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Merid MW, Chilot D, Yigzaw ZA, Melesse AW, Ferede MG, Aragaw FM, Bitew DA. Women in low- and middle-income countries receive antenatal care at health institutions, yet not delivered there: a multilevel analysis of 2016-2021 DHS data. Trop Med Health 2024; 52:1. [PMID: 38163909 PMCID: PMC10759610 DOI: 10.1186/s41182-023-00561-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 12/10/2023] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND The institutional delivery dropout (IDD) is a major problem that disproportionately affects low- and middle-income countries (LMICs). It is associated with increased risks of adverse birth outcomes among pregnant women. Hence, this study assessed the pooled estimate and determinants of IDD after antenatal care (ANC) visit among women in LMICs. METHOD The Demographic and Health Survey (DHS) data from 29 LMICs were used for this study. Data analysis was performed with STATA version 14. The forest plot was used to estimate the pooled prevalence of IDD. Multilevel binary logistic regression was fitted to identify determinants of IDD. The statistical significance level between the outcome and independent variables was determined through the adjusted odds ratio (AOR) with 95% CI and p-value less than 0.05. RESULT The pooled prevalence of IDD after ANC booking among reproductive age women in LMICs was 22.25% (95%CI: 18.25, 26.25). Additionally, the prevalence of IDD was highest (29.83%) among women from the South and Central Europe and the Caribbean countries and lowest (13.72%) in Central/Western Asia and the Oceania. In the multilevel analysis; no education (AOR = 2.92; 95% CI: 2.72, 3.13), poorest wealth index (AOR = 3.46; 95% CI: 3.28, 3.66), inadequate ANC visits (AOR = 1.73; 95% CI: 1.39, 1.77), no media exposure (AOR = 1.27; 95% CI: 1.23, 1.30), rural (AOR = 1.50; 95% CI: 1.43, 1.54), distance a big problem (AOR = 1.28; 95% CI: 1.25, 1.31), and women located in the South/Eastern Europe and Caribbean region 6.67 (AOR = 6.67; 95% CI: 6.20, 7.20), women lived in low-income countries 7.05 (AOR = 7.05; 95% CI: 6.57, 7.56), and women from lower middle-income countries 5.34 (AOR = 5.57; 95% CI: 4.93, 5.78), had increased odds of IDD after ANC among women in LMICs. However, women who had ever born one child (AOR = 0.29; 95% CI: 0.28, 0.31), and women from Central and Western Asia and the Oceania (AOR = 0.78; 95%CI: 0.74, 0.82) had decreased odds of IDD. CONCLUSION The IDD was high among women in LMICs and significantly increased among women with no education, from poorest household, had inadequate ANC visit, no media exposure, rural, distance a big problem. Hence, interventions to reduce IDD should focus on addressing the gaps related to maternal education, access to media, and number of ANC visits among women in LMICs.
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Affiliation(s)
- Mehari Woldemariam Merid
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Dagmawi Chilot
- Department of Human Physiology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Zeamanuel Anteneh Yigzaw
- Department of Health Promotion and Behavioural Sciences, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Alemakef Wagnew Melesse
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Menberesibhat Getie Ferede
- Departments of Human Anatomy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Fantu Mamo Aragaw
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Desalegn Anmut Bitew
- Department of Reproductive Health, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Alem AZ, Efendi F, McKenna L, Felipe-Dimog EB, Chilot D, Tonapa SI, Susanti IA, Zainuri A. Prevalence and factors associated with anemia in women of reproductive age across low- and middle-income countries based on national data. Sci Rep 2023; 13:20335. [PMID: 37990069 PMCID: PMC10663544 DOI: 10.1038/s41598-023-46739-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 11/04/2023] [Indexed: 11/23/2023] Open
Abstract
Anemia is a global threat among women of reproductive age (WRA), or 15-49 years old women, both in developed and developing countries. Prevalence of anemia in WRA is higher by fourfold in developing countries, based on extensive studies and surveys conducted by WHO and UNICEF. However, there is limited studies that conducted pooled analysis of anemia prevalence in low resource countries. This study aimed to assess the prevalence and factors associated with anemia among women of reproductive age in low- and middle-income countries (LMICs). This study used secondary data from the Demographic and Health Survey (DHS) in 46 low- and middle-income countries during 2010-2021. Descriptive statistics of proportions between pregnant and non-pregnant mothers were assessed. Multilevel binary logistic regression was used to test the factors associated with anemia among women of reproductive age. A total of 881,148 women of childbearing age in LMICs were included. This study found a high prevalence of 45.20% (95% CI 41.21, 49.16) of anemia was observed in among pregnant women and 39.52% (95% CI 33.88, 45.15) anemia was observed in non-pregnant women. Educational status, wealth status, family size, media exposure, and residence were common factors significantly associated with anemia in both pregnant and non-pregnant women. The high global burden of anemia in LMICs continues to underline the need for unusual approaches and target interventions on an individual basis. Global commitment and movement to reduce the prevalence of anemia need to be revisited and redesigned for current circumstances.
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Affiliation(s)
- Adugnaw Zeleke Alem
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Ferry Efendi
- Faculty of Nursing, Universitas Airlangga, Jl. Mulyorejo Kampus C Unair, Surabaya, 60115, Indonesia.
- School of Nursing and Midwifery, La Trobe University, Melbourne, VIC, Australia.
