalence ratios with 95% confidence intervals. Overall, the prevalence of pelvic floor disorders was 20.5% (95% CI: 19%-22%). Women who had no education (APR = 1.47; 95% CI: 1.06, 2.04) or had undergone five or more vaginal deliveries (APR = 1.56; 95% CI: 1.18, 2.05), an abortion (APR = 1.85; 95% CI: 1.43, 2.38) or episiotomy (APR = 1.39; 95% CI: 1.02, 1.90) were independently associated with having pelvic floor disorders. Obstetric events are strongly associated with pelvic floor disorders. This finding highlights the greater need for policies to focus on prevention, diagnosis and treatment services to mitigate women's suffering from pelvic floor disorders.

Bovine herpesvirus-1 in three major milk sheds of Ethiopia: Serostatus and association with reproductive disorders in dairy cattle

Bovine herpesvirus-1 (BHV-1) causes infectious bovine rhinotracheitis (IBR), and infectious pustular vulvovaginitis (IPV) in cows and infectious pustular balanopostitis (IPB) in bulls worldwide. Infection of seronegative cattle with BHV-1 leads to abortion, retention of fetal membranes, increased service per conception, metritis and oophoritis. As part of an ongoing study on infectious causes of reproductive disorders in Ethiopia, this investigation aims at assessing the role of BHV-1 in the disorders and the risk factors affecting its seroprevalence. A cross-sectional study was conducted on a total of 1379 randomly selected dairy cattle from 149 herds. These dairy cattle were sampled from milks sheds of central (n = 555), western (n = 195) and southern (n = 629) Ethiopia. Blocking enzyme-linked immunosorbent assay (B-ELISA) was applied to detect antibodies specific to BHV-1. Additionally, a semi-structured questionnaire was administered and farm records were assessed to capture potential risk factors associated with BHV-1 seropositivity. Univariable and multivariable random-effects logistic regression analyses were used to assess potential risk factors associated with BHV-1 serostatus. Model fitness and reliability were assessed using the Hosmer and Lemeshow method and the receiver operating curve (ROC) respectively. An overall herd level BHV-1 seroprevalence of 81.8% (95% confidence interval (CI): 74.7–87.7%) and individual animal level seroprevalence of 41.0% (95% CI: 38.4–43.7%) were found. In a random-effects multivariable logistic regression model, the seroprevalence of BHV-1 exposure was higher in dairy cattle from breeding (Odds ratio [OR] = 1.3; p = 0.036) than in commercial (OR = 0.9; p = 0.137) and small-holder farms. Geographically, the prevalence was higher in western (OR = 1.4; p < 0.001) and southern Ethiopia (OR = 1.2; p < 0.001) than in central regions. BHV-1 seropositive cows had higher (p < 0.05) odds of clinical reproductive disorders including abortion, retained fetal membranes, stillbirth, birth of weak calf and metritis compared to seronegative cows. Thus, it is suggested that BHV-1 should be considered as differential diagnosis among improved dairy cattle herds with reproductive disorders in Ethiopia.

The burden of headache disorders in Ethiopia: national estimates from a population-based door-to-door survey

