288 research outputs found
Suggestions for the socio-economic perspective in the Ramsar Guidelines on agriculture-wetland interactions
No full textInfant mortality and causes of infant deaths in rural Ethiopia: a population-based cohort of 3684 births
No full textResearch articleBACKGROUND: Ethiopia has made large-scale healthcare investments to improve child health and survival. However, there is insufficient population level data on the current estimates of infant mortality rate (IMR) in the country. The aim of this study was to measure infant mortality rate, investigate risk factors for infant deaths and identify causes of death in a rural population of northern Ethiopia. METHODS: Live births to a cohort of mothers under the Kilite Awlaelo Health and Demographic Surveillance System were followed up to their first birthday or death, between September 11, 2009 and September 10, 2013. Maternal and infant characteristics were collected at baseline and during the regular follow-up visit. Multiple-Cox regression was used to investigate risk factors for infant death. Causes of infant death were identified using physician review verbal autopsy method. RESULTS: Of the total 3684 infants followed, 174 of them died before their first birthday, yielding an IMR of 47 per 1000 live births (95 % CI: 41, 54) over the four years of follow-up. About 96 % of infants survived up to their first birthday, and 56 % of infant deaths occurred during the neonatal period. Infants born to mothers aged 15-19 years old had higher risk of death (HR = 2.68, 95 % CI: 1. 74, 4.87) than those born to 25-29 years old. Infants of mothers who attained a secondary school and above had 56 % lower risk of death (HR = 0.44, 95 % CI: 0.24, 0.81) compared to those whose mothers did not attend formal education. Sepsis, prematurity and asphyxia and acute lower respiratory tract infections were the commonest causes of death. CONCLUSION: The IMR for the four-year period was lower than the national and regional estimates. Our findings suggest the need to improve the newborn care, and empower teenagers to delay teenage pregnancy and attain higher levels of education.Berhe Weldearegawi, Yohannes Adama Melaku, Semaw Ferede Abera, Yemane Ashebir, Fisaha Haile, Afework Mulugeta, Frehiwot Eshetu and Mark Spig
Prevalence of Anemia and Associated Factors among Pregnant Women in North Western Zone of Tigray, Northern Ethiopia: A Cross-Sectional Study
No full textBackground. Anemia affects the lives of more than 2 billion people globally, accounting for over 30% of the world’s population. Anemia is a global public health problem occurring at all stages of the life cycle but the burden of the problem is higher in pregnant women particularly in developing countries. The aim of this study was to determine the prevalence of anemia and associated factors among pregnant women attending antenatal clinics in north western zone of Tigray, northern Ethiopia. Methods. A facility based cross-sectional study was employed. A systematic random sampling procedure was employed to select 714 pregnant women who were attending antenatal clinics in health facilities found in the study area from April to May 2014. The data was entered and analyzed using Epi-info version 3.5.1 and SPSS version 20.0 statistical software, respectively. Logistic regression analysis was used to identify factors associated with anemia among the study participants. All tests were two-sided and p value < 0.05 was considered statistically significant. Results. The overall prevalence of anemia (hemoglobin < 11 g/dL) among the pregnant women was 36.1% (95% CI = 32.7%–39.7%) of which 58.5% were mildly, 35.7% moderately, and 5.8% severely anemic. In pregnant women, rural residence (AOR = 1.75, 95% CI = 1.01–3.04), no education/being illiterate (AOR = 1.56, 95% CI = 1.03–2.37), absence of iron supplementation during pregnancy (AOR = 2.76, 95% CI = 1.92–5.37), and meal frequency of less than two times per day (AOR = 2.28, 95% CI = 1.06–4.91) were the independent predictors for increased anemia among the pregnant women. Conclusions. Anemia was found to be moderate public health problem in the study area. Residence, educational status, iron supplementation during pregnancy, and meal frequency per day were statistically associated with anemia among the pregnant women. Awareness creation and nutrition education on the importance of taking iron supplementation and nutritional counseling on consumption of extra meal and iron-rich foods during pregnancy are recommended to prevent anemia in the pregnant women
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
Policies and Program Implementation Experience to Improve Maternal Nutrition in Ethiopia
No full textBACKGROUND:
Maternal undernutrition persists as a serious problem in Ethiopia. Although there are maternal nutrition interventions that are efficacious and effective in improving maternal, neonatal, and child health (MNCH) outcomes, implementation has been limited.