| | - Lisa McKenna
- School of Nursing and Midwifery, La Trobe University, Melbourne, VIC, Australia
| | - Eva Belingon Felipe-Dimog
- Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung City, Taiwan
- Nursing Department, Mountain Province State Polytechnic College, Bontoc, Mountain Province, Philippines
| | - Dagmawi Chilot
- Department of Human Physiology, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
- Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | | | | | - Agus Zainuri
- Faculty of Public Health, Universitas Cenderawasih, Jayapura, Indonesia
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Bitew DA, Diress M, Gela YY, Belay DG, Kibret AA, Chilot D, Sinamaw D, Seid MA, Seid AM, Simegn W, Eshetu HB, Andualem AA. Determinants of early discharge after birth among mothers delivered vaginally at health facilities: further analysis of the Ethiopian demographic health survey. BMC Public Health 2023; 23:2128. [PMID: 37904085 PMCID: PMC10617109 DOI: 10.1186/s12889-023-16922-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 10/06/2023] [Indexed: 11/01/2023] Open
Abstract
INTRODUCTION The majority of maternal and newborn deaths take place during the first few hours and days after birth and thus postnatal contacts should begin as early as possible, especially within the first 24 h, then again within two to three days after delivery. Globally, early postnatal discharge has increased over the past 50 years and currently too. Even if Ethiopia has very low PNC coverage, there is no evidence on who is discharged early. Hence, the aim of this study was to determine the magnitude and the predictors for early postnatal discharge in Ethiopia. METHODS This study was based on the secondary data analysis using the Ethiopian Demographic and Health survey (EDHS) 2016 data set. The weighted sample of 2,225 delivered mothers were included for the final analysis. The model was best fitted as assessed by Hosmer-Lemeshow test (p value = 0.1988). The variables with P-value ≤ 0.2 in the bi- variable binary logistic regression analysis were included in to the multi-variable binary logistic regression analysis. The Adjusted Odds Ratio (AOR) with 95% confidence interval (95% CI) was computed to assess the strength of association between the outcome and independent variables. The variables with a P-value of less than 0.05 in the multi-variable binary logistic regression analysis were declared as statistically significant predictors of the outcome variable. RESULT The overall magnitude of early discharge was 70.41% (CI: 68.48, 72.30). Residence (rural; AOR: 0.61, 95% CI: 0.46, 0.80), educational status (No education; AOR: 1.87, 95% CI: 1.19, 2.94), religion (Muslim; AOR: 0.69, 95% CI: 0.55, 0.87, Others; AOR: 0.24, 95% CI: 0.10, 0.57), wealth index (Poor; AOR: 0.77; 95% CI: 0.59, 0.99), marital status (Not married; AOR: 0.29; 95% CI: 0.13, 0.67), ANC visits (No ANC visits; AOR: 0.63; 95% CI: 0.46,0.86), parity (3rd parity; AOR: 1.48; 95% CI: 1.03, 2.11), and size of the child (larger size; AOR: 0.63;95% CI: 0.50,0.79, (smaller size; AOR: 0.72; 95% CI: 0.56,0.92) were independent determinants of early discharge. CONCLUSION A substantial proportions of mothers in Ethiopia had been discharged early (before 24 h). Residence, education, wealth index, religion, marital status, ANC follow up, parity and size of the child were predictors of early discharge. Adequate hospital stay should be promoted. Since the early discharge in Ethiopia is very high, home based postnatal visit should be strengthened focusing the identified predictors.
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Affiliation(s)
- Desalegn Anmut Bitew
- Department of Reproductive Health, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, P. O. Box 196, Gondar, Ethiopia.
| | - Mengistie Diress
- Department of Human Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, P. O. Box 196, Gondar, Ethiopia
| | - Yibeltal Yismaw Gela
- Department of Human Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, P. O. Box 196, Gondar, Ethiopia
| | - Daniel Gashaneh Belay
- Department of Human Anatomy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, P. O. Box 196, Gondar, Ethiopia
- Department of Epidemiology and Biostatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, P. O. Box 196, Gondar, Ethiopia
| | - Anteneh Ayelign Kibret
- Department of Human Anatomy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, P. O. Box 196, Gondar, Ethiopia
| | - Dagmawi Chilot
- Department of Human Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, P. O. Box 196, Gondar, Ethiopia
- College of Health Sciences, Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), Addis Ababa University, Addis Ababa, Ethiopia
| | - Deresse Sinamaw
- Department of Biomedical Science, Debre Markos University, P. O. Box 269, Debre Markos, Ethiopia
| | - Mohammed Abdu Seid
- Unit of Human Physiology, Department of Biomedical Science, College of Health Sciences, Debre Tabor University, P. O. Box: 272, Debre Tabor, Ethiopia
| | | | - Wudneh Simegn
- Department of Social and Administrative Pharmacy, University of Gondar, P. O. Box 196, Gondar, Ethiopia
| | - Habitu Birhan Eshetu
- Department of Health Education and Behavioral Sciences, University of Gondar, P. O. Box 196, Gondar, Ethiopia
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Asratie MH, Tesema GA, Chilot D, Aragaw FM, Merid MW, Belay DG. Socio-demographic and antenatal care-related factors associated with early post-partum family planning use in Ethiopia: evidence from Ethiopian Demographic and Health Survey 2016 data. Front Glob Womens Health 2023; 4:1131143. [PMID: 37727741 PMCID: PMC10505931 DOI: 10.3389/fgwh.2023.1131143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 07/20/2023] [Indexed: 09/21/2023] Open
Abstract
Introduction Initiation of family planning in the early post-partum period is a strategic move to reduce maternal, neonatal, and child mortality due to the negative consequences of short interbirth interval and the complications of unintended pregnancy. Antenatal care (ANC) is the noteworthy predictor of scaling up early initiation of post-partum family planning (PPFP) and preventing unintended pregnancy before menses resume. Despite the great role of ANC, information is scant about the effect of content, timing, and the number of ANC visits on the early initiation of PPFP in Ethiopia. Objective This study aimed to assess the association of ANC services with the early initiation of PPFP in Ethiopia. Methods The study was based on Ethiopian Demographic and Health Survey 2016 data, which was a cross-sectional survey from 18 January 2016 to 27 June 2016. A total weighted sample size of 2,920 post-partum women was included. A multilevel logistic regression model was used because of the hierarchical data, and variables with a p-value of ≤0.2 in the bivariable multilevel analysis were taken to multivariable multilevel analysis. An adjusted odds ratio with a 95% confidence interval (CI) was used to declare both the direction and strength of the association, and variables with a p-value of <0.05 were considered as statistically significant for the outcome variable. Results The early initiation of PPFP was 20.4%. Women with at least four ANC visits [adjusted odds ratio (AOR) = 1.31; CI 1.12-2.32], women who started ANC within the first trimester (AOR = 1.25; CI 1.10-2.23), complete routine ANC (AOR = 1.11; CI 1.01-2.03), post-natal care (AOR = 1.45; CI 1.19-1.87), resumption of menses (AOR = 1.67; CI 1.18-1.93), urban residency (AOR = 2.14; CI 1.18-2.51), and high community women's education (AOR = 1.71; CI 1.51-2.11) were variables significantly associated with the early initiation of PPFP. Conclusion The early initiation of PPFP in Ethiopia was very low. Attention needs to be given to the quality of ANC, post-natal care, resumption of menses, residency, and community-level education of women to increase the prevalence of the early initiation of PPFP in Ethiopia. Therefore, the government should design a program targeting the quality of ANC in rural communities, considering women without menses and scaling up the education of women at the community level to the culture of the early initiation of PPFP in order to achieve reduced maternal, neonatal, and child mortality.
