Mortality In Ethiopia Research Articles

The Promotion of Non-Communicable Disease Screening in Gurage Zone, Ethiopia: A Mixed-Method Study

Background: Despite the high non-communicable disease (NCD) mortality in Ethiopia, NCD screening in the country remains suboptimal. This study assessed the health communication process and materials designed to promote NCD screening among adult primary healthcare facility attendants in the Gurage Zone, Ethiopia. Methods: A parallel mixed-methods approach was employed. Seven health communication materials were evaluated using the Modified Clear Communication Index Score by the Center for Disease Control and Prevention (CDC). Seven key informants who were involved in the production were interviewed to explore the process. Users’ satisfaction with the materials was assessed through a cross-sectional survey (N = 412). We used multivariable logistic regression with SPSS version 27 software to determine the factors associated with users’ satisfaction. Thematic analysis was applied for the qualitative data analysis using Opencode 4.03 software. Results: Qualitative interviews indicated that the production process relied on evidence, involved stakeholders, and included pretesting. The CDC index score revealed that five of the seven materials were considered clear and user-friendly, whereas two required improvement. Overall users’ satisfaction with the material was high with a mean score of 22.10 (SD ± 2.34; min: 14, max: 25). Age and educational status had significant positive association with users’ satisfaction. Conclusions: Developing health communication materials on promoting NCD screening based on evidence, stakeholders’ input, and pretesting can lead to good quality material and user satisfaction. We recommend future research works to measure changes in NCD screening service uptake as a result of using the health communication materials considered in this study.

Trends in maternal education-based inequalities in under-five mortality in Ethiopia: multilevel, decomposition and concentration index analyses

Trends in maternal education-based inequalities in under-five mortality in Ethiopia: multilevel, decomposition and concentration index analyses

Spatiotemporal patterns and factors contributing to neonatal mortality in Ethiopia: Data from EDHS 2000 to 2019.

Although Ethiopia has substantial improvements in various health indicators such as maternal and child mortality, the burden of neonatal mortality remains high. Between 2016 and 2019, neonatal mortality increased from 29 deaths per 1,000 live births to 33 deaths per 1,000 live births. This study aimed to explore the spatial patterns and factors contributing to neonatal mortality in Ethiopia. Data from the Ethiopian Demographic and Health Surveys (EDHS) for the years 2000, 2005, 2011, 2016, and 2019 were analyzed. The EDHS sampling design uses a two-stage cluster sampling technique, considering census enumeration areas as primary sampling units and households as secondary sampling units. We used the Spatial Scan analysis in SaTScan and Getis-Ord Gi* statistic in Geographic Information System (GIS), to analyse the spatiotemporal patterns of neonatal mortality. Maternal, newborn and health service-related factors contributing to neonatal mortality were also analyzed using a multilevel logistic regression model. Adjusted Odds Rios (AOR) with corresponding 95% CI were presented as a measure of association and a P-value of 0.05 was used to declare statistical significance. During the initial three consecutive surveys, there was a consistent pattern of hot spot clusters in the Amhara and Benshangul Gumuz regions, along with certain parts of the Oromia region. However, in later surveys, these clusters shifted to the eastern parts of the country, notably including the Somali region. Early initiation of breast feeding was associated with reduced chances of neonatal death (Adjusted Odds Ratio [AOR]) = 0.27; 95% Confidence Interval [CI]: 0.23, 0.32). Neonates born at home (AOR = 1.46; 95% CI: 1.16, 1.82) and male babies had a higher likelihood of mortality during the neonatal period compared to their counterparts (AOR = 1.36; 95% CI: 1.24, 1.51). The odds of neonatal mortality increased with the number of children a mother had ever given birth to (AOR = 1.36; 95% CI: 1.24, 1.51). In contrast, longer birth intervals were associated with a reduced risk of neonatal mortality (AOR = 0.76; 95% CI: 0.68, 0.83). The central southern, central-western, north-western, and northern parts of Ethiopia had most of the neonatal death clusters in the first three rounds of DHS while eastern Ethiopia had the highest neonatal mortality clusters in the latest two surveys. Our results underscore the importance for policymakers and health administrators to reassess intervention approaches and reallocate resources to regions identified as hot spots for neonatal mortality. Enhancing the initiation of breastfeeding within the first hour of birth would improve newborn survival rates. Special attention and care need to be given to babies born of smaller sizes.

