Mortality In Ethiopia Research Articles

Rising cases of cholera in Ethiopia: a need for sustainable wash practices?

Rising cases of cholera in Ethiopia: a need for sustainable wash practices?

Road traffic accident clinical pattern and management outcomes at JUMC Emergency Department; Ethiopia

Road Traffic Accident is an incident on a way or street open to public traffic. It becomes one of the most significant public health problems in the world especially in developing countries. In Ethiopia, it represents a significant risk for morbidity and mortality. It is also the major public health problem even though studies done on this topic in the study area is limited. To assess clinical pattern, associated factors and management outcomes among road traffic accident Victims attending emergency department of Jimma University Medical Center. Hospital based cross sectional study design was employed to review patients' chart visited the hospital from March to April 2021. A systematic random sampling technique was applied. The data were collected using pretested checklist and analyzed using SPSS version 26. Descriptive statistics and multivariate logistic regression were computed. Variables with P<0.05 were considered statistically significant. About 49.6%) were pedestrians injured of which motorcycle accounted 42.9%. More than half of victims never got any type of prehospital care. On arrival, 38.7% were classified as Red of which 71.4% of them were managed surgically. About 84.9% of victims were discharged with improvement whereas12.6% were died. Victims with head injury (AOR= 16.61: 95% CI; 3.85, 71.71), time elapsed to reach nearby health facility (AOR= 3.30; 95 CI (1.13, 9.60), condition of patient at Emergency Department (AOR= 7.78; 95% CI: 2.33, 26.06), GCS at admission (AOR= 20.12; 95% CI: 7.23, 55.96) and days spent in hospital (AOR= 6.85; 95% CI 5.81, 8.06) were independent predictors of unfavorable outcome. Road Traffic Accident represents a significant risk for morbidity and mortality in Ethiopia, of which head injury and multiple sites injury increase injury severity. Targeted approaches to improving care of the injured victims may improve outcomes. Thus, the clinician should take into consideration the clinical presentation and give due attention to the identified contributing factors in its management.

The Causes and Factors Associated with Infant Mortality Rate in Ethiopia: The Application of Structural Equation Modelling

Infant mortality rate is a proxy measure of population health. Previous studies on the infant mortality rate in Ethiopia did not consider measurement errors in the measured variables and had a one-directional effect; little emphasis was placed on testing multiple causal paths at the same time. We used structural equation modelling for a better understanding of the direct, indirect, and total effects among causal variables in a single model. A path analysis was part of an algorithm providing equations that were relating the variances and covariances of the indicators. From the results, the maternal mortality ratio (MMR) was significantly mediating the influence of out-of-pocket expenditure (OOP) on infant mortality rate (IMR), and the fertility rate (FR) was significantly mediating the influence of GDP to IMR (β = 1.168, p < 0.001). The GDP affects the IMR directly and indirectly while the OOP affects IMR indirectly. This study showed that there was a causal linkage between the World Bank Health and Population Variables for causing IMR in Ethiopia. The MMR and FR were found to be the intermediate indicators in this study. Through the indicators, FR had the highest standardised coefficients for increasing the IMR. We recommended that the existing interventions to reduce IMR be strengthened.

Boosting the Performance of Artificial Intelligence-Driven Models in Predicting COVID-19 Mortality in Ethiopia

Like other nations around the world, Ethiopia has suffered negative effects from COVID-19. The objective of this study was to predict COVID-19 mortality using Artificial Intelligence (AI)-driven models. Two-year daily recorded data related to COVID-19 were trained and tested to predict mortality using machine learning algorithms. Normalization of features, sensitivity analysis for feature selection, modelling of AI-driven models, and comparing the boosting model with single AI-driven models were the main activities performed in this study. Prediction of COVID-19 mortality was conducted using a combination of four dominant feature variables, and hence, the best determination of coefficient (DC) of AdaBoost, KNN, ANN-6, and SVM in the prediction process were 0.9422, 0.8618, 0.8629, and 0.7171, respectively. The Boosting model improved the performance of the individual AI-driven models KNN, SVM, and ANN-6 by 7.94, 22.51, and 8.02 percent, respectively, at the verification stage using the testing dataset. This suggests that the boosting model has the best performance for prediction of COVID-19 mortality in Ethiopia. As a result, it suggests a promising potential performance of boosting ensemble model to be applied in predicting mortality and cases from similarly recorded daily data to predict mortality due to COVID-19 in other parts of the world.