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Affiliation(s)
- Melaku Hunie Asratie
- Department of Women’s and Family Health, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Getayeneh Antehunegn Tesema
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Dagmawi Chilot
- Center for Innovative Drug Development and Therapeutic Trials for Africa (CDTAfrica), Addis Ababa University, College of Health Sciences, Addis Ababa, Ethiopia
- Department of Human Physiology, University of Gondar, College of Medicine and Health Science, School of Medicine, Gondar, Ethiopia
| | - Fantu Mamo Aragaw
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mehari Woldemariam Merid
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Daniel Gashaneh Belay
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Department of Human Anatomy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Gela YY, Belay DG, Chilot D, Andualem AA, Bitew DA, Sinamaw D, Eshetu HB, Seid AM, Simegn W, Kibret AA, Seid MA, Diress M. Prevalence of anemia and associated factors among adult hypertensive patients in Referral Hospitals, Amhara Regional State. Sci Rep 2023; 13:14329. [PMID: 37652948 PMCID: PMC10471574 DOI: 10.1038/s41598-023-41553-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 08/28/2023] [Indexed: 09/02/2023] Open
Abstract
Anemia is a risk factor for adverse cardiovascular disease outcomes in hypertensive patients. Chronic anemia increases preload, reduces afterload, and leads to increased cardiac output in hypertension patients. In the long term, this may result in maladaptive left ventricular hypertrophy, which in turn is a well-recognized risk factor for cardiovascular disease outcomes and all-cause mortality in hypertension. Low hemoglobin and hematocrit levels might be strongly indicate hypertensive end-organ damage, specifically kidney failure. Therefore, this study determined the prevalence of anemia and associated factors among hypertensive patients in Referral Hospitals, Amhara Regional State, Ethiopia, in 2020. An institution-based cross-sectional study was conducted in Amhara Regional Referral Hospitals from February 20 to April 30, 2020. Random and systemic sampling techniques were used to select 428 study participants. Data were entered and coded in to Epi data version 3.0 and then exported into STATA 14 for analysis. In bivariable logistic regression, variables with a p-value of < 0.25 were included in multivariable logistic regression. Using a 95% confidence interval, variables having a p-value ≤ 0.05 in multivariable logistic regression were declared as statistically significant variables. In this study, a total of 428 study participants were involved with 99.5% response rate. The prevalence of anemia among hypertensive patients was 17.6%, with a 95% CI (14.3-21.5%). Estimated glomerular filtration rate (eGFR) < 90 ml/min (AOR = 2.77, 95% CI 1.56- 4.92)], duration of hypertension (HTN) ≥ 5 years (AOR = 2.37, 95% CI 1.36-4.15), uncontrolled blood pressure (AOR = 1.91, 95% CI 1.08-3.35), and higher pulse pressure (AOR = 1.05 (95% CI 1.02-1.08) were significantly associated with anemia. Nearly one out of five hypertensive patients had anemia. Impaired estimated glomerular filtration rate, duration of HTN, blood pressure status, and pulse pressure were the independent predictors of anemia among hypertensive patients. Screening hemoglobin level at a regular interval is recommended for the hypertensive patients to take an appropriate intervention.
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Affiliation(s)
- Yibeltal Yismaw Gela
- Department of Physiology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Daniel Gashaneh Belay
- Department of Human Anatomy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Department of Epidemiology and Biostatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Dagmawi Chilot
- Department of Physiology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), Addis Ababa University, College of Health Sciences, Addis Ababa, Ethiopia
| | - Amare Agmas Andualem
- Department of Anesthesia, College of Medicine and Health Science, Injibara University, Injibara, Ethiopia
| | - Desalegn Anmut Bitew
- Department of Reproductive Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Deresse Sinamaw
- Department of Biomedical Science, Debre Markos University, Debre Markos, Ethiopia
| | - Habitu Birhan Eshetu
- Department of Health Promotion and Health Behavior, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, PO.Box.196, Gondar, Ethiopia
| | | | - Wudneh Simegn
- Department of Social and Administrative Pharmacy, School of Pharmacy, University of Gondar, Gondar, Ethiopia
| | - Anteneh Ayelign Kibret
- Department of Human Anatomy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mohammed Abdu Seid
- Unit of Human Physiology, Department of Biomedical Science, College of Health Sciences, Debre Tabor University, Debra Tabor, Ethiopia
| | - Mengistie Diress
- Department of Physiology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Aragaw FM, Alem AZ, Asratie MH, Chilot D, Belay DG. Spatial distribution of delayed initiation of antenatal care visits and associated factors among reproductive age women in Ethiopia: spatial and multilevel analysis of 2019 mini-demographic and health survey. BMJ Open 2023; 13:e069095. [PMID: 37620267 PMCID: PMC10450135 DOI: 10.1136/bmjopen-2022-069095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 07/13/2023] [Indexed: 08/26/2023] Open
Abstract
OBJECTIVES This study aimed to assess the spatial distribution, wealth-related inequality and determinants for delayed initiation of antenatal care (ANC) visits among reproductive-age women in Ethiopia. DESIGN Cross-sectional study design. SETTING Ethiopia. PARTICIPANTS A total of 2924 reproductive-age women who had given birth in the 5 years preceding the survey. OUTCOME MEASURE Delayed initiation of ANC visits. RESULTS The magnitude of delayed initiation of ANC visits among reproductive-age women in Ethiopia was 62.63% (95% CI 60.86%, 64.37%). Women aged 35-49 (AOR=1.42; 95% CI 1.04, 1.94), being protestant religion followers (AOR=1.43; 95% CI 1.06, 1.94), being in higher wealth index (AOR=0.53; 95% CI 0.41, 0.69), living in rural residence (AOR=1.50; 95% CI 1.02, 2.19) and living in the metropolitan region (AOR=0.45; 95% CI 0.26, 0.77) were significantly associated with delayed initiation of ANC visit. Southern Nations Nationalities and Peoples Region (SNNPR), Somalia, Benishangul Gumuz, Southern Addis Ababa and Gambella regions were hot spot regions for delayed initiation of ANC visits. The SaTScan analysis result identified 107 primary clusters of delayed initiation of ANC visits located in regions of SNNPR, Gambella, Southern Addis Ababa, Eastern Oromia and Benishangul Gumuz. CONCLUSIONS Significant spatial clustering of delayed initiation of ANC visits was observed in Ethiopia. More than half of women had delayed initiation of ANC visits in Ethiopia. Women's age, religion, wealth index, residence and region were significant predictors of delayed initiation of ANC visits. There is a disproportional pro-poor distribution of delayed initiation of ANC visits in Ethiopia. Therefore, interventions should be designed in the hot spot areas where delayed initiation of ANC visits was high to enhance the timely initiation of ANC visits.