BackgroundHeadache disorders are the third-highest cause of disability worldwide, with migraine and medication-overuse headache (MOH) the major contributors. In Ethiopia we have shown these disorders to be highly prevalent: migraine 17.7%, TTH 20.6%, probable MOH (pMOH) 0.7%, any headache yesterday (HY) 6.4%. To inform local health policy, we now estimate disability and other burdens attributable to headache in this country.MethodsIn a cross-sectional survey using cluster-randomized sampling, we visited households unannounced in four diverse regions (urban and rural) of Ethiopia. We interviewed one member (18–65 years old) of each household using the HARDSHIP structured questionnaire. Screening and diagnostic questions based on ICHD-II were followed by burden enquiry in multiple domains. We estimated disability using disability weights (DWs) from the Global Burden of Disease 2013 study.ResultsWe interviewed 2385 participants (1064 [44.7%] male, 596 [25.0%] urban; participating proportion 99.8%). Reported mean intensity of migraine was 2.6 (scale 1–3). People with migraine spent 11.7% of their time in the ictal state (DW: 0.441); they were therefore 5.2% disabled overall. Pain and disability from TTH were much lower. Mean intensity of pMOH was 2.95. People with pMOH spent 60.2% of time with headache (DW: 0.223), and were 13.4% disabled. Average proportions of per-person lost productive time were, for migraine, 4.5% from paid work, 5.3% from household work; for pMOH they were 29.2% and 16.0%. There were highly-disabled minorities, and large gender differences, males losing more paid workdays, females more household workdays. All headache types were associated with impairments in quality of life. Across the population aged 18–65 years (effectively the working population), disability from headache was 1.4%, with 1.6% of workdays lost (half from migraine). Estimates from HY, eliminating recall error, were highly compatible.ConclusionsEthiopia is a low-income country, and cannot afford these losses – including, perhaps, 1.6% of GDP. Political action is necessary, aimed at mitigating both the economic burden and the associated ill health. WHO has recommended structured headache services with their basis in primary care as the most efficient, effective, affordable and equitable solution, potentially cost-saving. We believe they can be implemented within Ethiopia’s existing health-care infrastructure.

Prevalence of Common Mental Disorders and Factors Associated with These Disorders among Pregnant Women Attend Ante Natal Care Services at Hawassa Referral Hospital, Ethiopia, 2016

Background: Common mental disorder such as depression, somatoform disorder and anxiety are increasingly recognized for their burden in low resource countries such as Ethiopia. However, the magnitude of antenatal common mental disorder in Ethiopia is not well established. Pregnancy is generally assumed to be a happy time, both for parents and society as a whole. But pregnancy can be a difficult and even a dangerous period for women living in low and middle income countries. Objective: To assess the prevalence of common mental disorders and identify factors associated with these disorders among pregnant women attend ante natal care services at Hawassa referral hospital, Ethiopia, 2016. Methodology: A cross-sectional study was employed among 232 pregnant women, from April 01-May 15. Systematic sampling technique was employed to select the study population. The self-reporting questionnaires (SRQ- 20) were used to detect common mental disorders. Statistical Package of Social Science (SPSS) version 20 was used in the statistical analysis. Results: The prevalence of common mental disorder was high. Poor health status before pregnancy like, minor health problems (headache) (AOR, 95% CI 2(1.06-3.77), ongoing health concern (diabetes mellitus) (AOR, 95% CI 2.83(1.21-6.66), and serious health problem like hypertension (AOR, 95% CI 4.17(1.24-13.98) were all independently associated with common mental disorder among pregnant women. Conclusion: The prevalence of common mental disorder among pregnant women who attended antenatal care follow up at HURH was higher and previous history of health problem before current pregnancy was significantly associated with common mental disorder. Therefore health care providers responsible for ANC must be trained about the relevance and detection of CMD during pregnancy and proper counseling and emotional support should be given for women exhibiting the risk factors.

The prevalence of primary headache disorders in Ethiopia.