Born in Ethiopia

Abstract Background Goal 3 of the United Nation 2030 Agenda states that we want to ensure health and well-being for all. This is even more true for countries in the IV World. The aim of our study is to investigate the timing of childbirth in Ethiopia. Methods The stages of our ethnographic study include: choosing the study topic and location, participating in group life, collecting and analysing data. The field experience, led by a midwife, took place from September 2023 to October 2023 in Ethiopia, within the Saint Luke Catholic Hospital in Wolisso. Results The instruments that the midwives have at their disposal are few and obsolete: the most is Pinard’s stethoscope. The mothers are all very young: the youngest woman was fourteen years old while the oldest woman was thirty-eight years old. As for parity, the fertility rate is around 4.6 live births per woman. Women’s family members take care of them in all aspects of care. Pregnant and new mothers receive support from their attendants, an all-female network. Pregnancy monitoring is almost non-existent. There is no prenatal diagnosis. In 2022, St. Luke’s hospital saw a 20% caesarean section rate, an increase from the previous two years. Poverty and the lack of government facilities that can support a problem child are two of the reasons why many of these children are abandoned. In terms of maternal and child health, mortality indicators are still too high for mothers and children. There are 353 mothers dying per 100,000 live births and 41 babies dying per 1,000 live births. Conclusions The biomedical model exported from the Western world, as shown for example by the increase in caesarean sections, has led to a slow but progressive hospitalisation of childbirth in the search for safety from maternal and neonatal mortality. Key messages • Poverty, malnutrition, lack of sanitation and drinking water, as well as early pregnancies and high parity remain among the leading causes of mortality in Ethiopia. • The biomedical model exported from the Western world has led to a slow but progressive hospitalisation of childbirth in the search for safety.

Pregnancy-Induced Hypertensive Disorders predictors among pregnant and delivery mothers receiving care in public health institutions in Sidama, Ethiopia: a multicenter case control study

BackgroundPregnancy-Induced Hypertensive Disorders (PIHD) include conditions like Pre-Eclampsia, Eclampsia, and Gestational Hypertension, impacting 5–10% of pregnancies globally. These disorders are responsible for 16% of maternal deaths in Sub-Saharan Africa and account for 16.9% of maternal mortality in Ethiopia, representing 10% of the country's total maternal deaths.ObjectiveTo identify predictors of PIHD among pregnant and delivery women in public hospitals and primary health care units (health centers) in Sidama, Ethiopia.MethodsA multi-center unmatched case–control study was conducted on women in antenatal care and obstetrics/gynecology departments at 12 randomly selected public health institutions, including one specialized teaching hospital, two general hospitals, three primary hospitals, and six health centers. The study involved 920 women (230 cases and 690 controls) selected from December 2023 to February 2024. Cases included pregnant or delivery women at 20 + weeks gestation with PIHD such as pre-eclampsia, eclampsia, gestational hypertension, and chronic hypertension with superimposed preeclampsia. Controls were normotensive pregnant women or delivering mothers without PIHD after 20 weeks gestation. Data was manually verified, entered, and validated using Epidata software, followed by analysis with SPSS 22. Univariate analysis assessed predictors of PIHD, while binary logistic regression evaluated the relationships between factors. Model fitness was checked using collinearity assessments and the Hosmer–Lemeshow test, with variables having a P value < 0.05 deemed independent predictors.ResultsOut of 920 planned participants, 686 were included, resulting in a response rate of 94.35%. Factors associated with PIHD in women included age at first conception (AOR = 1.26), mid (AOR = 6.05) and high (AOR = 5.01) wealth index levels, multigravidity (AOR = 4.34), pregnancy age ≥ 42 weeks (AOR = 3.65), maternal mid-upper arm circumference (MUAC) (AOR = 1.29), hemoglobin levels of 6.5–10.9 g/dL (AOR = 5.59), pre-pregnancy Body Mass Index (BMI) ≥ 25 kg/M2 (AOR = 0.81), preexisting hypertension (AOR = 8.97), family history of diabetes mellitus (AOR = 20.02), former alcohol consumption (AOR = 0.27), and total physical activity during pregnancy (AOR = 0.54).ConclusionsThe study identifies key predictors of PIHD in women, including age at conception, wealth index, multigravidity, gestational age, and pre-pregnancy BMI. It underscores the link between socioeconomic status and maternal health, highlighting that financial resources alone don’t ensure better outcomes without educational access. The research advocates for a health intervention strategy focusing on socioeconomic factors and public health initiatives to reduce maternal health disparities while exploring the role of partner stability and psychosocial aspects.