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Affiliation(s)
- Fantu Mamo Aragaw
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Adugnaw Zeleke Alem
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Melaku Hunie Asratie
- Department of Women's and Family Health,School of Midwifery,College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Dagmawi Chilot
- Department of Human Physiology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Daniel Gashaneh Belay
- Department of Human Anatomy,College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Alem AZ, Yeshaw Y, Liyew AM, Tessema ZT, Worku MG, Tesema GA, Alamneh TS, Teshale AB, Chilot D, Ayalew HG. Double burden of malnutrition and its associated factors among women in low and middle income countries: findings from 52 nationally representative data. BMC Public Health 2023; 23:1479. [PMID: 37537530 PMCID: PMC10398981 DOI: 10.1186/s12889-023-16045-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 06/02/2023] [Indexed: 08/05/2023] Open
Abstract
BACKGROUND Double burden of malnutrition (DBM) is an emerging global public health problem. The United Nations member states adopted eradicating all forms of malnutrition as an integral component of the global agenda. However, there is evidence of a high burden of undernutrition among women and rising rates of overweight and obesity, especially in low and middle income countries (LMICs). Therefore, this study aimed to investigate the prevalence and associated factors of underweight, overweight, and obesity among women of reproductive age in LMICs. METHODS Data for the study were drawn from a recent 52 Demographic and Health Surveys (DHS) conducted in LMICS. We included a sample of 1,099,187 women of reproductive age. A multilevel multinomial logistic regression model was used to identify factors associated with DBM. Adjusted relative risk ratio (RRR) with a 95% Confidence Interval (CI) was reported to show an association. RESULTS The prevalence of underweight, overweight, and obesity in LMICs among women of reproductive age was 15.2% (95% CI: 15.1-15.3), 19.0% (95% CI: 18.9- 19.1), and 9.1% (95% CI: 9.0-9.2), respectively. This study found that women aged 24-34 years, aged ≥ 35 years, with primary, secondary, and above educational level, from wealthy households, using modern contraceptives, exposed to media (radio and television), and with high parity (more than one birth) were more likely to have overweight and obesity and less likely to have underweight. Moreover, the risk of having obesity (RRR = 0.59; 95% CI = 0.58-0.60 and overweight (RRR = 0.78; 95% CI = 0.77-0.79) were lower among rural women, while the risk of being underweight was (RRR = 1.13; 95% CI = 1.11-1.15) higher among rural women compared to urban women. CONCLUSION The prevalence of underweight, overweight, and obesity was high among women of reproductive age in LMICs. Underweight, overweight, and obesity are influenced by sociodemographic, socioeconomic, and behavioral-related factors. This study shows that, in order to achieve Sustainable Development Goal 2, a multifaceted intervention approach should be considered to prevent both forms of malnutrition in women of reproductive age. This can be achieved by raising awareness and promoting healthy behaviors such as healthy eating and physical activity, especially among educated women, women from wealthy households, and women exposed to the media.
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Affiliation(s)
- Adugnaw Zeleke Alem
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Yigizie Yeshaw
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Department of Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Alemneh Mekuriaw Liyew
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Zemenu Tadesse Tessema
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Misganaw Gebrie Worku
- Department of Human Anatomy, College of Medicine and Health Science, School of Medicine, University of Gondar, Gondar, Ethiopia
| | - Getayeneh Antehunegn Tesema
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tesfa Sewunet Alamneh
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Achamyeleh Birhanu Teshale
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Dagmawi Chilot
- Department of Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- College of Health Sciences, Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), Addis Ababa University, Addis Ababa, Ethiopia
| | - Hiwotie Getaneh Ayalew
- Department of Midwifery, School of Nursing and Midwifery, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
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Chilot D, Aragaw FM, Belay DG, Asratie MH, Merid MW, Kibret AA, Teshager NW, Alem AZ. Effectiveness of eight or more antenatal contacts on health facility delivery and early postnatal care in low- and middle-income countries: a propensity score matching. Front Med (Lausanne) 2023; 10:1107008. [PMID: 37547614 PMCID: PMC10401271 DOI: 10.3389/fmed.2023.1107008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 06/30/2023] [Indexed: 08/08/2023] Open
Abstract
Background Despite progress in reducing maternal and child mortality, many low- and middle-income countries (LMICs) still experience an unacceptably high level of the problem. The World Health Organization (WHO) recently recommended pregnant women should have at least eight antenatal care visits (ANC8+) with a trained healthcare provider as a key strategy to promote pregnant women's health. Antenatal care is an imperative factor for subsequent maternal healthcare utilization such as health facility delivery and early postnatal care (EPNC). This study aimed to examine the net impact of ANC8+ visits on health facility delivery and EPNC in LMICs using a propensity score matching analysis. Methods We used the recent Demographic and Health Survey (DHS) datasets from 19 LMICs. Women of reproductive age (15-49 years) who had given birth within 1 year preceding the survey were included. A propensity score matching analysis was employed to assess the net impact of eight or more antenatal care visits on health facility delivery and early postnatal care. Result After matching the covariates, women who attended ANC8+ visits had a 14% (ATT = 0.14) higher chance of having their delivery at health facilities compared with women who attended less than eight ANC visits. This study further revealed that women who had ANC8+ visits were associated with a 10% (ATT = 0.10) higher probability of early PNC compared with their counterparts. Conclusion and recommendation This study confirmed that ANC8+ visits significantly increased the likelihood of health facility-based delivery and early PNC utilization in LMICs. These findings call for public health programs to focus on pregnant women attending adequate ANC visits (according to revised WHO recommendation) as our study indicates that ANC8+ visits significantly improved the chances of subsequent care.