BackgroundKnowledge of the epidemiology of primary headache disorders in sub-Saharan Africa (SSA) remains very limited. We performed a population-based survey in rural and urban areas of Ethiopia, using methods similar to those of an earlier study in Zambia and tested in multiple other countries by Lifting The Burden.MethodsIn a cross-sectional survey we visited households unannounced in four regions of Ethiopia: the mostly urban populations in Addis Ababa and its environs and rural populations of selected districts in Oromia, Amhara and South Nations Nationalities and People’s Regions States (SNNPRS). We used cluster-randomized sampling: within clusters we randomly selected households, and one adult member (18–65 years old) of each household. The HARDSHIP structured questionnaire, translated into the local languages, was administered face-to-face by trained interviewers. Demographic enquiry was followed by diagnostic questions based on ICHD-II criteria.ResultsFrom 2,528 households approached, 2,385 of 2,391 eligible members (1,064 [44.7%] male, 596 [25.0%] urban) consented to interview (participating proportion 99.8%). Headache in the preceding year was reported by 1,071 participants (44.9% [95% CI: 42.4–46.3]; males 37.7%, females 49.9%), and headache yesterday by 170 (7.1% [6.2–8.2]; males 45 [4.1%], females 125 [9.2%]). Adjusted for gender, age and habitation (urban/rural), 1-year prevalence of migraine was 17.7%, of tension-type headache (TTH) 20.6%, of all headache on ≥15 days/month 3.2%, and of probable medication-overuse headache (pMOH) 0.7%. The adjusted prevalence of headache yesterday was 6.4%. Very few cases (1.6%) were unclassifiable. All headache disorders were more common in females. TTH was less common in urban areas (OR: 0.3; p < 0.0001), but pMOH was very strongly associated (OR: 6.1; p < 0.0001) with urban dwelling. Education was negatively associated with migraine (OR: 0.5–0.7; p < 0.05) but (at university level) positively with pMOH (OR: 2.9; p = 0.067). Income above ETB 500/month showed similar associations: negatively with migraine (OR: 0.8; p = 0.035), positively with pMOH (OR: 2.1; p = 0.164).ConclusionsFindings for migraine and TTH in Ethiopia were quite similar to those from Zambia, another SSA country; pMOH was much less prevalent but, as in Zambia, essentially an urban problem. Primary headache disorders are at least as prevalent in SSA as in high-income western countries.

Equitable access to integrated primary mental healthcare for people with severe mental disorders in Ethiopia: a formative study.

BackgroundThe provision of mental healthcare through integration into primary care is expected to improve access to care, but not all population groups may benefit equally. The aim of this study was to inform delivery of a new primary care-based mental health service in rural Ethiopia by identifying potential barriers to equitable access to mental healthcare and strategies to overcome them.MethodsA qualitative study was conducted as formative work for the PRogramme for Improving Mental healthcarE (PRIME), a project supporting delivery of mental healthcare integrated into primary care in a rural district in south central Ethiopia. In-depth interviews (n = 21) were carried out with stakeholders selected purposively from mental health service users, caregivers, community leaders and healthcare administrators. A focus group discussion (n = 12) was conducted with community health extension workers. Framework analysis was employed using an adapted version of the access framework developed for use in contexts of livelihood insecurity, which considers (1) availability, (2) accessibility and affordability. and (3) acceptability and adequacy dimensions of access.ResultsPrimary care-based mental healthcare was considered as a positive development, and would increase availability, accessibility and affordability of treatments. Low levels of community awareness, and general preference for traditional and religious healing were raised as potential challenges to the acceptability of integrated mental healthcare. Participants believed integrated mental healthcare would be comprehensive and of satisfactory quality. However, expectations about the effectiveness of treatment for mental disorders were generally low. Threats to equitable access to mental healthcare were identified for perinatal women, persons with physical disability, those living in extreme poverty and people with severe and persistent mental disability.ConclusionEstablishing an affordable service within reach, raising awareness and financial support to families from low socioeconomic backgrounds were suggested to improve equitable access to mental healthcare by vulnerable groups including perinatal women and people with disabilities. Innovative approaches, such as telephone consultations with psychiatric nurses based in nearby towns and home outreach need to be developed and evaluated.

Reliability and Validity of an Interviewer-Administered Adaptation of the Youth Self-Report for Mental Health Screening of Vulnerable Young People in Ethiopia.