Tuberculosis Treatment Outcomes and Associated Factors at Zewditu Memorial Hospital, Ethiopia

&amp;lt;i&amp;gt;Background:&amp;lt;/i&amp;gt; Tuberculosis (TB) remains a leading cause of morbidity and mortality in Ethiopia, with treatment success rates consistently below the WHO target. Various factors contribute to poor treatment outcomes. &amp;lt;i&amp;gt;Objective:&amp;lt;/i&amp;gt; To assess treatment outcomes for TB and associated factors at Zewditu Memorial Hospital (ZMH) from 2017 to 2021. &amp;lt;i&amp;gt;Methods:&amp;lt;/i&amp;gt; An institutional-based analytical cross-sectional study was conducted using TB logbook data. After bivariable analysis, clinically relevant variables and variables with a p-value &amp;lt; 0.2 were included in multivariable logistic regression analysis. Statistical significance was set at p-value &amp;lt; 0.05. &amp;lt;i&amp;gt;Results:&amp;lt;/i&amp;gt; The overall successful treatment outcome (cured or completed) was 197 (83.1%). Factors significantly associated with poor treatment outcomes included age group 35 to 44 years (AOR=4.663; 95% CI: 1.215-17.901), extrapulmonary TB (AOR=3.451; 95% CI: 1.172-10.16), and registration in 2019 (AOR=4.367; 95% CI: 1.2-15.87). &amp;lt;i&amp;gt;Conclusion:&amp;lt;/i&amp;gt; The treatment success rate falls short of the national target of 85%, highlighting the need for targeted improvements in TB management. The associations with age and extrapulmonary TB emphasize the necessity for focused control measures. Strengthening targeted TB programs at ZMH is recommended.

Early onset neonatal sepsis and its associatited factors: a cross sectional study

BackgroundSepsis is the 3rd leading cause of neonatal mortality in Ethiopia contributing to 16% of neonatal death. In a hospital study, neonatal sepsis was the leading diagnosis at admission and the second leading cause of neonatal death at the neonatal intensive care unit. Among other factors repeated vaginal examination during labor is known to contribute to sepsis in low-income settings. However, there is limited evidence in the Ethiopian setting.ObjectiveThe objective of this study was to examine the association between early-onset neonatal sepsis and repeated vaginal examinations.MethodsThe study was conducted at Gandhi Memorial Hospital, a public maternity and newborn care hospital. We followed 672 mother-newborn pairs by phone until 7 days of age to detect clinical sepsis. Data were analyzed using SPSS version 20 software. Adjusted odds ratio risk (AOR) with a corresponding 95% confidence interval (CI) was used to show the strength of associations and variables with p-value < 0.05 were considered to be statistically significant.ResultsThe incidence of early-onset neonatal sepsis was found to be 20.83% (95% CI 17.60, 24.00). Having a frequent vaginal examination (four or more times) during labor and delivery, prolonged rupture of membranes, induced labor and gestational age < 37 weeks were strongly associated with the development of early-onset neonatal sepsis, (AOR 2. 69;95 CI: 1.08, 6.70) AOR 5.12(95% CI 1.31, 20.00), AOR of 5.24 (95% CI 1.72, AOR4.34 (95% CI 1.20, 15.68), 16.00), respectively.ConclusionFrequent digital vaginal examination prolonged rupture of membranes, induced labor and gestational age < 37 weeks significantly increases the risk of early onset neonatal sepsis. We also recommend further study using neonatal blood culture to better diagnose early onset neonatal sepsis objectively.

