88 research outputs found
Causes of death among adults in northern Ethiopia: evidence from verbal autopsy data in health and demographic surveillance system
No full textBACKGROUND: In countries where registration of vital events is lacking and the proportion of people who die at home without medical care is high, verbal autopsy is used to determine and estimate causes of death. METHODS: We conducted 723 verbal autopsy interviews of adult (15 years of age and above) deaths from September 2009 to January 2013. Trained physicians interpreted the collected verbal autopsy data, and assigned causes of death according to the international classification of diseases (ICD-10). We did analysis of specific as well as broad causes of death (i.e. non-communicable diseases, communicable diseases and external causes of death) by sex and age using Stata version 11.1. We performed logistic regression to identify socio-demographic predictors using odds ratio with 95% confidence interval and a p-value of 0.05. FINDINGS: Tuberculosis, cerebrovascular diseases and accidental falls were leading specific causes of death accounting for 15.9%, 7.3% and 3.9% of all deaths. Two hundred sixty three (36.4% [95% CI: 32.9, 39.9]), 252 (34.9% [95% CI: 31.4, 38.4]) and 89 (12.3% [95% CI: 10.1, 14.9]) deaths were due to non-communicable, communicable diseases, and external causes, respectively. Females had 1.5 times (AOR = 1.53 [95% CI: 1.10, 2.15]) higher odds of dying due to communicable diseases than males. The odds of dying due to external causes were 4 times higher among 15-49 years of age (AOR = 4.02 [95% CI: 2.25, 7.18]) compared to older ages. Males also had 1.7 times (AOR = 1.70 [95% CI: 1.01, 2.85]) higher odds of dying due to external causes than females. CONCLUSION: Tuberculosis, cerebrovascular diseases and accidental falls were the top three causes of death among adults. Efforts to prevent tuberculosis and cerebrovascular diseases related deaths should be improved and safety efforts to reduce accidents should also receive attention.Yohannes Adama Melaku, Berhe Weldearegawi Sahle, Fisaha Haile Tesfay, Afework Mulugeta Bezabih, Alemseged Aregay, Semaw Ferede Abera, Loko Abreha, Gordon Alexander Zell
Undernutrition in early life: using windows of opportunity to break the vicious cycle
No full textThe Sustainable Development Goal (SDG 2) targets the intergenerational cycle of chronic undernutrition and its consequences by their focus on optimizing maternal and child nutrition. The preconception period and the first 1,000 days of life, i.e., from conception to 2 years of age, are critical intervention windows to optimize maternal and child nutrition. However, less is known on the first 1,000 days including pregnancy, as well as what are important determinants of a healthy first 1,000 days when looking at the pre-pregnancy conditions. Therefore, the current thesis aims to shed light on the window of opportunity in the pre-pregnancy period and during the first 1,000 days to improve maternal and child outcomes to contribute to breaking the vicious circle of chronic undernutrition and its consequences. Based on the evidence in the current thesis, we believe that the pre-pregnancy, pregnancy, and postpartum period are clearly still missed opportunities to optimize maternal nutrition status, birth outcomes, and child growth. Multifaceted factors were found to affect maternal and child nutrition. Therefore, nutrition should be part of a life-course approach that regards maternal and child nutrition within women’s and their children’s overall health. To this end, selected nutrition-sensitive and-specific interventions may play a role in breaking the intergenerational cycle of undernutrition and its consequences. The nutrition-sensitive interventions may include strengthening the health extension package, women empowerment, and screening and managing perinatal distress. Similarly, preconception nutritional supplements, promoting maternal dietary quality, and optimizing sociocultural factors such as religious fasting may be some of the nutrition-specific interventions
BMC Res Notes
No full textBackgroundIn developing countries, investigating mortality levels and causes of death among all age female population despite the childhood and maternal related deaths is important to design appropriate and tailored interventions and to improve survival of female residents.MethodsUnder Kilite-Awlealo Health and Demographic Surveillance System, we investigated mortality rates and causes of death in a cohort of female population from 1st of January 2010 to 31st of December 2012. At the baseline, 33,688 females were involved for the prospective follow-up study. Households under the study were updated every six months by fulltime surveillance data collectors to identify vital events, including deaths. Verbal Autopsy (VA) data were collected by separate trained data collectors for all identified deaths in the surveillance site. Trained physicians assigned underlining causes of death using the 