OBJECTIVE:
This study explored needs, perceptions, priorities,facilitatingfactors and barriers to implementation of relevant policies and programs to find opportunities to improve maternal nutrition in Ethiopia
METHODS:
Background information was compiled and synthesized for a situation analysis. This informed focus group discussions and in-depth interviews with mothers, community leaders, health workers, and district health officials in four woredas (districts) in Tigray and Southern Nations, Nationalities and Peoples Region.
RESULTS:
Findings focused on three priority issues: maternal anemia, intrauterine growth retardation (IUGR), and maternal thinness and stunting. Community-level investigations found that women's low status, food insecurity and poverty, and workload were key factors perceived to contribute to women's undernutrition. Awareness of and demand for services to improve women's nutrition were low, except for high demand for supplementary food. On the supply side, barriers included low prioritization of maternal nutrition in health and nutrition service delivery and weak technical capacity to deliver context-sensitive maternal nutrition interventions at all levels.
CONCLUSIONS:
Community-based health and nutrition services were promising platforms for expanding access to interventions such as micronutrient supplements and social and behavior change communication. Investments are needed to support these community-based programs, including training, supplies, supervision and monitoring. To address IUGR at scale, increased access to cash or food transfers could be explored
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
BMC Public Health
No full textBackgroundEthiopia has made large-scale healthcare investments to improve child health and survival. However, there is insufficient population level data on the current estimates of infant mortality rate (IMR)\ua0in the country. The aim of this study was\ua0to measure infant mortality rate, investigate risk factors for infant deaths and identify causes of death in a rural population of northern Ethiopia.MethodsLive\ua0births to a cohort of mothers under the Kilite Awlaelo Health and Demographic Surveillance System were followed up to their first birthday or death, between September 11, 2009 and September 10, 2013. Maternal and infant characteristics were collected at baseline and during the regular follow-up visit. Multiple-Cox regression was used to investigate risk factors for infant death. Causes of infant death were identified using physician review verbal autopsy method.ResultsOf the total 3684 infants followed, 174 of them died before their first birthday, yielding an IMR of 47 per 1000 live births (95 % CI: 41, 54) over the four years of follow-up. About 96\ua0% of infants survived up to their first birthday, and 56\ua0% of infant deaths occurred during the neonatal period. Infants born to mothers aged 15\u201319 years old had higher risk of death (HR\u2009=\u20092.68, 95\ua0% CI: 1. 74, 4.87) than those born to 25\u201329 years old. Infants of mothers who attained a secondary school and above had 56 % lower risk of death (HR\u2009=\u20090.44, 95\ua0% CI: 0.24, 0.81) compared to those whose mothers did not attend formal education. Sepsis, prematurity and asphyxia and acute lower respiratory tract infections were the commonest causes of death.ConclusionThe IMR for the four-year period was lower than the national and regional estimates. Our findings suggest the need to improve the newborn care, and empower teenagers to delay teenage pregnancy and attain higher levels of education.20152015-08-11T00:00:00ZU22 PS022179/PS/NCHHSTP CDC HHS/United States26260495PMC4531534691
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
Antibiogram Profiles of Bacteria Isolated from Different Body Site Infections Among Patients Admitted to GAMBY Teaching General Hospital, Northwest Ethiopia