Early neonatal mortality and determinants in Ethiopia: multilevel analysis of Ethiopian demographic and health survey, 2019

IntroductionDespite remarkable achievements in improving maternal and child health, early neonatal deaths still persist, with a sluggish decline in Ethiopia. As a pressing public health issue, it requires frequent and current studies to make appropriate interventions. Therefore, by using the most recent Ethiopian Mini Demographic Health Survey Data of 2019, we aimed to assess the magnitude and factors associated with early neonatal mortality in Ethiopia.MethodsSecondary data analysis was conducted based on the demographic and health survey data conducted in Ethiopia in 2019. A total weighted sample of 5,753 live births was included for this study. A multilevel logistic regression model was used to identify the determinants of early neonatal mortality. The adjusted odds ratio at 95% Cl was computed to assess the strength and significance of the association between explanatory and outcome variables. Factors with a p-value of < 0.05 are declared statistically significant.ResultsThe prevalence of early neonatal mortality in Ethiopia was 26.5 (95% Cl; 22.5–31.08) per 1000 live births. Maternal age 20–35 (AOR, 0.38; 95% Cl, 0.38–0.69), richer wealth index (AOR, 0.47; 95% Cl, 0.23–0.96), having no antenatal care visit (AOR, 1.86; 95% Cl, 1.05–3.30), first birth order (AOR, 3.41; 95% Cl, 1.54–7.56), multiple pregnancy (AOR, 18.5; 95% Cl 8.8–38.9), presence of less than two number of under-five children (AOR, 5.83; 95% Cl, 1.71–19.79) and Somali region (AOR, 3.49; 95% Cl, 1.70-12.52) were significantly associated with early neonatal mortality.ConclusionThis study showed that, in comparison to other developing nations, the nation had a higher rate of early newborn mortality. Thus, programmers and policymakers should adjust their designs and policies in accordance with the needs of newborns and children’s health. The Somali region, extreme maternal age, and ANC utilization among expectant moms should all be given special consideration.

Early neonatal mortality in Ethiopia from 2000 to 2019: an analysis of trends and a multivariate decomposition analysis of Ethiopian demographic and health survey

BackgroundEarly neonatal deaths, occurring within the first six days of life, remain a critical public health challenge. Understanding the trends and factors associated with this issue is crucial for designing effective interventions and achieving global health goals. This study aims to examine the trends in early neonatal mortality in Ethiopia and identify the key factors associated with changes in early neonatal mortality over time.MethodsThis study utilized five consecutive Ethiopian Demographic and Health Survey datasets from 2000 to 2019. To investigate the trends and identify factors influencing changes in early neonatal mortality over time, conducted a trend analysis and a logit-based multivariate decomposition analysis. Data management and analyses were performed using STATA version 17/MP software. All analyses were weighted to account for sampling probabilities and non-response. Statistical significance was determined at a two-sided p-value threshold of less than 0.05.ResultThe analysis included a total of 12,260 weighted women from the 2000 survey and 5,527 weighted women from the 2019 survey. Over the study period, there was an overall downward trend in early neonatal mortality, decreasing from 34 deaths per 1000 live births in 2000 to 27 deaths per 1000 live births in 2019. The annual rate of reduction was estimated to be 1.03%. Approximately 45% of the observed decline in early neonatal mortality rate can be attributed to changes in population characteristics or endowments (E) during the study period. Factors such as the mother’s age, maternal education, marital status, preceding birth interval, types of pregnancy, and the sex of the child significantly contributed to the compositional change in the early neonatal mortality rate.ConclusionOver the past two decades, Ethiopia has seen a modest decline in early neonatal mortality, but this progress falls short of the Sustainable Development Goal (SDGs) targets. To achieve the SDGs, the Ministry of Health and its partners should intensify efforts to reduce early neonatal mortality. Strategies like preventing early/late pregnancies, promoting appropriate marriage timing, and prioritizing education could help further reduce early neonatal deaths. Further research is also needed to explore the factors driving this issue.