ObjectiveEvaluate the reliability and validity of the Youth Self-Report (YSR) as a screening tool for mental health problems among young people vulnerable to HIV in Ethiopia.DesignA cross-sectional assessment of young people currently receiving social services.MethodsYoung people age 15–18 participated in a study where a translated and adapted version of the YSR was administered by trained nurses, followed by an assessment by Ethiopian psychiatrists. Internal reliability of YSR syndrome scales were assessed using Chronbach's alpha. Test-retest reliability was assessed through repeating the YSR one month later. To assess validity, analysis of the sensitivity and specificity of the YSR compared to the psychiatrist assessment was conducted.ResultsAcross the eight syndrome scales, the YSR best measured the diagnosis of anxiety/depression and social problems among young women, and attention problems among young men. Among individual YSR syndrome scales, internal reliability ranged from unacceptable (Chronback’s alpha = 0.11, rule-breaking behavior among young women) to good (α≥0.71, anxiety/depression among young women). Anxiety/depression scores of ≥8.5 among young women also had good sensitivity (0.833) and specificity (0.754) to predict a true diagnosis. The YSR syndrome scales for social problems among young women and attention problems among young men also had fair consistency and validity measurements. Most YSR scores had significant positive correlations between baseline and post-one month administration. Measures of reliability and validity for most other YSR syndrome scales were fair to poor.ConclusionsThe adapted, personally administered, Amharic version of the YSR has sufficient reliability and validity in identifying young vulnerable women with anxiety/depression and/or social problems, and young men with attention problems; which were the most common mental health disorders observed by psychiatrists among the migrant populations in this study. Further assessment of the applicability of the YSR among vulnerable young people for less common disorders in Ethiopia is needed.

Prevalence and Correlates of Co-occurring Substance Use Disorder among Patients with Severe Mental Disorder at Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia

Introduction: Substance use disorder occurs significantly in patients with severe mental disorders. When substance use concurrently occurs with severe mental disorders, it is associated with poor treatment outcomes, more frequent use of hospitals, treatment noncompliance, more frequent suicidal attempt, frequent and longer episodes, and poor over all adjustments, violent behavior and greater risk of HIV infection. However; little is known about the prevalence of co-occurring substance use disorders in patients with severe mental disorders in Ethiopia. The objective of this study was to assess the prevalence and correlates of co-occurring substance use disorder among patients with severe mental disorders at Amanual mental specialized hospital, Addis Ababa, Ethiopia. Method: Institution based cross sectional study design was conducted in June, 2014. Study Participants were recruited by using systematic random sampling technique. Substance use disorder was assessed through face to face interviews by trained psychiatry nurses using Structured Clinical Interview of DSM-IV (SCID). Correlates for substance use disorder were assessed using a structured questionnaire. Results: A total of 260 schizophrenic and 261 bipolar patients were included in the study. About 84.4% (bipolar) and 82.7% (schizophrenic) patients were life time substance users, while 77.4% (bipolar) and 75% (schizophrenic) patients were current substance users. Of all substance users, 49.8% (bipolar) and 48.1% (schizophrenic) were poly substance users. When we adjusted for the effect of potential confounding variables Age [AOR=2.32, CI= (1.18-4.56), history of hospitalizations [AOR=3.12, CI= (1.20-8.27)] and history of relapse [AOR=3.35, CI= (1.13- 8.83)] were more likely to have substance use disorder as compared to schizophrenic patients who were in age group of <27, no history of hospitalizations and no history of relapse respectively. Bipolar patients, who were in age group of >38 AOR=2.32, CI= (1.18-4.56), history of hospitalizations [AOR=1.75, CI= (1.07-4.37) ] and history of relapse [AOR=5.18, CI=(1.72-15.64)] were more likely to have substance use disorder as compared to bipolar patients who were in age group of <27, no history of hospitalizations and no history of relapse respectively. Conclusion and recommendation: In general, prevalence of co-occurring substance use disorder among patients with severe mental disorder is high. Patient’s age, history of hospitalization and relapses were associated with substance use disorder. Early identification and integrated management of co- occurring substance use disorder in patients with severe mental disorders is vital.

Prevalence and Correlates of Co-occurring Substance Use Disorder among Patients with Severe Mental Disorder at Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia