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Affiliation(s)
- Dagmawi Chilot
- Department of Human Physiology, College of Medicine and Health Science, School of Medicine, University of Gondar, Gondar, Ethiopia
| | - Fantu Mamo Aragaw
- Department of Epidemiology and Biostatistics, College of Medicine and Health Science, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Daniel Gashaneh Belay
- Department of Epidemiology and Biostatistics, College of Medicine and Health Science, Institute of Public Health, University of Gondar, Gondar, Ethiopia
- Department of Human Anatomy, College of Medicine and Health Science, School of Medicine, University of Gondar, Gondar, Ethiopia
| | - Melaku Hunie Asratie
- Department of Women and Family Health, College of Medicine and Health Science, School of Midwifery, University of Gondar, Gondar, Ethiopia
| | - Mehari Woldemariam Merid
- Department of Epidemiology and Biostatistics, College of Medicine and Health Science, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Anteneh Ayelign Kibret
- Department of Human Anatomy, College of Medicine and Health Science, School of Medicine, University of Gondar, Gondar, Ethiopia
| | - Nahom Worku Teshager
- Department of Pediatrics and Child Health, College of Medicine and Health Science, School of Medicine, University of Gondar, Gondar, Ethiopia
| | - Adugnaw Zeleke Alem
- Department of Epidemiology and Biostatistics, College of Medicine and Health Science, Institute of Public Health, University of Gondar, Gondar, Ethiopia
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Merid MW, Chilot D, Alem AZ, Aragaw FM, Asratie MH, Belay DG, Kibret AA. An unacceptably high burden of anaemia and it's predictors among young women (15-24 years) in low and middle income countries; set back to SDG progress. BMC Public Health 2023; 23:1292. [PMID: 37407912 DOI: 10.1186/s12889-023-16187-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 06/23/2023] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND Anaemia is a major global public health problem, considerably affects young women in resource limited countries. The available researches on anaemia focused on children, pregnant women, or all women of reproductive age. However, women's biology and life experiences vary dramatically across 15 to 49 years, putting young women bear the higher burden of anaemia, mainly in low and middle income countries (LMICs). Therefore, this study assessed the burden of anaemia among young women (15-24 years) in 24 LMICs which conducted Demographic and Health Surveys (DHS) between 2016 and 2021. METHOD Data analysis was carried out with STATA version 14. The forest plot was used to explore the pooled prevalence of anaemia. Multilevel binary logistic regression was fitted to accommodate the hierarchical nature of the DHS data. Accordingly, a model with lowest deviance (model III) was the best-fitted model. All variables with a p-value ≤ 0.2 in the bi-variable analysis were fitted in the multi-level multivariable model. Adjusted odds ratio with 95% CI and p < 0.05 were presented to declare statistical significance. RESULT The pooled prevalence of anaemia among young (15-24 years) women in 24 LMICs was 41.58% (95%CI: 34.51, 48.65). Country wise, Mali (62.95%) and Rwanda (14.13%) constitute the highest and lowest prevalence of anaemia. In this study, young women who lived in the poorest wealth status, had no education, were underweight, perceived distance to the health facility a big problem, larger family size, and women who had ever terminated pregnancy were associated with increased odds of anaemia. Whereas, young women who were overweight and not breast feeding had decreased odds of anaemia. CONCLUSION The unacceptably high burden of anaemia among young women setbacks the SDG target; to end all forms of malnutrition by 2030. Therefore, it is highly recommended to take relevant interventions to reduce the burden of anaemia targeted the young women who are uneducated, have low socio-economic status, limited access to health facilities, and lived in larger family size.
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Affiliation(s)
- Mehari Woldemariam Merid
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Dagmawi Chilot
- Department of Human Physiology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Adugnaw Zeleke Alem
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Fantu Mamo Aragaw
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Melaku Hunie Asratie
- Department of Women's and Family Health, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Daniel Gashaneh Belay
- Department of Human Anatomy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Anteneh Ayelign Kibret
- Department of Human Anatomy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Diress M, Gashaneh Belay D, Abdu Seid M, Birhan Eshetu H, Ayelign Kibret A, Chilot D, Melese M, Sinamaw D, Simegn W, Mohammed Seid A, Agmas Andualem A, Anmut Bitew D, Yismaw Gela Y. Determinants of knowledge of the highest conception probability period among reproductive age women in Low-Income African countries: A multilevel analysis based on the recent Demographic and Health Survey. PLoS One 2023; 18:e0287164. [PMID: 37319183 PMCID: PMC10270567 DOI: 10.1371/journal.pone.0287164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 05/31/2023] [Indexed: 06/17/2023] Open
Abstract
BACKGROUND Adequate knowledge about the highest conception probability period in the reproductive cycle allows individuals and couples to attain or avoid their fertility probabilities. Poor knowledge of conception probability period leads to undesirable outcomes like unwanted pregnancy, miscarriage, and abortion. Determinants of knowledge of highest conception probability period were not well studied on economically disadvantaged countries. Therefore, our study aimed to identify individual and community level factors of knowledge of the highest conception probability period among women of reproductive age in low income African countries. METHODS The appended and latest Demographic and Health Survey datasets of 15 low-income African countries was used for analysis. Model fitness was done using the Intraclass correlation coefficient, median odds ratio, and deviance. A model with the lowest deviance (model-III) was selected as the best model. Multilevel logistic regression model was used to identify determinant factors of knowledge of the highest conception probability period. In the final model, adjusted odds ratio with 95% confidence interval was reported and variables with p<0.05 were considered as statistically significant with knowledge of the highest conception probability period. RESULTS Total weighted sample of 235,574 reproductive aged women with a median age of 27 years were included. The correct knowledge of the highest conception probability period among the study participants was 24.04% (95%CI = 23.87-24.22%). Maternal age groups ((20-24 (AOR = 1.49; 95%CI = 1.44-1.55), 25-29 (AOR = 1.62; 1.56-1.68), 35-39 (AOR = 1.76; 1.68-1.84), 40-44 (AOR = 1.75; 1.67-1.83), and 45-49 (AOR = 1.83; 1.74-1.93)), marital status((currently in union (AOR = 1.75; 1.16; 1.13-1.20), formerly in union (AOR = 1.75; 1.11; 1.06-1.16)), better educational status ((secondary (AOR = 2.08; 2.01-2.14) and higher(AOR = 3.36; 3.18-3.55)), higher wealth index ((middle (AOR = 1.08; 1.04-1.12), richer (AOR = 1.24; 1.20-1.28), and richest (AOR = 1.51; 1.45-1.57)), knowledge of contraceptive methods (AOR = 2.63; 2.49-2.77), current contraceptive use (AOR = 1.14; 1.11-1.16), and urban residency (AOR = 1.26; 1.21-1.29) were statistically significant with knowledge of the highest conception probability period. CONCLUSION In this study, knowledge of the highest conception probability period among women of reproductive age in low-income African countries was low. Therefore, improving the fertility awareness through comprehensive reproductive education or counseling could be one of the operational ways to control unintended pregnancy.
