247 research outputs found
BMC Public Health
No full textBackgroundChanges in socioeconomic status, lifestyle and behavioral factors among the urban population in Ethiopia is resulting in a shift in the causes of mortality.MethodsA total of 49,309 deaths from burial surveillance were eligible for verbal autopsy for the years 2006 to 2009. Among these, 10% (4,931) were drawn randomly for verbal autopsy of which 91% (4,494) were adults of age 6515 years. Verbal autopsies, used to identify causes of death and frequency of risk factors, were completed for 3,709 (83%) of the drawn sample.ResultsAccording to the results of the verbal autopsy, non-communicable diseases caused 1,915 (51%) of the total adult deaths, while communicable diseases and injuries caused 1,566 (42%) and 233 (6%) of the deaths respectively.ConclusionThe findings from the analysis suggest that public health interventions targeting HIV/AIDS, tuberculosis, as well as non-communicable diseases need to consider behavioral factors related to alcohol, tobacco and khat consumption. We also recommend large scale national level studies to further assess the specific contributions of these risk factors to the burden of mortality in the country.20135U22/PS022179_05/PS/NCHHSTP CDC HHS/United States23835193PMC3708758691
Preventing Chronic Disease (PCD)
No full textIntroductionIn Ethiopia, lack of reliable data on causes of death prevents full understanding of the double mortality burden of communicable and noncommunicable diseases. Our objective was to help bridge this research gap by analyzing surveillance data on causes of death in Addis Ababa.MethodsBurial surveillance identified 58,010 deaths in Addis Ababa from 2006 through 2009, of which 49,309 were eligible for verbal autopsies, a method of interviewing caregivers of the deceased about the circumstances, signs, and symptoms preceding death. We randomly selected 10% from the eligible sample, of whom 91% were defined as adults (aged 6515 y). Verbal autopsies were completed and causes of death were assigned for 3,709 adults.ResultsOverall, 51% (95% confidence interval [CI], 49.7%-52.9%) of deaths were attributed to noncommunicable diseases, 42% (95% CI, 40.6%-43.8%) to communicable diseases, and 6% (95% CI, 5.5%-7.0%) to injuries. Similar proportions of male and female deaths were caused by noncommunicable and communicable diseases. Adults aged 55 to 84 were more likely, and those aged 15 to 44 were less likely, to die from noncommunicable diseases compared with the age group 85 or older. Premature deaths (defined as earlier than age 65) from noncommunicable diseases were mainly due to certain cancers, type 1 and type 2 diabetes, hypertension, stroke, and genitourinary disease.ConclusionNoncommunicable diseases are the leading cause of death among adults in Addis Ababa, where the health care system is still geared toward addressing communicable diseases. Health policy attention is needed to remedy this situation. This observed double mortality burden is unlikely to be unique to Addis Ababa and provides new insight into the epidemiological transition in urban Ethiopia. Nationwide studies should be conducted in Ethiopia to examine the pattern of epidemiological transition and the magnitude of double mortality burden.5U22/PS022179_05/PS/NCHHSTP CDC HHS/United State
Assessmenet of VCT Utilization among Attendees of Familly Planning, ANC, and Delivery Care Services, Butajira, SNNPR, Ethiopia
No full textTo date all efforts that are aimed at developing a drug that completely
clears HIV infection and a vaccine that prevents it have ended up in no
conclusive outcomes. The disease is overwhelmingly spreading and it is
resulting in huge tolls of morbidity and mortality of human kind all over the
world. The only option to avert the spread of the infection is changing
behavior through proper behavior change communication. In this study,
Knowledge, Attitude and practices related to HIV test and counseling and
its link with FP, ANC, and Delivery care services were assessed on those
mothers coming to health facilities for the later services.
A cross - sectional study was carried out from Jan10-Feb 15, 2006 among
attendees of FP, ANC, and Delivery care Services at Butajira Hospital and
Butajira Health center. A total of 405 women participants involved using
quota sampling technique. Quantitative and qualitative methodologies
used. Questions addressed socio-demographic characteristics, VCT
related knowledge, attitude and practices, and the linkage between VCT
and FP, ANC, and Delivery care services. Data collected using an
interviewer administered Amharic version structured questioner, nonparticipant
observation checklist for the process of service delivery, and indepth
interview with service providers. Trained interview teams
administered the questioner. Finally the data were analyzed for the target
group as appropriate.
Overall, 52.8% of the study subjects have sufficient knowledge score and
81.2% have favorable attitude and 44% have good VCT practice. There
was a significant difference between ANC and FP attendees, respectively,
level of knowledge 53% & 50%, favorable attitude 86%& 77%, and good
VCT practice 86% and 29% (p<0.05). Generally, VCT service linkage with
FP, ANC and Delivery care services was weak. Specifically the linkage
vii
with FP was very weak. FP services were not available in VCT settings.