Introduction: Substance use disorder occurs significantly in patients with severe mental disorders. When substance use concurrently occurs with severe mental disorders, it is associated with poor treatment outcomes, more frequent use of hospitals, treatment noncompliance, more frequent suicidal attempt, frequent and longer episodes, and poor over all adjustments, violent behavior and greater risk of HIV infection. However; little is known about the prevalence of co-occurring substance use disorders in patients with severe mental disorders in Ethiopia. The objective of this study was to assess the prevalence and correlates of co-occurring substance use disorder among patients with severe mental disorders at Amanual mental specialized hospital, Addis Ababa, Ethiopia. Method: Institution based cross sectional study design was conducted in June, 2014. Study Participants were recruited by using systematic random sampling technique. Substance use disorder was assessed through face to face interviews by trained psychiatry nurses using Structured Clinical Interview of DSM-IV (SCID). Correlates for substance use disorder were assessed using a structured questionnaire. Results: A total of 260 schizophrenic and 261 bipolar patients were included in the study. About 84.4% (bipolar) and 82.7% (schizophrenic) patients were life time substance users, while 77.4% (bipolar) and 75% (schizophrenic) patients were current substance users. Of all substance users, 49.8% (bipolar) and 48.1% (schizophrenic) were poly substance users. When we adjusted for the effect of potential confounding variables Age [AOR=2.32, CI= (1.18-4.56), history of hospitalizations [AOR=3.12, CI= (1.20-8.27)] and history of relapse [AOR=3.35, CI= (1.13- 8.83)] were more likely to have substance use disorder as compared to schizophrenic patients who were in age group of <27, no history of hospitalizations and no history of relapse respectively. Bipolar patients, who were in age group of >38 AOR=2.32, CI= (1.18-4.56), history of hospitalizations [AOR=1.75, CI= (1.07-4.37) ] and history of relapse [AOR=5.18, CI=(1.72-15.64)] were more likely to have substance use disorder as compared to bipolar patients who were in age group of <27, no history of hospitalizations and no history of relapse respectively. Conclusion and recommendation: In general, prevalence of co-occurring substance use disorder among patients with severe mental disorder is high. Patient’s age, history of hospitalization and relapses were associated with substance use disorder. Early identification and integrated management of co- occurring substance use disorder in patients with severe mental disorders is vital.

High prevalence of overweight, obesity, and hypertension with increased risk to cardiovascular disorders among adults in northwest Ethiopia: a cross sectional study.

BackgroundOverweight and obesity are components of a defined cluster of risk factors for non-communicable diseases, once problems for only the high-income countries, in recent days became rampant in developing countries. Despite the lack of extensive data on metabolic and cardio vascular disorders in Ethiopia, the prevalence of obesity among young adults (15–24 years), in a cross sectional study conducted in 1997, was 0.7% for men and 6% for women. The prevalence of hypertension (HTN) was found to be 7.1% of the population. The objective of this study was to see the prevalence and association of overweight, obesity and HTN and to check if there was any agreement among the various anthropometric measurements in detecting overweight and obesity.MethodsThis cross-sectional study was conducted in Gondar city, Northwest Ethiopia. A total of 68 participants with age >18 year were randomly selected and included. Data were collected using questionnaires and through physical measurements of weight, height and blood pressure, using the WHO recommendations.ResultThe prevalence of hypertension was 13.3% (9/68). The prevalence of overweight based on calculated body mass index (BMI) was 32.4% (22/68) while the prevalence of obesity was 16.2% (11/68). Body fat percentage (BFP) effectively classified all of the ‘overweight’ and ‘obese’ values according to the BMI as ‘overweight/obese’ (P = 0.016). Risk level classification with waist circumference enabled to correctly classify most (90.9%) and all of the ‘overweight’ and ‘obese’ BMI values as ‘increased risk/substantially increased risk’ (P < 0.001). Similarly, waist-to-height ratio (WHtR) was able to classify all ‘overweight’ and ‘obese’ BMI values as ‘increased risk/substantially increased risk’ (P < 0.001).ConclusionIn conclusion, the current study was able to detect a high prevalence of overweight, obesity, and HTN among adult population in Gondar town. There is a prevalent high level of general adiposity and central obesity. WHtR and BFP were the most efficient measurements to identify all ‘high risk’ groups of individuals as ‘high risk’ irrespective of their gender. Further study is recommended to elucidate the risk factors and complications of obesity and overweight in the study area and beyond.