A Perioperative Quality Improvement Program for Cesarean Delivery in Ethiopia

Infections and complications following cesarean delivery are a significant source of maternal mortality in Ethiopia. To study the effectiveness of a program to strengthen compliance with perioperative standards and reduce postoperative complications following cesarean delivery. This stepped-wedge cluster randomized clinical trial included patients undergoing cesarean delivery from August 24, 2021, to January 31, 2023, at 9 hospitals organized into 5 clusters in Ethiopia. Clean Cut, a multimodal surgical quality improvement program that includes process-mapping 6 perioperative standards and creating site-specific, systems-level improvements. The control period was the period before implementation of the intervention. The primary end point was surgical site infection rate, and secondary end points were maternal mortality and perinatal mortality and a composite outcome of infections and both mortality outcomes. All were assessed at 30 days postoperatively in the intervention and control groups, adjusting for clustering and demographics. Compliance with standards and the relationship between compliance and outcomes were also compared between the 2 arms. Among 9755 women undergoing cesarean delivery, 5099 deliveries (52.3%) occurred during the control period (2722 emergency cases [53.4%]) and 4656 (47.7%) during the intervention period (2346 emergency cases [50.4%]). Mean (SD) patient age was 27.04 (0.05) years. Thirty-day follow-up was completed for 5153 patients (52.8%). No significant reduction in infection rates was detected after the intervention (OR, 0.84; 95% CI, 0.55-1.27; P = .40). Intraoperative infection prevention standards improved significantly in the intervention arm vs control arm for compliance with at least 5 of the 6 standards (odds ratio [OR], 2.95; 95% CI, 2.40-3.62; P < .001). Regardless of trial arm, high compliance was associated with reduced odds of maternal (OR, 0.32; 95% CI, 0.11-0.93; P = .04) and perinatal (OR, 0.64; 95% CI, 0.47-0.89; P = .008) mortality. In this stepped-wedge cluster randomized clinical trial of patients undergoing cesarean delivery, no significant reductions in surgical site infections were observed. However, compliance with perioperative standards improved following the intervention. ClinicalTrials.gov Identifier: NCT04812522; Pan-African Clinical Trials Registry Identifier: PACTR202108717887402.

Trend, and multivariate decomposition of perinatal mortality in Ethiopia using further analysis of EDHS 2005–2016

BackgroundPerinatal mortality is a global health problem, especially in Ethiopia, which has the highest perinatal mortality rate. Studies about perinatal mortality were conducted in Ethiopia, but which factors specifically contribute to the change in perinatal mortality across time is unknown.ObjectivesTo assess the trend and multivariate decomposition of perinatal mortality in Ethiopia using EDHS 2005–2016.MethodsA community-based, cross-sectional study design was used. EDHS 2005–2016 data was used, and weighting has been applied to adjust the difference in the probability of selection. Logit-based multivariate decomposition analysis was used using STATA version 14.1. The best model was selected using the lowest AIC value, and variables were selected with a p-value less than 0.05 at 95% CI.ResultThe trend of perinatal mortality in Ethiopia decreased from 37 per 1000 births in 2005 to 33 per 1000 births in 2016. About 83.3% of the decrease in perinatal mortality in the survey was attributed to the difference in the endowment (composition) of the women. Among the differences in the endowment, the difference in the composition of ANC visits, taking the TT vaccine, urban residence, occupation, secondary education, and birth attendant significantly decreased perinatal mortality in the last 10 years. Among the differences in coefficients, skilled birth attendants significantly decreased perinatal mortality.Conclusion and recommendationThe perinatal mortality rate in Ethiopia has declined over time. Variables like ANC visits, taking the TT vaccine, urban residence, occupation, secondary education, and skilled birth attendants reduce perinatal mortality. To reduce perinatal mortality more, scaling up maternal and newborn health services has a critical role.

Abortion beyond a medical issue; women's perception on the current Ethiopian abortion law among reproductive-aged women by 2023, a community-based cross-sectional study.

A nationwide study on the contribution of abortion to maternal mortality in Ethiopia was 6%-9%. To bring Ethiopia's legal system into compliance with the country's new constitution, a new criminal code was created in 2005. In the new penal code, after 2005, abortion was permitted under broad circumstances; in the case of rape, incest, or fetal impairment; if pregnancy continuation or birth would endanger the health or life of the woman or fetus; if the woman has physical or mental disabilities; and if the woman is a minor who is physically or mentally unprepared for childbirth. To determine the status of women's perception toward the current Ethiopian abortion law among reproductive-aged women. A community-based study was conducted from June 10 to October 30, 2023. Chi-square test and multivariable logistic regression methods were employed using SPSS 23. The strength of associations and the significance level was examined using p-value and odds ratio at 95% CI, respectively. The prevalence of women's positive perception toward Ethiopian abortion law among reproductive-aged women is 21.18%. The age group of between 18 and 24, educational status of being unable to read and write, living solely, history of unplanned pregnancy, and age of marriage under 18 were associated with women's perception to the current abortion law of Ethiopia. The finding of this study is unexpectedly low, which needs exhaustive intervention.