No full textLitegebew Yitayeh,1 Addisu Gize,2 Melkayehu Kassa,2 Misrak Neway,1 Aschalew Afework,1 Mulugeta Kibret,3 Wondemagegn Mulu4 1GAMBY Teaching General Hospital, Bahir Dar, Ethiopia; 2Department of Microbiology, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia; 3Department of Biology, Science College, Bahir Dar University, Bahir Dar, Ethiopia; 4Department of Medical Laboratory Science, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, EthiopiaCorrespondence: Addisu Gize Email [email protected]: Infections with multi-drug resistant (MDR) bacteria are serious threats to many low-income countries associated with overuse and misuse of antibiotics. This study determined the antibiogram profiles of bacteria isolated from different body site infections among patients admitted to GAMBY Teaching General Hospital, Bahir Dar, Northwest Ethiopia.Methods: A hospital-based cross-sectional study was done between November 2015 and May 2018. Various clinical specimens were sampled from patients and analyzed for aerobic bacterial isolation and Kirby–Bauer disk diffusion susceptibility testing. Chi-square test was calculated to see association among variables, and P-value < 0.05 was taken as a cutoff value for statistical significance.Results: From the 716 clinical specimens processed, 134 (18.7%) were culture-positive for aerobic bacterial pathogens. Culture-confirmed positivity was higher in ear discharge (27.3%) and urine (26.3%) samples. The prevalence of infection was significantly highest among females (P = 0.001). Escherichia coli 63 (47.4%) and 10 (7.4%) of Klebsiella spp. from Gram-negative bacteria were the predominant bacterial isolates, while Staphylococcus saprophyticus 17 (12.6%) and S. aureus 14 (10.4%) were from Gram-positive bacteria. Overall, 61.8% of the isolates were found to be MDR. The proportion of MDR among Klebsiella spp., S. aureus and E. coli isolates was 90.9%, 60.9% and 50%, respectively. Gram-positive bacteria demonstrated 20%, 48.6% and 100% of resistance against norfloxacin, ciprofloxacin and clindamycin, respectively. Gram-negative bacteria also revealed from 20% resistance for the antibiotic nitrofurantoin and 100% of resistance for ampicillin and penicillin.Conclusion: Infections with bacterial isolates resistant to the majority of antibiotics are a major issue in the study area. Most of the identified bacteria were resistant to the routinely used antibiotics, and MDR isolates are alarmingly high. Therefore, clinicians should practice rational choice of antibiotics and treatment should be guided by antimicrobial susceptibility testing.Keywords: bacterial isolates, antibiogram, clinical specimen, GAMBY, Bahir Dar, Ethiopi
Diurnal activity patterns, habitat use and foraging habits of Egyptian goose (Alopochena egyptiacus Linnaeus, 1766) in the Boyo wetland, southern Ethiopia
No full textEgyptian goose (Alopochena egyptiacus) is a resident bird species in Africa South of the Sahara occurring throughout the entire Nile Valley. Despite the wide distribution, the available information on its behavioral ecology is limited in Ethiopia. A study on the activity patterns, habitat use and foraging habits of Egyptian goose was carried out in and around Boyo wetland, Ethiopia, during the dry and wet seasons. Scan sampling method was used to study the activity patterns and habitat use of Egyptian goose in grassland, mudflat and shallow water habitats of the wetland. The feeding behavior of Egyptian goose was also observed in the surrounding farmland habitats using scan sampling method. Generally, Egyptian geese spent most of their time resting (39.81%) followed by foraging (32.64%). They spent 10.43% of their time in comfort movement preening or stretching. The rest of their time was allocated for locomotion (6.63%), vigilance (5.75%), and social behavior (1.59%), and other activities (2.86%). Most of the birds were engaged in foraging activity in the morning (07:00-9:00 h) and afternoon (16:00 - 18:00 h) hours both during the wet and dry seasons. About 39% of Egyptian geese were scanned in mudflat, 31.5% in grassland, and 30.05% in shallow water habitats engaged in different activities. Most individuals used the grassland habitat for foraging during the dry (59.5%) and wet (74%) seasons, while they used shallow water and mudflat habitats for resting both during the wet and dry seasons seasons. The birds were observed foraging mainly grass during the dry (93.62%) and wet (59.52%) seasons. The Egyptian geese show diurnal activity pattern with feeding peaks in early morning and late afternoon hours as is observed in many other avian taxa. The Boyo wetland is also as an important foraging ground for this species and other birds in the area. Further ecological studies on the species and impact of human activities on the Boyo wetland should be conducted for the conservation of the avifauna
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