10th edition of International Classification of Diseases (ICD). We assessed overall, age- and cause-specific mortality rates per 1000 person-years. Causes of death among all deceased females and by age groups were ranked based on cause specific mortality rates. Analysis was performed using Stata Version 11.1.ResultsDuring the follow-up period, 105,793.9 person-years of observation were generated, and 398 female deaths were recorded. This gave an overall mortality rate of 3.76 (95% confidence interval (CI): 3.41, 4.15) per 1,000 person-years. The top three broad causes of death were infectious and parasitic diseases (1.40 deaths per 1000 person-years), non-communicable diseases (0.98 deaths per 1000 person-years) and external causes (0.36 per 1000 person-years). Most deaths among reproductive age female were caused by Human Deficiency Virus/Acquired Immune Deficiency Virus (HIV/AIDS) and tuberculosis (0.14 per 1000 person-years for each cause). Pregnancy and childbirth related causes were responsible for few deaths among women of reproductive age\u20143 out of 73 deaths (4.1%) or 5.34 deaths per 1,000 person-years.ConclusionsCommunicable diseases are continued to be the leading causes of death among all age females. HIV/AIDS and tuberculosis were major causes of death among women of reproductive age. Together with existing efforts to prevent pregnancy and childbirth related deaths, public health and curative interventions on other causes, particularly on HIV/AIDS and tuberculosis, should be strengthened.20142014-09-10T00:00:00Z5U22/PS022179_10/PS/NCHHSTP CDC HHS/United States25208473PMC4174652691
Metabolic syndrome and lifestyle factors among type 2 diabetes mellitus patients in Dessie Referral Hospital, Amhara region, Ethiopia.
No full textBackgroundThe prevalence of metabolic syndrome is rising at an alarming rate and more common among Type 2 Diabetes Mellitus patients in the world. The risk for cardiovascular disease is greater among individuals who have a combination of Type 2 Diabetes Mellitus and metabolic syndrome compared to those who have either alone.ObjectiveTo assess the proportion of metabolic syndrome and lifestyle factors among Type 2 Diabetes Mellitus Patients in Dessie Referral Hospital, Amhara Region, Ethiopia.MethodsA hospital-based cross-sectional study was conducted from February to March 2017 among 343 randomly selected Type 2 Diabetes Mellitus patients. Three definitions of Metabolic syndrome were considered. Multivariable logistic regression analysis was conducted to identify factors associated with metabolic syndrome. Adjusted odds ratio (AOR) with 95% confidence intervals (CI) were reported to show the strength of association. Statistical significance was declared at P-value ResultThe proportion of metabolic syndrome was 50.3%, 59.4% and 64.5% according to 2005 International Diabetes Federation, revised ATP III and 2009 harmonized criteria, respectively. Being female (AOR = 2.43; 95% CI = 1.40, 4.21), consumption of red meat (AOR = 2.61; 95% CI = 1.28, 5.33), sedentary leisure time activity (AOR = 2.65; 95% CI = 1.47, 4.78), coffee intake (AOR = 0.43; 95% CI = 0.21, 0.86), BMI ≥ 25 kg/m2 (AOR = 9.59; 95% CI = 4.98, 18.47), 40-49 years of age (AOR = 2.74, 95% CI = (1.02, 7.37), 50-59 years of age (AOR = 4.22; 95% CI = 1.60, 11.11) and ≥70 years of age (AOR = 4.51, 95% CI = 1.44, 14.15) were significantly associated with metabolic syndrome.Conclusion and recommendationThe proportion of metabolic syndrome was high among Type 2 Diabetes Mellitus patients. Overweight and obesity, being female, age of respondent, intake of coffee, regular red meat consumption, and sedentary leisure-time activity were factors associated with metabolic syndrome. Counseling of Type 2 Diabetes Mellitus patients on the need for spending leisure time with activities, intake of coffee, control of body weight, and avoidance of regular red meat consumption is recommended
Heterogeneous Risk Preferences, Discount Rates and Land Contract Choice in Ethiopia
No full textThis paper analyses the role of risk and rate of time preference in the choice of land contracts. The analysis builds on the risk-sharing and imperfect market explanations of contract choice. Unique data from Ethiopia, which contain land contract information and experimental risk and rate of time preference measures on matched landlord-tenant partners, are employed in the empirical analysis. The results show that landlord and tenant time preferences are significant determinants of contract choice. For landlords (but not tenants), risk preference is also significant, indicating the importance of financial constraints and production risk in the determination of contract choice. The results are of particular relevance to land market policy in Ethiopia, where production is risk-prone, financial markets are imperfect, and where there is a major need for the development of vibrant land rental markets. Copyright (c) 2009 The Author. Journal compilation (c) 2009 The Agricultural Economics Society.