Cost-benefit analysis of intervention reducing young stock mortality in Ethiopia.

Livestock provide meat, milk, draught labour, are used for breeding, and act as a store of value for smallholder farmers. High young stock mortality (YSM) has the potential to cause significant financial loss. The Young Stock Mortality Reduction Consortium collaborated on a project to deliver a package of basic health and husbandry interventions to reduce YSM for cattle and small ruminants in mixed and pastoral production systems in Ethiopia. Prior to the intervention, YSM rates ranged from 9.8% for calves in mixed systems, to 35.6% for small ruminants in pastoral systems. Proportional reductions YSM from the intervention ranged from 60% for calves and for small ruminants in mixed systems, to 72% for calves in pastoral systems. This brief research report assesses the costs and benefits of the intervention ex-poste to determine its efficiency. NPVs for the intervention (per household) were calculated for a range of benefit periods (from 1 to 20 years), based on the cost of training enumerators and farmers and the net annual household benefits realised within each benefit period. We found in both pastoral and mixed systems the net annual household benefit for the intervention was positive. For pastoral households the intervention achieves a positive NPV after 2 years. For mixed households the intervention achieves a positive NPV after 11 years. Overall, we found the benefits of the intervention exceed the costs, by a very large amount in pastoral systems, and that benefits were larger for households that kept larger numbers of breeding females.

The influence of parental occupational status on under-five mortality in Ethiopia

ABSTRACT Few studies have examined the mediators of the association between parental occupational status and under-five mortality risk in Ethiopia. We examine the association between parental occupational status and under-five mortality risk in Ethiopia and the role of two mediating variables, antenatal care visits and delivery by a health professional, in this relationship. Using birth data from the nationally representative 2016 Ethiopia Demographic and Health Survey, the study finds that parental occupation, antenatal care visits, and delivery by a health professional are associated with under-five mortality risk. The study also finds that after controlling for mediating variables, parents engaged in professional, agricultural, and manual labor still have lower odds of under-five mortality risk than children of non-working parents. Future research should focus on the pathway from parental employment to child mortality risk, not through access to antenatal care and delivery by health professionals.

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.