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Affiliation(s)
- Mengistie Diress
- Department of Human Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Daniel Gashaneh Belay
- Department of Human Anatomy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Department of Epidemiology and biostatistics, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Mohammed Abdu Seid
- Unit of Human Physiology, Department of Biomedical Science, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Habitu Birhan Eshetu
- Department of Health Education and Behavioral Sciences, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Anteneh Ayelign Kibret
- Department of Human Anatomy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Dagmawi Chilot
- Department of Human Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Addis Ababa university, college of health sciences, Center for innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), Addis Ababa, Ethiopia
| | - Mihret Melese
- Department of Human Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Deresse Sinamaw
- Unit of Human Physiology, Department of Biomedical Science, College of Health Sciences, Debre Markos University, Debre Tabor, Ethiopia
| | - Wudneh Simegn
- Department of social and administrative Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Abdulwase Mohammed Seid
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | | | - Desalegn Anmut Bitew
- Department of Reproductive Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Yibeltal Yismaw Gela
- Department of Human Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Merid MW, Alem AZ, Chilot D, Belay DG, Kibret AA, Asratie MH, Shibabaw YY, Aragaw FM. Impact of access to improved water and sanitation on diarrhea reduction among rural under-five children in low and middle-income countries: a propensity score matched analysis. Trop Med Health 2023; 51:36. [PMID: 37322559 DOI: 10.1186/s41182-023-00525-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 06/04/2023] [Indexed: 06/17/2023] Open
Abstract
BACKGROUND Diarrhea, the second leading cause of child morbidity and mortality worldwide, is responsible for more than 90% of deaths in children under 5 years of age in low and middle-income countries (LMICs). The high burden of diarrhea is mainly attributable to the limited access to improved water and sanitation. However, the impacts of improved sanitation and drinking water in preventing diarrheal diseases are not well understood. Therefore, this study estimated both the independent and joint effects of improved sanitation and water on diarrhea occurrence among rural under-five children in LMICs. METHODS The current study utilized secondary data from the Demographic and Health Survey (DHS) datasets conducted between 2016 and 2021 in 27 LMICs. A total weighted sample of 330,866 under-five children was included in the study. We employed propensity score matching analysis (PSMA) to examine the effects of accessing improved water and sanitation on childhood diarrheal disease reduction. RESULTS The prevalence of diarrhea among children under 5 years of age in rural LMICs was 11.02% (95% CI; 10.91%, 11.31%). The probability of developing diarrhea among under-five children from households with improved sanitation and water was 16.6% (Average Treatment Effect on the Treated (ATT) = - 0.166) and 7.4% (ATT = - 0.074) times less likely among those from households with unimproved sanitation and water, respectively. Access to improved water and sanitation is significantly associated with a 24.5% (ATT = - 0.245) reduction of diarrheal disease among under-five children. CONCLUSIONS Improved sanitation and drinking water source reduced the risk of diarrhea among under-five children in LMIC. The effects of both interventions (improved water and sanitation) had a larger impact on the reduction of diarrheal disease than the improvements to water or sanitation alone. Therefore, achieving Sustainable Development Goal 6 (SDG 6) is key to reducing diarrhea among rural under-five children.
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Affiliation(s)
- Mehari Woldemariam Merid
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Adugnaw Zeleke Alem
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Dagmawi Chilot
- Department of Human Physiology, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
- Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Daniel Gashaneh Belay
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Department of Human Anatomy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Anteneh Ayelign Kibret
- Department of Human Anatomy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Melaku Hunie Asratie
- Department of Women's and Family Health, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Yadelew Yimer Shibabaw
- Department of Biochemistry, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Fantu Mamo Aragaw
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Chilot D, Mondelaers A, Alem AZ, Asres MS, Yimer MA, Toni AT, Ayele TA. Pooled prevalence and risk factors of malaria among children aged 6-59 months in 13 sub-Saharan African countries: A multilevel analysis using recent malaria indicator surveys. PLoS One 2023; 18:e0285265. [PMID: 37256889 DOI: 10.1371/journal.pone.0285265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 04/19/2023] [Indexed: 06/02/2023] Open
Abstract
BACKGROUND Every 75 seconds, a child under five dies of malaria. Mainly children, aged between six months and five years, are at the highest risk for malaria. These children lost maternal immunity and did not yet developed specific immunity to the infection. Under the age of five, children bear the highest burden of malaria in Sub-Saharan Africa (SSA). Many individual and community level factors could contribute to malaria prevalence remaining high among under-five children in the region. Thus, this study aimed to assess the pooled prevalence of malaria among children aged 6-59 months and identify potential factors associated with malaria by using recent Malaria Indicator Surveys in 13 SSA countries. METHODS Data for this study were drawn from recent 13 Sub-Saharan African countries Malaria Indicator Surveys (MIS). A total weighted sample of 60,541 children aged 6-59 months was included. STATA version 14.2 was used to clean, code and analyze the data. Multilevel logistic regression was employed to identify factors associated with malaria. Adjusted odds ratio with 95% CI and a P value <0.05 was reported to indicate statistical association. Model fitness and comparison were done using Inter cluster correlation coefficient, Median odds ratio, proportional change in variance, and deviance. RESULTS The pooled prevalence of malaria among children aged 6-59 months was found to be 27.41% (95% CI: 17.94%-36.88%). It ranges from 5.04% in Senegal to 62.57% in Sierra Leone. Aged 36-47 months (AOR = 3.54, 95% CI 3.21-3.91), and 48-59 months (AOR = 4.32, 95% CI 3.91-4.77), mothers attended primary education (AOR = 0.78, 95% CI 0.73-0.84), richer (AOR = 0.35, 95% CI 0.32-0.39), and richest household (AOR = 0.16, 95% CI 0.14-0.19), number of three and more under-five children (AOR = 1.35, 95% CI 1.26-1.45), improved floor material (AOR = 0.65, 95% CI 0.57-0.73), improved wall material (AOR = 0.73, 95% CI 0.64-0.84), improved roof material (AOR = 0.70, 95% CI 0.51-0.93), insecticide-treated bed net (ITN) use (0.56, 95% CI 0.51-0.62), not anemic (AOR = 0.05, 95% CI 0.04-0.06), rural resident (AOR = 2.16, 95% CI 2.06-2.27), high community ITN use (AOR = 0.40, 95% CI 0.24-0.63) and high community poverty (AOR = 2.66, 95% CI 2.53-2.84) were strongly associated with malaria. CONCLUSIONS AND RECOMMENDATIONS Almost 3 out of 10 children were infected by malaria in 13 SSA countries. Malaria infection remains one of the main killers of children aged 6-59 months in the SSA. This study revealed that older under-five children living in large families with low incomes in rural areas are most vulnerable to malaria infection. Our results clearly indicate that ITN utilization and improved housing are promising means to effectively prevent malaria infection among children aged 6-59 months. It is therefore important to note that households with low wealth quintiles and rural residents should be prioritized in any mass distribution of ITNs. This has to be accompanied by education using mass media to enhance community awareness.