Causes of death among females-investigating beyond maternal causes: a community-based longitudinal study
No full textBACKGROUND: In developing countries, investigating mortality levels and causes of death among all age female population despite the childhood and maternal related deaths is important to design appropriate and tailored interventions and to improve survival of female residents. METHODS: Under Kilite-Awlealo Health and Demographic Surveillance System, we investigated mortality rates and causes of death in a cohort of female population from 1st of January 2010 to 31st of December 2012. At the baseline, 33,688 females were involved for the prospective follow-up study. Households under the study were updated every six months by fulltime surveillance data collectors to identify vital events, including deaths. Verbal Autopsy (VA) data were collected by separate trained data collectors for all identified deaths in the surveillance site. Trained physicians assigned underlining causes of death using the 10th edition of International Classification of Diseases (ICD). We assessed overall, age- and cause-specific mortality rates per 1000 person-years. Causes of death among all deceased females and by age groups were ranked based on cause specific mortality rates. Analysis was performed using Stata Version 11.1. RESULTS: During the follow-up period, 105,793.9 person-years of observation were generated, and 398 female deaths were recorded. This gave an overall mortality rate of 3.76 (95% confidence interval (CI): 3.41, 4.15) per 1,000 person-years. The top three broad causes of death were infectious and parasitic diseases (1.40 deaths per 1000 person-years), non-communicable diseases (0.98 deaths per 1000 person-years) and external causes (0.36 per 1000 person-years). Most deaths among reproductive age female were caused by Human Deficiency Virus/Acquired Immune Deficiency Virus (HIV/AIDS) and tuberculosis (0.14 per 1000 person-years for each cause). Pregnancy and childbirth related causes were responsible for few deaths among women of reproductive age--3 out of 73 deaths (4.1%) or 5.34 deaths per 1,000 person-years. CONCLUSIONS: Communicable diseases are continued to be the leading causes of death among all age females. HIV/AIDS and tuberculosis were major causes of death among women of reproductive age. Together with existing efforts to prevent pregnancy and childbirth related deaths, public health and curative interventions on other causes, particularly on HIV/AIDS and tuberculosis, should be strengthened.Yohannes Adama Melaku, Berhe Weldearegawi, Alemseged Aregay, Fisaha Haile Tesfay, Loko Abreha, Semaw Ferede Abera and Afework Mulugeta Bezabi
Utilization of growth monitoring and promotion services and associated factors among under two years of age children in Southern Ethiopia.
No full textGrowth monitoring and promotion (GMP) is a prevention activity comprised of growth monitoring (GM) linked with promotion that serves as the core activity in an integrated child health and nutrition program. However, different methods of institutional studies have shown that utilization of GM services has remained to be inadequate. There is scarcity of studies conducted about GMP in quantitative method. Therefore, this study was conducted to address the proportion of GMP services and associated factors among children under two years of age in rural communities of Mareka district, Southern Ethiopia. Community based cross-sectional survey was conducted from August to September 2015. Single population proportion formula was used to determine the sample size with multi stage sampling technique. A total of 819 children under two years of age were included. Pretest was done on 10% of the total sample size. Data were analyzed using SPSS version 20.0 software. Bivariate and multivariate logistic regressions used to analyze data. The response rate was 95%. Utilization of GMP services was 16.9%. Institutional delivery AOR (95% CI): 3.01(1.65-5.50), index child age 12-17 months AOR (95% CI): 4.03(2.16-7.51) and 18-23 months AOR (95% CI): 3.08(1.70-5.57), family size 4-5 AOR(95% CI): 0.14(0.06-0.33), family size >5 AOR(95% CI): 0.34(0.14-0.82), regular GMP attendance AOR (95% CI): 4.37(2.45-7.80), medium wealth index AOR(95% CI): 3.14(1.51-6.52) and high wealth index AOR(95% CI): 3.24(1.59-6.62) were factors associated with utilization of GMP services. Utilization of GMP services was low. Thus, efforts should be made to improve utilization of GMP services through promotion of institutional delivery, different family planning methods, and regular GMP attendance
Demand and Supply Side Barriers that Limit the Uptake of Nutrition Services among Pregnant Women from Rural Ethiopia: An Exploratory Qualitative Study