Machine learning algorithms for predicting COVID-19 mortality in Ethiopia

BackgroundCoronavirus disease 2019 (COVID-19), a global public health crisis, continues to pose challenges despite preventive measures. The daily rise in COVID-19 cases is concerning, and the testing process is both time-consuming and costly. While several models have been created to predict mortality in COVID-19 patients, only a few have shown sufficient accuracy. Machine learning algorithms offer a promising approach to data-driven prediction of clinical outcomes, surpassing traditional statistical modeling. Leveraging machine learning (ML) algorithms could potentially provide a solution for predicting mortality in hospitalized COVID-19 patients in Ethiopia. Therefore, the aim of this study is to develop and validate machine-learning models for accurately predicting mortality in COVID-19 hospitalized patients in Ethiopia.MethodsOur study involved analyzing electronic medical records of COVID-19 patients who were admitted to public hospitals in Ethiopia. Specifically, we developed seven different machine learning models to predict COVID-19 patient mortality. These models included J48 decision tree, random forest (RF), k-nearest neighborhood (k-NN), multi-layer perceptron (MLP), Naïve Bayes (NB), eXtreme gradient boosting (XGBoost), and logistic regression (LR). We then compared the performance of these models using data from a cohort of 696 patients through statistical analysis. To evaluate the effectiveness of the models, we utilized metrics derived from the confusion matrix such as sensitivity, specificity, precision, and receiver operating characteristic (ROC).ResultsThe study included a total of 696 patients, with a higher number of females (440 patients, accounting for 63.2%) compared to males. The median age of the participants was 35.0 years old, with an interquartile range of 18–79. After conducting different feature selection procedures, 23 features were examined, and identified as predictors of mortality, and it was determined that gender, Intensive care unit (ICU) admission, and alcohol drinking/addiction were the top three predictors of COVID-19 mortality. On the other hand, loss of smell, loss of taste, and hypertension were identified as the three lowest predictors of COVID-19 mortality. The experimental results revealed that the k-nearest neighbor (k-NN) algorithm outperformed than other machine learning algorithms, achieving an accuracy of 95.25%, sensitivity of 95.30%, precision of 92.7%, specificity of 93.30%, F1 score 93.98% and a receiver operating characteristic (ROC) score of 96.90%. These findings highlight the effectiveness of the k-NN algorithm in predicting COVID-19 outcomes based on the selected features.ConclusionOur study has developed an innovative model that utilizes hospital data to accurately predict the mortality risk of COVID-19 patients. The main objective of this model is to prioritize early treatment for high-risk patients and optimize strained healthcare systems during the ongoing pandemic. By integrating machine learning with comprehensive hospital databases, our model effectively classifies patients' mortality risk, enabling targeted medical interventions and improved resource management.Among the various methods tested, the K-nearest neighbors (KNN) algorithm demonstrated the highest accuracy, allowing for early identification of high-risk patients. Through KNN feature identification, we identified 23 predictors that significantly contribute to predicting COVID-19 mortality. The top five predictors are gender (female), intensive care unit (ICU) admission, alcohol drinking, smoking, and symptoms of headache and chills.This advancement holds great promise in enhancing healthcare outcomes and decision-making during the pandemic. By providing services and prioritizing patients based on the identified predictors, healthcare facilities and providers can improve the chances of survival for individuals. This model provides valuable insights that can guide healthcare professionals in allocating resources and delivering appropriate care to those at highest risk.

Financial Hardship Among Women With Breast Cancer in Addis Ababa Ethiopia: A Comparative Cross-Sectional Study

PURPOSE Breast cancer (BC) is the leading cause of cancer morbidity and mortality in Ethiopia, yet financial hardship is often overlooked. Herein, we examined the financial hardship of BC among women newly diagnosed with the disease in Addis Ababa, Ethiopia. MATERIALS AND METHODS We conducted a comparative cross-sectional study of financial hardship between 353 women diagnosed with BC from 2017 to 2018 in Addis Ababa and 618 women without a history of the disease but with medical expenses selected by multistaging sampling from the city's general population. Financial hardship measures, coded as binary variables (yes, no), included selling assets to pay for medical expenses, borrowing money to meet medical expenses, and worrying about family's financial security. The associations between BC diagnoses and each of the financial hardship measures were evaluated using the multivariable logistic regression model. RESULTS Women with BC compared with those without a history of the disease were more likely to report out-of-pocket costs (98% v 38.9%), sell properties (10.2% v 4.2%), and worry about families' financial security (53.8% v 41.8%), but they were equally likely to report borrowing money (19.8% v 17.8%). In the multivariable-adjusted model, women with BC compared with those without the disease were three times as likely to sell their property to cover medical expenses (adjusted odds ratio [AOR], 2.94 [95% CI, 1.49 to 5.83]) and 1.4 more likely to worry about their family's financial security (AOR, 1.42 [95% CI, 1.02 to 1.96]). CONCLUSION The material and psychological burden of BC is considerably high among women in Addis Ababa, Ethiopia, suggesting the need for discussion of cost as part of delivering high-quality care and expanding health care coverage.

Common predictors of cervical cancer related mortality in Ethiopia. A systematic review and meta-analysis

BackgroundCervical cancer accounts for 7.5% of all female cancer related deaths worldwide; peaking between the ages of 35 and 65, and not only kills young women but also destroys families with young children.ObjectiveThis review was intended to measure national level magnitude and the most common predictors of cervical cancer related mortality in Ethiopia.MethodsCommon Public databases like Science Direct, Embase, the Cochrane Library, and PubMed were thoroughly searched. The STATA 14 and Rev-Manager 5.3 statistical software packages were used for analysis, as well as a standardized data abstraction tool created in Microsoft Excel. The Cochrane Q-test statistics and the I2 test were used to assess non-uniformity. The pooled magnitude and predictors of cervical cancer related mortality were estimated using fixed-effect and random-effect models, respectively.ResultThe pooled mortality among cervical cancer patients was estimated that 16.39% at 95% confidence level fall in 13.89–18.88% in Ethiopia. The most common predictors of cervical cancer related mortality were late diagnosed, radiation therapy alone, and Being anemic were identified by this review. Among cervical cancer treatment modalities effectiveness of surgery with adjuvant therapy was also approved in this meta-analysis.Conclusion and recommendationIn this study high cervical cancer-related mortality was reported as compared to national strategies to alleviate cervical cancer related mortality. Advanced implementation of cervical cancer screening at the national level for early diagnosis, anaemia detection, and combination anticancer therapy during initiation, as well as combination therapy, is critical to improve cervical cancer patient survival and decreasing mortality rates.