Geographical and Socioeconomic Inequalities in Maternal Mortality in Ethiopia.

In Ethiopia, social inequalities are common among women residing in deprived communities and between the poor and the rich. This study aimed to assess geographical and socioeconomic inequalities in maternal mortality using nationally representative data from Ethiopian Demographic and Health Surveys conducted from 2000 to 2019 (inclusive). Four health-related geographical and socioeconomic factors were assessed. Four relative and absolute health-related inequality measures were also used: rate difference, rate ratio, population attributable risk, and population attributable fraction. A total of 61,610 sister siblings were included. The highest reported inequalities in maternal mortality were residence-related (46% in 2005 among rural women), region-related (66% in 2005 among women in Beshangul-Gumuz regional state), education-related (83% in 2011 among women with primary education), and wealth-related (47% in 2000 among poorer women). So, if education-related inequalities in maternal mortality alone had been averted, the national maternal mortality could have been reduced by 52% in 2000, 51% in 2005, 83% in 2011, and 76% in 2016. In conclusion, inequalities in maternal mortality were high and concentrated among poorer women, women with lower educational status, and rural areas. Therefore, reducing the effects of poverty including social determinants of maternal mortality is recommended.

The effect of distance to health facility on neonatal mortality in Ethiopia

IntroductionIn Ethiopia, more than half of newborn babies do not have access to Emergency Obstetric and Neonatal Care (EmONC) services. Understanding the effect of distance to health facilities on service use and neonatal survival is crucial to recommend policymakers and improving resource distribution. We aimed to investigate the effect of distance to health services on maternal service use and neonatal mortality.MethodsWe implemented a data integration method based on geographic coordinates. We calculated straight-line (Euclidean) distances from the Ethiopian 2016 demographic and health survey (EDHS) clusters to the closest health facility. We computed the distance in ESRI ArcGIS Version 10.3 using the geographic coordinates of DHS clusters and health facilities. Generalised Structural Equation Modelling (GSEM) was used to estimate the effect of distance on neonatal mortality.ResultsPoor geographic accessibility to health facilities affects maternal service usage and increases the risk of newborn mortality. For every ten kilometres (km) increase in distance to a health facility, the odds of neonatal mortality increased by 1.33% (95% CI: 1.06% to 1.67%). Distance also negatively affected antenatal care, facility delivery and postnatal counselling service use.ConclusionsA lack of geographical access to health facilities decreases the likelihood of newborns surviving their first month of life and affects health services use during pregnancy and immediately after birth. The study also showed that antenatal care use was positively associated with facility delivery service use and that both positively influenced postnatal care use, demonstrating the interconnectedness of the components of continuum of care for maternal and neonatal care services. Policymakers can leverage the findings from this study to improve accessibility barriers to health services.