Generalized psychological distress among HIV-infected patients enrolled in antiretroviral treatment in Dilla University Hospital, Gedeo zone, Ethiopia

BackgroundPsychological disorders like depression and anxiety are potentially dangerous conditions. In the context of HIV/AIDS, this can influence health-seeking behavior or uptake of diagnosis and treatment for HIV/AIDS, add to the burden of disease for HIV patients, create difficulty in adherence to treatment, and increase the risk of mortality and morbidity. The objective of this study was to assess the prevalence and correlates of generalized psychological distress among HIV-infected subjects on antiretroviral treatment (ART).DesignAn institution-based cross-sectional study was conducted. Interviews were conducted with 500 patients initiating ART at Dilla Referral Hospital. Generalized psychological distress was measured using the Hospital Anxiety and Depression Scale (HADS). A cutoff score ≥19 was used to identify possible cases of patients with generalized psychological distress. Multivariable logistic regression analysis using SPSS Version 20 was performed to identify factors associated with psychological distress.ResultsThe prevalence of generalized psychological distress among the population of this study was 11.2% (HADS≥19). Factors independently associated with generalized psychological distress were moderate stress (OR=6.87, 95% CI 2.27–20.81), low social support (OR=10.17, 95% CI 2.85–36.29), number of negative life events of six and above (OR=3.99, 95% CI 1.77–8.99), not disclosing HIV status (OR=5.24, 95% CI 1.33–20.62), and CD4 cell count of <200 cells/mm3 (OR=1.98, 95% CI 0.45–0.83) and 200–499 cells/mm3 (OR=3.53, 95% CI 1.62–7.73).ConclusionsThis study provides prevalence of psychological distress lower than the prevalence of common mental disorders in Ethiopia and comparable to some other studies in sub-Saharan Africa. The findings are important in terms of their relevance to identifying high-risk groups for generalized psychological distress and preventing distress through integrating mental health services with HIV/AIDS care and support program.

Communities and community genetics in Ethiopia.

The rates of congenital and genetic disorders in low and middle income countries are similar or might be higher than in high income countries due to a multitude of risk factors and the dearth of community genetic services. To direct effective preventive, diagnostic and counseling services, collecting data on the incidence and prevalence of various congenital and genetic disorders and their risk factors is a pre-requisite for establishing genetic services at the community level and mainly at the primary health care setting. This brief review is meant to assess the available epidemiological data in Ethiopia pertaining to congenital and genetic disorders on which the future community genetic services could be built. Existing epidemiological data on congenital and genetic disorders in Ethiopia is limited, and the few studies conducted revealed that folate and iodine deficiencies are prevalent among women in the reproductive age. Pregnant women's infection with syphilis and rubella is prevailing. Based on available data, cleft lip and palate, congenital heart diseases, club-foot, and gastro-intestinalmalformations are the most common birth defects in Ethiopia. Community based studies to accurately demonstrate the incidence and prevalence levels of these disorders are almost unavailable. To plan for organization and implementation of community genetic services at the primary health care level in Ethiopia, conducting standardized epidemiological studies is currently highly recommended.

Communication Disorders in Ethiopia: Emerging Needs and New Models of Development

In this article, the author considers the state of communication disorders in Ethiopia today by first discussing the health status of adults and children, particularly as it relates to the prevalence of neurologic and communication disorders. The author goes on to describe new models of treatment for communication and related disorders and the current system of health-care delivery. Next, the author examines the multilingual nature of education in Ethiopia. The article concludes with a consideration of the language development of internationally adopted children, as well as the expected influence of Amharic on English production in mature bilingual speakers.

Mental health services in Ethiopia: Emerging public health issue

Examine the mental health issues in Ethiopia in relation to services offered in this direction. Retrospective. Results of the 2005 Ethiopian Demographic and Health Survey and other secondary data sources were explore dimensions of to understand the mental health issues. The average prevalence of mental disorders in Ethiopia was 18 % for adults and 15% for children. People are now more than ever aware of the importance of mental health. Families now do not need much agitation to seek medical help for their mentally ill members. Unfortunately, the mental health services are available only in Addis Ababa the capital city of Ethiopia. By consequence, a large number of the adolescent is homeless, and lives on the street. Low status of women in Ethiopia underpins and often directly undermines utilization of reproductive health services. Even though, the policy makers or research managers are giving more importance to the reproductive health issues. But, mental health services are emerging issues which determines the development goals of the country. A critical requirement for the mental health promotion is to have information, increase mental health services, trained skilled workers, education and self-confidence to access available services. The key policy rapid actions needed.