Similarly, on both sides almost no referral. Respondents from ANC and
delivery were better informed and referred for PMTCT.
The study revealed that participants have high level of knowledge and also
favorable attitude but low VCT practice. To increase utilization of services
need to strengthen the PMTCT programs, VCT providers should refer their
clients to MCH (FP&ANC) and vice versa to minimize missed opportunities
and service delivery guideline to integrate especially FP with VCT is
required
BMC Med Res Methodol
No full textBackgroundVerbal autopsy has been widely used to estimate causes of death in settings with inadequate vital registries, but little is known about its validity. This analysis was part of Addis Ababa Mortality Surveillance Program to examine the validity of verbal autopsy for determining causes of death compared with hospital medical records among adults in the urban setting of Ethiopia.MethodsThis validation study consisted of comparison of verbal autopsy final diagnosis with hospital diagnosis taken as a \u201cgold standard\u201d. In public and private hospitals of Addis Ababa, 20,152 adult deaths (15 years and above) were recorded between 2007 and 2010. With the same period, a verbal autopsy was conducted for 4,776 adult deaths of which, 1,356 were deceased in any of Addis Ababa hospitals. Then, verbal autopsy and hospital data sets were merged using the variables; full name of the deceased, sex, address, age, place and date of death. We calculated sensitivity, specificity and positive predictive values with 95% confidence interval.ResultsAfter merging, a total of 335 adult deaths were captured. For communicable diseases, the values of sensitivity, specificity and positive predictive values of verbal autopsy diagnosis were 79%, 78% and 68% respectively. For non-communicable diseases, sensitivity of the verbal autopsy diagnoses was 69%, specificity 78% and positive predictive value 79%. Regarding injury, sensitivity of the verbal autopsy diagnoses was 70%, specificity 98% and positive predictive value 83%. Higher sensitivity was achieved for HIV/AIDS and tuberculosis, but lower specificity with relatively more false positives.ConclusionThese findings may indicate the potential of verbal autopsy to provide cost-effective information to guide policy on communicable and non communicable diseases double burden among adults in Ethiopia. Thus, a well structured verbal autopsy method, followed by qualified physician reviews could be capable of providing reasonable cause specific mortality estimates in Ethiopia. However, the limited generalizability of this study due to the fact that matched verbal autopsy deaths were all in-hospital deaths in an urban center, thus results may not be generalizable to rural home deaths. Such application and refinement of existing verbal autopsy methods holds out the possibility of obtaining replicable, sustainable and internationally comparable mortality statistics of known quality. Similar validation studies need to be undertaken considering the limitation of medical records as \u201cgold standard\u201d since records may not be confirmed using laboratory investigations or medical technologies. The validation studies need to address child and maternal causes of death and possibly all underlying causes of death.20125U22 PS022179_05/PS/NCHHSTP CDC HHS/United States22928712PMC3568023691
BMC Public Health
No full textBackgroundEthiopia is encountering a growing burden of non-communicable diseases along with infectious diseases, perinatal and nutritional problems that have long been considered major problems of public health importance. This retrospective analysis was carried out to examine the mortality patterns from communicable diseases and non communicable diseases in public and private hospitals of Addis Ababa.MethodsApproximately 47,153 deaths were captured over eight years (2002\u20132010) in forty three public and private hospitals of Addis Ababa, Ethiopia. Data collectors (43 hospital clerks) and coordinators (3 nurses) had been extensively trained on how to review hospital death records. Information obtained included: dates of admission and death, age, sex, address, and principal cause of death. Only the diseases responsible for deaths are taken as the cause of death. Cause of death was coded using International Classification of Diseases (ICD-10) and data were double entered. Diseases were classified into: Group I (communicable diseases, maternal conditions and nutritional deficiencies); Group II (non-communicable causes); and Group III (injuries). Percentages, proportional mortality ratios, 95% confidence intervals (CI) and Adjusted odd ratios (OR) were calculated.ResultsOverall, 59% of the deaths were attributed to Group I diseases, and 31% to Group II diseases and 12% to injuries. Nearly 56% of the males and 68% of the females deaths were due to five leading causes (conditions arising during perinatal period, HIV/AIDS, tuberculosis, cardiovascular diseases and respiratory infections). Significantly larger proportions of females died from Group I (67%) and Group II diseases (32%) compared with males (where the respective proportions were 52% and 30%). Significantly higher proportion of males (17%) than females (6%) were dying from Group III diseases. Deaths due to Group I diseases decreased while those due to Group II diseases increased with age. Overall Group I diseases and HIV/AIDS, tuberculosis and still birth mortality in particular have showed decreasing trend while Group II and III increasing over