Preventive herd management practices and their effect on lamb mortality in Ethiopia

According to previous studies, lamb mortality is high in the Ethiopian highlands. The present study aims to evaluate the execution of preventive sheep herd health management practices with respect to if, and how, such practices are linked to occurrence of lamb mortality. Interviews were performed with 74 sheep-owning households participating in a capacity development program on livestock and 69 households not participating in such program. To evaluate the impact of combinations of performed practices, a scoring system was developed—the households retrieved a higher score the more desired routines were accomplished. To identify which practices had the highest impact on lamb mortality, a similar score was calculated for each phase of the sheep reproductive year, creating sub-scores for each phase. The results showed a significant (p < 0.05) negative correlation between the total number of performed practices and occurrence of lamb mortality, indicating a lower occurrence of lamb mortality the more desired practices implemented. Further analysis of sub-scores showed significant (p < 0.05) negative correlations between a higher number of performed desired practices during gestation period and during lambing. Conclusively, the study indicates that preventive herd management routines are beneficial for lamb survival, foremost when enforced during the gestation period and around lambing—hence, this is where to focus future interventions.

Epidemiology of neonatal mortality: a spatial and multilevel analysis of the 2019 mini-Ethiopian demographic and health survey data

BackgroundSub-Saharan African countries are a high-burden region of neonatal mortality and showed slow progress in its reduction. In developing countries, as long as the current trend of mortality persists, achieving a sustainable development target for neonatal mortality would be challenging. The aim of this study was to detect significant geographic areas and identify community and individual-level predictors of neonatal mortality in Ethiopia to draw attention to a policy.Methods A weighted total sample of 24,136 mothers from the 2019 mini-Ethiopian demographic and health survey data were included in the analysis. Global Moran’s I statistics was run to check the clustering of neonatal mortality and then kriging interpolation was done to predict the magnitude of neonatal mortality in Ethiopia. In addition, SaTScan analysis was also executed to identify hot spot clusters of neonatal mortality. Finally, a multilevel mixed-effect logistic regression model was used to identify community and individual-level predictors of early neonatal and neonatal mortality.ResultsThe lifetime early neonatal and neonatal mortality among mothers in Ethiopia was 5.08 (95% CI: 4.13–6.03) and 6.54 (5.55, 7.52) per 1000 births respectively. Neonatal mortality was spatially clustered in the country and the SaTScan analysis identified significant hotspot areas of neonatal mortality in the Amhara and Afar regions and some areas of the Somali and Oromia regions. Its predicted magnitude was > 8 per 1000 births in wide areas of the Amhara and Benishangul regions. A multilevel mixed-effect logistics regression analysis identified that a lower level of maternal education, being a twin neonate, and being a male neonate were predictors of both early neonatal and neonatal mortality. Whereas, the younger age of mothers predicted neonatal mortality.ConclusionsNeonatal mortality in Ethiopia is geographically clustered and sociodemographic and obstetric factors played a significant role. Policy direction should focus on evidence-based practices like midwives-led community and facility-based continuum of care from preconception to postnatal periods to possibly reduce neonatal mortality.

A woman's lifetime risk disparities in maternal mortality in Ethiopia

AbstractBackgroundIn Ethiopia, a woman's lifetime risk (chance) of dying from maternal causes over a woman's reproductive lifespan continues to be a public health challenge. However, detailed evidence is scarce. This study aimed to assess woman's lifetime risk disparities in maternal mortality.MethodsNational data from the Ethiopian Demographic and Health Survey from 2000 to 2016 were used. To determine a woman's lifetime risk of dying, first, the maternal mortality ratio was calculated. Then, a woman's lifetime risk of dying was calculated. Four policy‐relevant socio‐economic factors were assessed: residence, education, regional states and economic status. To assess a woman's lifetime risk disparities in maternal mortality, the rate ratio (R) was used as per the World Health Organization's Health Equity Assessment Toolkit and software.ResultsFrom 61,610 respondents, 795 deaths were reported. A woman's lifetime risk of dying nearly halved from 4.6% in 2000 (1 in 22 women) to 1.9% in 2016 (1 in 52 women). In 2016, the highest woman's lifetime risk of dying was observed among rural women (1 in 111 women), in Oromiya regional state (1 in 71 women), women with secondary education (1 in 82 women) and women with middle income (1 in 77 women). The socioeconomic factors that drive a woman's lifetime risk disparities in maternal mortality include residence (1.3‐times higher among rural women), regional state (2‐times higher among women in Oromiya regional state), education (6‐times higher among women with lower educational status), and economic status (1.3‐times higher among the poorest women).ConclusionEthiopian women experienced a high lifetime risk of maternal mortality which varies across socioeconomic groups. Therefore, equity‐oriented maternal healthcare is recommended to reduce the effects of structural inequities, such as poverty, and the inequitable distribution of the socioeconomic factors of maternal health that sustain a woman's lifetime risk disparities in maternal mortality.