Household food insecurity and symptoms of neurologic disorder in Ethiopia: an observational analysis.

BackgroundFood insecurity (FI) has been shown to be associated with poor health both in developing and developed countries. Little is known about the relation between FI and neurological disorder. We assessed the relation between FI and risk for neurologic symptoms in southwest Ethiopia.MethodsData about food security, gender, age, household assets, and self-reported neurologic symptoms were collected from a representative, community-based sample of adults (N = 900) in Jimma Zone, Ethiopia. We calculated univariate statistics and used bivariate chi-square tests and multivariate logistic regression models to assess the relation between FI and risk of neurologic symptoms including seizures, extremity weakness, extremity numbness, tremors/ataxia, aphasia, carpal tunnel syndrome, vision dysfunction, and spinal pain.ResultsIn separate multivariate models by outcome and gender, adjusting for age and household socioeconomic status, severe FI was associated with higher odds of seizures, movement abnormalities, carpal tunnel, vision dysfunction, spinal pain, and comorbid disorders among women. Severe FI was associated with higher odds of seizures, extremity numbness, movement abnormalities, difficulty speaking, carpal tunnel, vision dysfunction, and comorbid disorders among men.ConclusionWe found that FI was associated with symptoms of neurologic disorder. Given the cross-sectional nature of our study, the directionality of these associations is unclear. Future research should assess causal mechanisms relating FI to neurologic symptoms in sub-Saharan Africa.

Maternal common mental disorders and infant development in Ethiopia: the P-MaMiE Birth Cohort

BackgroundChronicity and severity of early exposure to maternal common mental disorders (CMD) has been associated with poorer infant development in high-income countries. In low- and middle-income countries (LAMICs), perinatal CMD is inconsistently associated with infant development, but the impact of severity and persistence has not been examined.MethodsA nested population-based cohort of 258 pregnant women was identified from the Perinatal Maternal Mental Disorder in Ethiopia (P-MaMiE) study, and 194 (75.2%) were successfully followed up until the infants were 12 months of age. Maternal CMD was measured in pregnancy and at two and 12 months postnatal using the WHO Self-Reporting Questionnaire, validated for use in this setting. Infant outcomes were evaluated using the Bayley Scales of Infant Development.ResultsAntenatal maternal CMD symptoms were associated with poorer infant motor development ( -0.20; 95% CI: -0.37 to -0.03), but this became non-significant after adjusting for confounders. Postnatal CMD symptoms were not associated with any domain of infant development. There was evidence of a dose-response relationship between the number of time-points at which the mother had high levels of CMD symptoms (SRQ ≥ 6) and impaired infant motor development ( = -0.80; 95%CI -2.24, 0.65 for ante- or postnatal CMD only, = -4.19; 95%CI -8.60, 0.21 for ante- and postnatal CMD, compared to no CMD; test-for-trend χ213.08(1), p < 0.001). Although this association became non-significant in the fully adjusted model, the coefficients were unchanged indicating that the relationship was not confounded. In multivariable analyses, lower socio-economic status and lower infant weight-for-age were associated with significantly lower scores on both motor and cognitive developmental scales. Maternal experience of physical violence was significantly associated with impaired cognitive development.ConclusionsThe study supports the hypothesis that it is the accumulation of risk exposures across time rather than early exposure to maternal CMD per se that is more likely to affect child development. Further investigation of the impact of chronicity of maternal CMD upon child development in LAMICs is indicated. In the Ethiopian setting, poverty, interpersonal violence and infant undernutrition should be targets for interventions to reduce the loss of child developmental potential.

Food insecurity, stressful life events and symptoms of anxiety and depression in east Africa: evidence from the Gilgel Gibe growth and development study

Objectives:Common mental disorders are a major contributor to the burden of disease in developing countries. An assessment was carried out of whether food insecurity and exposure to stressful life events,...