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Affiliation(s)
- Dagmawi Chilot
- Department of Human Physiology, University of Gondar, College of Medicine and Health Science, School of Medicine, Gondar, Ethiopia
| | - Annelies Mondelaers
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Adugnaw Zeleke Alem
- Department of Epidemiology & Biostatistics, Institute of Public Health, University of Gondar, College of Medicine and Health Science, Gondar, Ethiopia
| | - Mezgebu Selamsew Asres
- Department of Internal Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mulugeta Ayalew Yimer
- Department of Pediatrics and Child Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Alemayehu Teklu Toni
- Department of Pediatrics and Child Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tadesse Awoke Ayele
- Department of Epidemiology & Biostatistics, Institute of Public Health, University of Gondar, College of Medicine and Health Science, Gondar, Ethiopia
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Chilot D, Aragaw FM, Belay DG, Asratie MH, Bicha MM, Alem AZ. Anaemia among lactating and non-lactating women in low-income and middle-income countries: a comparative cross-sectional study. BMJ Open 2023; 13:e069851. [PMID: 37202128 DOI: 10.1136/bmjopen-2022-069851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/20/2023] Open
Abstract
OBJECTIVE This study aimed to assess the prevalence and determinants of anaemia among lactating and non-lactating women in low-income and middle-income countries (LMICs). DESIGN Comparative cross-sectional study. SETTING LMICs. PARTICIPANTS Reproductive-age women. PRIMARY OUTCOME Anaemia. METHODS Data for the study were drawn from the recent 46 LMICs Demographic and Health Surveys (DHS). A total of 185 330 lactating and 827 501 non-lactating women (both are non-pregnant) who gave birth in the last 5 years preceding the survey were included. STATA V.16 was used to clean, code and analyse the data. Multilevel multivariable logistic regression was employed to identify factors associated with anaemia. In the adjusted model, the adjusted OR with 95% CI and a p value <0.05 was reported to indicate statistical association. RESULT The prevalence of anaemia among lactating and non-lactating women was found at 50.95% (95% CI 50.72, 51.17) and 49.33% (95% CI 49.23%, 49.44%), respectively. Maternal age, mother's educational status, wealth index, family size, media exposure, residence, pregnancy termination, source of drinking water and contraceptive usage were significantly associated determinants of anaemia in both lactating and non-lactating women. Additionally, the type of toilet facility, antenatal care visit, postnatal care visit, iron supplementation and place of delivery were factors significantly associated with anaemia in lactating women. Besides, smoking was significantly associated with anaemia in non-lactating women. CONCLUSIONS AND RECOMMENDATIONS The prevalence of anaemia was higher in lactating women compared with non-lactating. Almost half of the lactating and non-lactating women were anaemic. Both individual-level and community-level factors were significantly associated with anaemia. Governments, non-governmental organisations, healthcare professionals and other stakeholders are recommended to primarily focus on disadvantageous communities where their knowledge, purchasing power, access to healthcare facilities, access to clean drinking water and clean toilet facilities are minimal.
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Affiliation(s)
- Dagmawi Chilot
- Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), Addis Ababa University College of Health Sciences, Addis Ababa, Ethiopia
- Department of Human Physiology, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia
| | - Fantu Mamo Aragaw
- Department of Epidemiology and Biostatistics, University of Gondar, Gondar, Ethiopia
| | - Daniel Gashaneh Belay
- Epidemology, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia
- Human Anatomy, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia
| | | | - Mequanint Melesse Bicha
- Department of Gynecology and Obstetrics, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia
| | - Adugnaw Zeleke Alem
- Epidemiology and Biostatistics, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia
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Chilot D, Belay DG, Merid MW, Kibret AA, Alem AZ, Asratie MH, Teshager NW, Aragaw FM. Triple burden of malnutrition among mother-child pairs in low-income and middle-income countries: a cross-sectional study. BMJ Open 2023; 13:e070978. [PMID: 37160393 PMCID: PMC10174032 DOI: 10.1136/bmjopen-2022-070978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/11/2023] Open
Abstract
OBJECTIVE This study aimed to assess the prevalence and determinants of the triple burden of malnutrition among mother-child pairs in low-income and middle-income countries. DESIGN Cross-sectional study. SETTING Low-income and middle-income countries. PARTICIPANTS Women and children. PRIMARY OUTCOME Triple burden of malnutrition (overweight/obese mother with undernourished and anaemic under 5 years child). METHODS Data for this study were drawn from recent 22 low-income and middle-income countries Demographic and Health Surveys. A total weighted sample of 116 795 mother-child pairs was included in the study. STATA V.14.2 was used to clean, code and analyse the data. Multilevel logistic regression was employed to identify factors associated with the problem. Adjusted OR (AOR) with 95% CI and a p<0.05 was reported to indicate statistical association. Model fitness and comparison were done using intraclass correlation coefficient, median OR, proportional change in variance and deviance. RESULT The pooled prevalence of the triple burden of malnutrition among mother-child pairs was 11.39%. It showed statistically significant positive associations with mothers aged ≥35 years (AOR 2.25, 95% CI 2.08 to 2.44), family size >10 (AOR 1.17, 95% CI 1.08 to 1.26), delivery by caesarean section (AOR 1.93, 95% CI 1.83 to 2.03), the richest household (AOR 1.72, 95% CI 1.56 to 1.88), grand multiparous (AOR 1.62, 95% CI 1.46 to 1.81), age of child 36-47 months (AOR 1.77, 95% CI 1.64 to 1.90), at a p<0.05. Whereas breast feeding (AOR 0.94, 95% CI 0.89 to 0.99), married mothers (AOR 0.87, 95% CI 0.78 to 0.96), female children (AOR 0.88, 95% CI 0.84 to 0.92), improved toilet (AOR 0.23, 95% CI 0.17 to 0.29), improved source of drinking water (AOR 0.28, 95% CI 0.21 to 0.35), rural residents (AOR 0.66, 95% CI 0.62 to 0.69) had a contrasting relationship with the triple burden of malnutrition. CONCLUSION About 1 out of 10 households suffer from the triple burden of malnutrition in low-income and middle-income countries. This study revealed that several maternal, child, household and community-level factors have a significant impact on the triple burden of malnutrition among mother-child pairs.