The effects of advanced maternal age on perinatal mortality in Ethiopia: A systematic review and meta-analysis.

Pregnancy in women over the age of 35 years is considered advanced maternal age. The relationship between advanced maternal age and the risk of perinatal mortality is still controversial. As a result, this systematic review and meta-analysis were carried out to clarify the relationship between advanced maternal age and perinatal mortality in Ethiopia. The following electronic databases were used for this systematic review and meta-analysis: PubMed, Web of Science, Scopus, Science Direct, Google Scholar, HINARI, and African Journals Online up to March 2022. Addis Ababa, Gondor, and Jimma University research repositories were also searched. A random-effects model was used to pool study-specific odds ratios. A total of 18 articles, including a total of 45,541 participants, were included in the meta-analysis. A total of 11 cross-sectional, 2 case-control, and 5 cohort studies were included. The overall pooled estimate indicates that women with advanced maternal age had a 1.58 higher risk of perinatal mortality compared to women in the younger age group (odds ratio = 1.58; 95% Confidence Interval: 1.13-2.03). The subgroup analysis also revealed that there were differences in the effect size as the geographical region differed. The result showed that the odd of perinatal mortality was highest in the Oromia region and lowest in the Southern Nations Nationalities and Peoples' Region. The overall pooled estimate indicates that women with advanced maternal age had a 1.58-fold higher risk of perinatal mortality. Even though this risk could also be increased with other comorbid diseases, it is important for healthcare providers and other concerned stakeholders to be aware of the increased risks associated with advanced maternal age and provide different intervention programs designed to create awareness and provide counseling services to couples who seek to have a child in their later ages about the risks of advanced maternal age pregnancy on perinatal mortality and other adverse pregnancy outcomes.

Cervical Cancer Screening Service Utilization and Associated Factors Among Women Living With HIV Receiving Anti-Retroviral Therapy at Adama Hospital Medical College, Ethiopia.

Cervical cancer is the second highest cause of cancer-related mortality in the world, and it is one of the top 20 causes of mortality in Ethiopia. Even though cervical cancer is more common among women living with HIV, the utilization of cervical cancer screening services remains low in Ethiopia. This study aimed to assess cervical cancer screening service utilization and associated factors among women living with HIV receiving anti-retroviral therapy at Adama Hospital Medical College, Ethiopia. An institution-based cross-sectional study was conducted among a sample of 304 women living with HIV from 1st-30th June 2022. Data were collected using an interviewer-administered questionnaire. The data were entered into Epi info version 7 and exported to SPSS version 25 for analysis. Bi-variable logistic regression analysis was used to identify candidate variables at p < .25. Finally, multivariable logistic regression analysis was used to identify the independent predictors of cervical cancer screening service utilization at p < .05 with 95% confidence intervals. The magnitude of cervical cancer screening service utilization was 26.9% (95% CI: 22.0, 32.6). Being a government employee (AOR: 8.09, 95% CI: 1.5, 41.19), having a family history of cervical cancer (AOR: 3.4, 95% CI: 1.02, 11.9), being aware of cervical cancer screening (AOR: 3.75, 95% CI: 2.11, 14.7), having a history of sexually transmitted infection (AOR: 3.14, 95% CI: 1.95, 10.2), and heard about cervical cancer (AOR: 2.6, 95% CI: 1.05, 6.41) were associated with cervical cancer screening service utilization. The magnitude of cervical cancer screening service utilization was low. It was associated with occupation status, family history of cervical cancer, awareness about cervical cancer screening, history of STI, and ever heard about cervical cancer. Thus, to maximize utilization, health education programs and other multidisciplinary strategies had to be implemented.