Predictors of neonatal mortality in Ethiopia: Cross sectional study using 2005, 2010 and 2016 Ethiopian demographic health survey datasets.

Ethiopia is among the countries that have highest neonatal mortality in the world. Despite efforts to reduce neonatal mortality, the country has faced challenges in achieving national and global targets. The study aims to determine the trends and predictors of change in neonatal mortality in Ethiopia for the past 15 years. The study used Ethiopian Demographic Health Survey Datasets (EDHS) from 2005, 2011, and 2016. All live births of reproductive-age women in Ethiopia were included in the study. Multivariate decomposition analysis for the nonlinear response variable (MVDCMP) based on the logit link function was employed to determine the relative contribution of each independent variable to the change in neonatal mortality over the last 15 years. The neonatal mortality rate has decreased by 11 per 1,000 live births, with an annual reduction rate of 2.8% during the survey period. The mortality rate increased in the pastoralist regions of the country from 31 per 1,000 live births to 36 per 1,000 live births, compared to the city and agrarian regions. Maternal ANC visits in 2005 and 2016 (AOR [95%CI] = 0.10 [0.01, 0.81]; 0.01 [0.02, 0.60]) were significantly associated with decreased neonatal mortality. In addition, the decomposition analysis revealed that increased birth interval of more than 24 months and early breastfeeding initiation contributed to the reduction of neonatal mortality by 26% and 10%, respectively, during the survey period. The study found that neonatal mortality is a public health problem in the country, particularly in pastoralist communities. Tailor made maternal and child healthcare interventions that promote early breastfeeding initiation, increased birth intervals and ANC utilization should be implemented to reduce neonatal mortality, particularly in pastoralist communities.

Epidemiology of Plasmodium vivax in Duffy negatives and Duffy positives from community and health centre collections in Ethiopia.

Malaria remains a significant cause of morbidity and mortality in Ethiopia with an estimated 3.8 million cases in 2021 and 61% of the population living in areas at risk of malaria transmission. Throughout the country Plasmodium vivax and Plasmodium falciparum are co-endemic, and Duffy expression is highly heterogeneous. The public health significance of Duffy negativity in relation to P. vivax malaria in Ethiopia, however, remains unclear. This study seeks to explore the prevalence and rates of P. vivax malaria infection across Duffy phenotypes in clinical and community settings. A total of 9580 and 4667 subjects from community and health facilities from a malaria endemic site and an epidemic-prone site in western Ethiopia were enrolled and examined for P. vivax infection and Duffy expression from February 2018 to April 2021. Association between Duffy expression, P. vivax and P. falciparum infections were examined for samples collected from asymptomatic community volunteers and symptomatic subjects from health centres. Infection rate of P. vivax among Duffy positives was 2-22 fold higher than Duffy negatives in asymptomatic volunteers from the community. Parasite positivity rate was 10-50 fold higher in Duffy positives than Duffy negatives among samples collected from febrile patients attending health centres and mixed P. vivax and P. falciparum infections were significantly more common than P. vivax mono infections among Duffy negative individuals. Plasmodium vivax parasitaemia measured by 18sRNA parasite gene copy number was similar between Duffy positives and Duffy negatives. Duffy negativity does not offer complete protection against infection by P. vivax, and cases of P. vivax in Duffy negatives are widespread in Ethiopia, being found in asymptomatic volunteers from communities and in febrile patients from health centres. These findings offer evidence for consideration when developing control and intervention strategies in areas of endemic P. vivax and Duffy heterogeneity.