time. Double burden in mortality was highly observed in the age groups of 15\u201364 years. Those aged >45 years were dying more likely with non-communicable diseases compared with children. Children aged below 15 years were 16 times more likely to die from communicable, perinatal and nutritional conditions compared with elders. Mortality variation with age has been identified between public and private hospitals.ConclusionsThe results of the present study shows that, in addition to the common Group I causes of death, emerging group II diseases are contributing to high proportions of mortality in the public and private hospitals of Addis Ababa, Ethiopia. Thus, priority should be given to the prevention and management of conditions arising during perinatal period such as low birth weight and still birth, HIV/AIDS; tuberculosis, respiratory infections, cardiovascular diseases, malignant neoplasm, chronic respiratory diseases and road traffic accident. The planning of health resources and activities should take into account the double burden in mortality due to Group I and Group II diseases. This calls for strengthening approaches towards the control and prevention of non-communicable diseases such as cardiovascular and malignant neoplasm.20125U22/PS022179_05/PS/NCHHSTP CDC HHS/United States23167315PMC3520706691
Linkage between VCT and reproductive health services (FP, ANC and delivery) in two public facilities of rural Ethiopia
No full textAbstractBackground: Linking of related health services or delivering services in an integrated setup is an indispensableundertaking to optimize utilization of scarce resources in developing countries like Ethiopia. However, very relatedservices such as HIV/AIDS and reproductive health are mostly delivered not in an integrated setup and a lot of missedopportunities are observed.Method: A cross-sectional study was conducted to describe the linkage between VCT and reproductive health servicesin two public health facilities of rural Ethiopia. A total of 405 women who were attending family planning (FP),antenatal and delivery care services were interviewed with structured questionnaire. Moreover, using qualitativetechnique, service provider interview and direct service delivery observation were conducted.Results: It was found that almost half of the women coming to attend ANC, delivery and family planning serviceshave sufficient knowledge about VCT. Overall, 80% have favorable attitude towards VCT. Family planning (FP)clients have less favorable attitude and less knowledge compared to ANC and delivery care attendees. Only 46.9% ofwomen reported that they were informed about VCT during their current visit. About 32.4% of FP, 62.8% of ANCwere informed by providers about VCT (P<0.001). Similarly, 22.4% of FP, 57.9% of ANC attendees were advised toget tested by the providers (P<0.001). Majority of ANC attendees were referred to the VCT sites as compared to FPclients which were found to be due to the existence of formal referral between the ANC and VCT clinics for PMTCTservices. Use of IE/BCC materials to disseminate messages in different service delivery sites was very limited.FP counseling and contraceptives are not provided at the VCT sites and there is no referral to FP clinics for those whomay need the services.Conclusion: The study revealed weak linkage between VCT and FP which was mainly due to shortage of trainedmanpower, lack of time to counsel clients, negligence, absence of clear guidelines and referral system and lack offollow up and supervision. Therefore, orientation of providers, development of clear referral guideline and supportivesupervision are recommended to minimize such missed opportunities. [Ethiop.J.Health Dev. 2008;22(2):158-166
Participatory Evaluation and Promotion of Tef Production Technologies for Moisture Deficit Areas of Simada District in Amhara Region, Ethiopia
No full textTef (Eragrostis tef Zucc. Trotter) is a small cereal crop resilient to adverse climatic and soil conditions and possesses desirable storage properties. It provides high-quality food and grows under marginal conditions which are not unsuitable for other cereal crops. Although tef is a major cultivated crop in the Simada district, demonstration and adoption of improved tef varieties and agronomic practices are very limited. Therefore, the study was initiated to select and promote the higher grain yielding tef varieties with agronomic practices and create awareness to farmers and end users. The activity was conducted on six farmers’ fields in the Simada district in the 2019 and 2020 cropping seasons. Early maturing tef released varieties, namely “Hiber-1”, “Boset”, and “Tseday” (Cr-37), and local tef varieties were used for the study in a plot area of 10m by 10m for each variety across sites. Farmers and researchers selected the “Hiber-1” tef variety due to agronomic traits and grain yield performance. “Hiber-1” was ranked 1st by farmers in both the Vertisol and Nitisol areas. It showed 31%, 28.4%, and 25.1% grain yield advantage over “Boset”, “Tseday”, and the local varieties respectively. In addition, the rank correlation of farmers’ rank and grain yield rank of the varieties showed a strong positive correlation. Therefore, the “Hiber-1” tef variety should be scaled out in the Simada district and areas with similar agro-ecologies in Amhara Region and Ethiopia
Association of socioeconomic and behavioral factors with adult mortality: analysis of data from verbal autopsy in Addis Ababa, Ethiopia
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