Multivariate frailty models using survey weights with applications to twins infant mortality in Ethiopia

Multivariate frailty models using survey weights with applications to twins infant mortality in Ethiopia

Determining factors of neonatal mortality in Ethiopia: An investigation from the 2019 Ethiopia Mini Demographic and Health Survey.

Neonatal mortality is the probability of dying during the first 28 days of life. Of approximately 5 million children who die in the first year of life in the world, about 3 million are within their first 28 days of birth. In Ethiopia, the neonatal mortality rate is high about 37 per 1000 live births, and the factors are not well documented. Then, this study aimed to determine the key factors that have a significant influence on neonatal mortality. A total of 5753 neonatal mortality-related data were obtained from Ethiopia Mini Demographic and Health Survey (2019) data. A frequency distribution to summarize the overall data and Binary Logistic Regression to identify the subset of significant risk factors for neonatal mortality were applied to analyze the data. An estimated 36 per 1000 live children had died before the first 28 days, with the highest in the Benishangul Gumuz region (15.9%) and the lowest in Addis Ababa (2.4%). From the Binary logistic regression analysis, the odds ratio and 95% CI of age 25-34 (OR = 0.263, 95% CI: 0.106-0.653), Afar (OR = 0.384, 95% CI: 0.167-0.884), SNNPR (OR = 0.265, 95% CI: 0.098-0.720), Addis Ababa (OR = 5.741, 95% CI: 1.115-29.566), Urban (OR = 0.253, 95% CI: 0.090, 0.709), toilet facility (OR = 0.603, 95% CI: 0.404-0.900), single birth (OR = 0.261, 95% CI: 0.138-0.495), poorest (OR = 10.573, 95% CI: 2.166-51.615), poorer (OR = 19.573, 95% CI: 4.171-91.848), never breastfed (OR = 35.939, 95% CI: 25.193-51.268), public health delivery (OR = 0.302, 95% CI: 0.106-0.859), private health facility (OR = 0.269, 95% CI: 0.095-0.760). All regional states of Ethiopia, specially Benishangul Gumuz, and the Somali region must take remedial actions on public health policy, design strategies to improve facilities, and improve the capacities of stakeholders living in their region toward those major factors affecting neonatal mortality in the country.

Predicting perinatal mortality based on maternal health status and health insurance service using homogeneous ensemble machine learning methods

BackgroundPerinatal mortality in Ethiopia is the highest in Africa, with 68 per 1000 pregnancies intrapartum deaths. It is mainly associated with home delivery, which contributes to more than 75% of perinatal deaths. Financial constraints significantly impact timely access to maternal health care. Financial incentives, such as health insurance, may address the demand- and supply-side factors. This study, hence, aims to predict perinatal mortality based on maternal health status and health insurance service using homogeneous ensemble machine learning methods.MethodsThe data was collected from the Ethiopian demographic health survey from 2011 to 2019 G.C. The data were pre-processed to get quality data that are suitable for the homogenous ensemble machine-learning algorithms to develop a model that predicts perinatal mortality. We have applied filter (chi-square and mutual information) and wrapper (sequential forward and sequential backward) feature selection methods. After selecting all the relevant features, we developed a predictive model using cat boost, random forest, and gradient boosting algorithms and evaluated the model using both objective (accuracy, precision, recall, F1_score, ROC) and subjective (domain expert) based evaluation techniques.ResultsPerinatal mortality prediction models were developed using random forest, gradient boosting, and cat boost algorithms with the overall accuracy of 89.95%, 90.24%, and 82%, respectively. Risk factors of perinatal mortality were identified using feature importance analysis and relevant rules were extracted using the best performing model.ConclusionsA prediction model that was developed using gradient boosting algorithms was selected for further use in the risk factor analysis, generating relevant rules, development of artifacts, and model deployment because it has registered better performance with 90.24% accuracy. The most determinant risk factors of perinatal mortality were identified using feature importance and some of them are community-based health insurance, mother's educational level, region and place of residence, age, wealth status, birth interval, preterm, smoking cigarette, anemia level, hemoglobin level, and marital status.