No full textDespite poverty reduction and increased promotion of improved nutrition practices in the community, undernutrition in Ethiopia remains a concern. The present study aimed to explore the demand and supply side barriers that limit the uptake of nutrition services among pregnant women from the rural communities of the Tigray Region, Northern Ethiopia. A community-based qualitative study was conducted in December through January 2017. A total of 90 key informant in-depth interviews and 14 focus group discussions were undertaken. Study participants were purposively selected for specific characteristics, along with health professionals deployed at various levels of the health system, including health posts, health centers, woreda health offices, and the regional health bureau. Study participants were asked to identify the barriers and implementation challenges that limit access to nutrition services for pregnant women. Participants’ responses were transcribed verbatim, without editing the grammar, to avoid losing meaning. The data were imported to ATLAS.ti 7 (qualitative data analysis software) for coding and analyzed using a thematic content analysis approach. The study findings indicated that the dietary quality of pregnant women in the study area remains poor and in some cases, poorer quality than pre-pregnancy. Across study sites, heavy workloads, food taboos and avoidances, low husband support, lack of economic resources, lack of awareness, low educational level of women, poor dietary habits, increased expenditure for cultural and religious festivities, “dependency syndrome”, low physical access to health facilities, poorly equipped health facilities, focus on child health and nutrition, poor coordination among nutrition specific and sensitive sectors, and limited sources of nutrition information were identified as the demand and supply side barriers limiting the uptake of nutrition services during pregnancy. In conclusion, the community would benefit from improved social behavior change communication on nutrition during pregnancy and multi-sectoral coordination among nutrition-specific and nutrition-sensitive sectors
Utilization of growth monitoring and promotion services and associated factors among under two years of age children in Southern Ethiopia
No full textGeospatial Distributions of Stunting and Determinants among Under-Five Children in Tigray: Using Partial Proportional Odds Model
No full textBackground. Despite improvements globally, child stunting remains one of the serious public health problems in Ethiopia. This study aimed to assess the distribution and determinants of stunting among under-five children in Tigray, Ethiopia. Materials and Methods. A cross-sectional survey was conducted in Tigray from June to July 2019. A total of 11,004 under-five children were included in this study with a stratified two-stage random sampling. The geospatial distribution of stunting among under-five children was determined using GIS and SATSCAN software. A partial proportional odds model was fitted to assess the risk of the child’s nutritional status, and an odds ratio with a 95% confidence interval was used to assess the strength of the association of the independent variables and the child’s nutritional status. Results. The average age of the children was 26.0 (SD = 14.0) months. The overall prevalence of stunting was found to be 41.0%. Western, Southern, South Eastern, Eastern, and Central zones experience a high proportion of stunting. Children having mothers who did not plan their last pregnancy (AOR = 0.90, 95% CI: 0.819–0.995), living in rural areas, and children being male (AOR = 1.33, 95% CI: 1.226–1.433) were more likely to be stunted. The estimated odds of stunting increased significantly with child’s age but decreased with the mother’s age. Children having mothers with primary and secondary education were 13% (AOR = 0.87, 95% CI: 0.787–0.969) and 12% (AOR = 0.88, 95% CI: 0.777–0.998) less likely to be severely stunted than children having mothers with no education. Likewise, children having fathers with secondary and college or above education had 0.76 (AOR = 0.76, 95% CI: 0.672–0.858) and 0.62 (AOR = 0.62, 95% CI: 0.517–0.736) times lower risk of having severely stunting compared with the children having fathers with no education. Conclusion. The prevalence of stunting in 6–59-month-old children from Tigray was unacceptably high. Potential factors associated with child stunting were parental educational level, child sex, child age, maternal age, place of residence, and zone. Thus, improving parental education and avoidance of early marriage are recommended in order to reduce the prevalence of stunting. Moreover, place and zone-specific interventions should be also introduced to tackle differences in the burden of stunting among children aged 6–59 months from Tigray
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