Prevalence and risk factors of diarrhea among children less than five years of age in the rural suburbs of Dire Dawa, Eastern Ethiopia; Robust Poisson Regression Analysis.

Diarrhea is the second leading cause of under-five mortality in Ethiopia. Information on the prevalence and the impacting factors of diarrhea in the rural suburbs of Dire Dawa is inadequate. This study was aimed at determining risk factors of diarrhea among children less than five years of age in the rural suburbs of Dire Dawa, eastern Ethiopia. A cross-sectional study was conducted from 02 May 2018, to 31 May 2018. The required 1146 children for this study were selected from the rural suburbs of Dire Dawa using multi-stage sampling. Both bi-variable and multivariable Robust Poisson regressions were used for identifying the risk factors. Explanatory variables with a p-value < 0.05 were considered as independently associated with diarrhea. The prevalence of diarrhea among the children was 23% (95% CI: 20.7 - 25.4). The type of house floor (aPR [adjusted prevalence ratio] = 0.89, 95% CI: 0.84 - 0.95) and sharing latrine with neighbours (aPR = 1.18, 95% CI: 1.09 - 1.26) were the significant factors associated with childhood diarrhea. Earthen house floor and shared use of latrine were the risk factors associated with childhood diarrhea. Hence, improving the house floor condition and construction of private latrine together with health education are recommended.

Residential inequalities in child mortality in Ethiopia: Multilevel and decomposition analyses

Ethiopia is among the five countries which account for half of the global under-five deaths, with the under-five mortality rate of 67 deaths/1000 live births in 2016. Ethiopia had significant inequalities in child mortality between rural and urban areas where the risk of child mortality is largely higher in rural than urban areas. Inequalities in the distribution of factors influencing child mortality need to explain the gap between and within urban-rural areas. The study used the risk of child mortality as an outcome variable. Multilevel logistic regression was used as a standard model for assessing the effect of socioeconomic and contextual factors on child mortality. Furthermore, the Blinder-Oaxaca decomposition technique was used to explain the urban-rural, intra-rural, and intra-urban inequalities in child mortality. The birth order and sanitation type seem to be the most important explanatory factors, followed by wealth status in explaining the rural-urban inequality of 39 deaths/1000 children. Mean proportion indicates that there would be 47 deaths/1000 children for urban poor and 21 deaths/1000 children for urban non-poor, resulting in 26 deaths/1000 children change in urban poor when applying the urban non-poor coefficient and characteristics to urban poor behavior. The findings showed that some residential inequalities in child mortality occur at a level that could be addressed by targeting children, households, and some occurs at a community level that could be addressed by targeting regions. Therefore, any residential sensitive and specific interventions should consider child’s and household’s characteristics, and geographical location.

Patterns of mortality in domesticated ruminants in Ethiopia.

Premature death of livestock is a problem in all ruminant production systems. While the number of premature ruminant deaths in a country is a reasonable indicator for the nation's health, few data sources exist in a country like Ethiopia that can be used to generate valid estimates. The present study aimed to establish if three different data sets, each with imperfect information on ruminant mortality, including abortions, could be combined into improved estimates of nationwide mortality in Ethiopia. We combined information from a recent survey of ruminant mortality with information from the Living Standards Measurement Study and the Disease Outbreak and Vaccination Reporting dataset. Generalized linear mixed and hurdle models were used for data analysis, with results summarized using predicted outcomes. Analyses indicated that most herds experienced zero mortality and reproductive losses, with rare occasions of larger losses. Diseases causing deaths varied greatly both geographically and over time. There was little agreement between the different datasets. While the models aid the understanding of patterns of mortality and reproductive losses, the degree of variation observed limited the predictive scope. The models revealed some insight into why mortality rates are variable over time and are therefore less useful in measuring production or health status, and it is suggested that alternative measures of productivity, such as number of offspring raised to 1 year old per dam, would be more stable over time and likely more indicative.

Fetomaternal Outcomes and Associated Factors among Mothers with Hypertensive Disorders of Pregnancy in Suhul Hospital, Northwest Tigray, Ethiopia.

Hypertensive disorder of pregnancy is the leading cause of maternal and perinatal morbidity and mortality worldwide and the second cause of maternal mortality in Ethiopia. The current study is aimed at assessing fetal-maternal outcomes and associated factors among mothers with hypertensive disorders of pregnancy complication at Suhul General Hospital, Northwest Tigray, Ethiopia, 2019. Methods:A hospital-based cross-sectional study was conducted from Oct. 1st, 2019, to Nov. 30, 2019, at Suhul General Hospital women's chart assisted from July 1st, 2014, to June 31st, 2019. Charts were reviewed consecutively during five years, and data were collected using data abstraction format after ethical clearance was assured from the Institutional Review Board of Mekelle University College of Health Sciences. Data were entered into Epi-data 3.5.3 and exported to SPSS 22 for analysis. Bivariable and multivariable analyses were done to ascertain fetomaternal outcome predictors. Independent variables with p value < 0.2 for both perinatal and maternal on the bivariable analysis were entered in multivariable logistic regression analysis and the level of significance set at p value < 0.05. Out of 497 women, 328 (66%) of them were from rural districts, the mean age of the women was 25.94 ± 6.46, and 252 (50.7%) were para-one. The study revealed that 252 (50.3%) newborns of hypertensive mothers ended up with at least low Apgar score 204 (23.1%), low birth weight 183 (20.7%), preterm gestation 183 (20.7%), intensive care unit admissions 90 (10.2%), and 95% CI (46.1% -54.9%), and 267 (53.7%) study mothers also developed maternal complication at 95% (49.3-58.1). Being a teenager (AOR = 1.815: 95%CI = 1.057 - 3.117), antepartum-onset hypertensive disorders of pregnancy (AOR = 7.928: 95%CI = 2.967 - 21.183), intrapartum-onset hypertensive disorders of pregnancy (AOR = 4.693: 95%CI = 1.633 - 13.488), and low hemoglobin level (AOR = 1.704: 95%CI = 1.169 - 2.484) were maternal complication predictors; rural residence (AOR = 1.567: 95%CI = 1.100 - 2.429), antepartum-onset hypertensive disorders of pregnancy (AOR = 3.594: 95%, CI = 1.334 - 9.685), and intrapartum-onset hypertensive disorders of pregnancy (AOR = 3.856: 95%CI = 1.309 - 11.357) were predictors of perinatal complications. Hypertensive disorder during pregnancy leads to poor fetomaternal outcomes. Teenage age and hemoglobin levels were predictors of maternal complication. A rural resident was the predictor of poor perinatal outcome. The onset of hypertensive disorders of pregnancy was both maternal and perinatal complication predictors. Quality antenatal care services and good maternal and childcare accompanied by skilled healthcare providers are essential for early detection and management of hypertensive disorder of pregnancy.

Determinants of Preeclampsia Among Pregnant Women in Public Hospitals of Wolaita and Dawuro Zones, Southern Ethiopia: A Case-Control Study.

Preeclampsia is a leading cause of maternal and fetal morbidity and mortality in Ethiopia. It is defined by the onset of new hypertension (HTN) and proteinuria in the second trimester of pregnancy. There is a research gap in the study area and there is an inconsistency of findings in previous studies. Therefore, this study aimed to determine the factors of preeclampsia among pregnant women in public hospitals. An institution-based unmatched case-control study was conducted in public hospitals in Wolaita and Dawuro Zones from February 1 to June 26, 2021. Women who were diagnosed with preeclampsia were cases, while those who did not have it were controls. They were selected using a consecutive sampling method. Descriptive statistics and logistic regression were done by STATA. A total of 349 cases and 698 controls participated in this study. The average age of the cases and controls was 26.1 ± 4.6 standard deviation (SD) and 24.6 ± 4.8 SD years, respectively. The determinants of preeclampsia in this study were a family history of HTN (adjusted odds ratio [AOR = 11.5; 95% confidence interval, CI: 6.46-20.41], family history of diabetes mellitus [AOR = 2.1; 95% CI: 1.10-3.90], having two or multiple pregnancies [AOR = 6.33; 95% CI: 2.28-17.51], primigravida [AOR = 1.49; 95% CI: 1.01-2.21], and being gravida 5-9 [AOR = 2.47; 95% CI: 1.34-4.58]). In this study, family history of HTN, family history of diabetes mellitus, history of preeclampsia, primigravida, and multiple gestation pregnancies were the determinants of preeclampsia. As a result, health care providers should pay special attention to pregnant women with a family history of HTN, primigravida, and two or multiple gestation pregnancies during antenatal care follow-up.

Geographic variation and factors associated with under-five mortality in Ethiopia. A spatial and multilevel analysis of Ethiopian mini demographic and health survey 2019.

The distribution of under-five mortality (U5M) worldwide is uneven and the burden is higher in Sub-Saharan African countries, which account for more than 53% of the global under-five mortality. In Ethiopia, though U5M decreased substantially between 1990 and 2019, it remains excessively high and unevenly distributed. Therefore, this study aimed to assess geographic variation and factors associated with under-five mortality (U5M) in Ethiopia. We sourced data from the most recent nationally representative 2019 Ethiopian Mini-Demographic and Health Survey for this study. A sample size of 5,695 total births was considered. Descriptive, analytical analysis and spatial analysis were conducted using STATA version 16. Both multilevel and spatial analyses were employed to ascertain the factors associated with U5M in Ethiopia. The U5M was 5.9% with a 95% CI 5.4% to 6.6%. Based on the multivariable multilevel logistic regression model results, the following characteristics were associated with under-five mortality: family size (AOR = 0.92, 95% CI: 0.84,0.99), number of under-five children in the family (AOR = 0.17, 95% CI: 0.14, 0.21), multiple birth (AOR = 14.4, 95% CI: 8.5, 24.3), children who were breastfed for less than 6 months (AOR = 5.04, 95% CI: 3.81, 6.67), people whose main roof is palm (AOR = 0.57, 95% CI: 0.34, 0.96), under-five children who are the sixth or more child to be born (AOR = 2.46, 95% CI: 1.49, 4.06), institutional delivery (AOR = 0.57, 95% CI: 0.41, 0.81), resident of Somali and Afar region (AOR = 3.46, 95% CI: 1.58, 7.55) and (AOR = 2.54, 95% CI: 1.10, 5.85), respectively. Spatial analysis revealed that hot spot areas of under-five mortality were located in the Dire Dawa and Somali regions. Under-five mortality in Ethiopia is high and unacceptable when compared to the 2030 sustainable development target, which aims for 25 per 1000 live births. Breastfeeding for less than 6 months, twin births, institutional delivery and high-risk areas of under-five mortality (Somali and Dire Dawa) are modifiable risk factors. Therefore, maternal and community education on the advantages of breastfeeding and institutional delivery is highly recommended. Women who deliver twins should be given special attention. An effective strategy should be designed for intervention in under-five mortality hot spot areas such as Somali and Dire Dawa.