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Affiliation(s)
- Dagmawi Chilot
- Department of Human Physiology, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia
| | - Daniel Gashaneh Belay
- Department of Human Anatomy, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia
| | - Mehari Woldemariam Merid
- Department of Epidemiology and Biostatistics, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia
| | - Anteneh Ayelign Kibret
- Department of Human Anatomy, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia
| | - Adugnaw Zeleke Alem
- Department of Epidemiology and Biostatistics, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia
| | - Melaku Hunie Asratie
- Department of women and family health, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia
| | - Nahom Worku Teshager
- Department of pediatrics, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia
| | - Fantu Mamo Aragaw
- Department of Epidemiology and Biostatistics, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia
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Belay DG, Chilot D, Alem AZ, Aragaw FM, Asratie MH. Spatial distribution and associated factors of severe malnutrition among under-five children in Ethiopia: further analysis of 2019 mini EDHS. BMC Public Health 2023; 23:791. [PMID: 37118793 PMCID: PMC10142160 DOI: 10.1186/s12889-023-15639-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 04/10/2023] [Indexed: 04/30/2023] Open
Abstract
BACKGROUND Malnutrition is both a significant cause and a result of poverty and deprivation. In developing nations, child malnutrition is still the main public health issue. Severe malnutrition affects every system of the body and leads to medical instability. The assessment of the burden of severe malnutrition is important for ready-to-use therapeutic foods and preparing therapy for these conditions. Therefore, this study aimed to assess the prevalence and spatial distribution of severe malnutrition and the factors associated with it. METHODS Data from the 2019 Mini-EDHS (Ethiopian Demographic and Health Surveys) with stratified sampling techniques were used. The data were weighted using sample weight to restore the data's representativeness and provide accurate statistical estimations. A total of 5,006 weighted samples of children under the age of five were used to analyze the study. A multilevel binary logistic regression model was built, and a cutoff P-value of 0.05 was used. The wag staff normalized concentration index and curve as well as spatial analysis were used. RESULTS The prevalence of severe malnutrition practice among under five years children in Ethiopia was 14.89% (95%CI: 13.93%, 15.91%), and ranges from 4.58% in Addis Ababa to 25.81% in the Afar region. Women with secondary and above education status as compared to uneducated [AOR = 0.17; 95%CI;[0.06, 0.48], high community women's education as compared to low [AOR = 0.54; 95%CI; 0.36, 0.78], women from richest household as compared to poorest [AOR = 0.63; 95%CI; 0.26, 0.94] and living in Oromia region as compared to Tigray [AOR = 0.33: 95%CI; 0.15, 0.74] were preventive factors. Whereas children 24-59 months of age as compared to under six months [AOR = 1.62; 95%CI; 1.50, 1.75], and being multiple births as compared to single [AOR = 5.34; 95%CI; 1.36,2 1.01] have significant risk factors for severe malnutrition. There was a pro-poor distribution of severe malnutrition among under-five children in Ethiopia with a concentration index of -0.23 [95%CI: -0.27, -0.19]. Severe malnutrition has significant spatial variation over regions in the country where the entire Afar, Eastern Amhara, Southern, and eastern Tigray regions were severely affected (RR = 1.72, P-value < 0.01). CONCLUSION AND RECOMMENDATIONS The prevalence of severe malnutrition in Ethiopia is relatively high as compared to other studies and most of them were severe chronic malnutrition. Having an educated mother/caregiver, and living in a cluster with high community women's education were preventive factors for severe malnutrition in children. Whereas having an unmarried mother/caregiver, old age of the child, plurality of birth, and having double children in the family have a positive association with it. Moreover, it was disproportionately concentrated in poor households (pro-poor distribution). The spatial distribution of childhood severe malnutrition was not random. Regions like Tigray, Afar, Eastern parts of Amhara, and Somalia regions should be considered priority areas for nutritional interventions for reducing severe malnutrition. Equity-focused nutritional interventions could be needed to curb the wealth-related inequalities of childhood severe malnutrition.
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Affiliation(s)
- Daniel Gashaneh Belay
- Department of Human Anatomy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Dagmawi Chilot
- Addis Ababa University, College of Health Sciences, Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), Addis Ababa, Ethiopia
- Department of Human Physiology, University of Gondar, College of Medicine and Health Science, School of Medicine, Gondar, Ethiopia
| | - Adugnaw Zeleke Alem
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Fantu Mamo Aragaw
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Melaku Hunie Asratie
- Department of Women's and Family Health, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Merid MW, Kibret AA, Alem AZ, Asratie MH, Aragaw FM, Chilot D, Belay DG. Spatial variations and multi-level determinants of modern contraceptive utilization among young women (15-24 years) in Ethiopia: spatial and multi-level analysis of mini-EDHS 2019. Contracept Reprod Med 2023; 8:26. [PMID: 37038207 PMCID: PMC10084619 DOI: 10.1186/s40834-023-00224-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 03/29/2023] [Indexed: 04/12/2023] Open
Abstract
INTRODUCTION There is tremendous regional inequalities and low uptake of modern contraceptives particularly among young women (15-24 years), characterized by high fertility but high unmet need for contraceptives in Ethiopia. Hence, the present study aimed at exploring the spatial distribution and the multi-level determinants of modern contraceptive use among young women in Ethiopia. METHODS This study was conducted using the 2019 Ethiopian demographic and health survey data on a weighted sample of 3,379 young women. STATA version 14 for the multi-level, and ArcGIS 10.7 and Sat Scan 9.6 for the spatial analysis were used. Spatial analysis was done to identify the hotspot areas of modern contraceptive use in Ethiopia. Multi-variable multi-level logistic regression was used for identifying determinants of modern contraceptive use and variables with a p-value < 0.05 were considered to be significant determinants. RESULT The overall prevalence of modern contraceptive use among young women in Ethiopia was 17.23% (95% CI: 10.98, 23.47). The hotspots areas for modern contraceptive use were detected in the central and south-western Amhara, western and central Oromia, and western SNNPR regions. Whereas the Somali region, Dire dawa, and Harari cities were cold spot areas for modern contraceptive use. Being married (AOR = 18.5; 95% CI: 12.66, 27.27), parity (AOR = 4.82; 95% CI: 1.27, 18.32), having television (AOR = 2.39; 95%CI: 1.43, 3.99), having radio (AOR = 1.43; 95%CI: 1.05, 1.94) had higher odds of using modern contraceptives compared to their counterparts. Besides, family size of above five (AOR = 0.46; 95% CI: 0.34, 0.62) and living in Somali region (AOR = 0.05; 95% CI: 0.01, 0.32) were associated with decreased odds of using modern contraceptives among young women in Ethiopia. CONCLUSION The modern contraceptive use was low among young women and considerably varied across regions in Ethiopia. A remarkably low rate of modern contraceptive use (cold spot) area was detected in Somali region-Ethiopia. Taking in to account a geographic perspective and key factors identified in this study would be vital for efficient resource allocation, targeted interventions, and informed decision-making to enhance contraceptive uptake in Ethiopia.
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Affiliation(s)
- Mehari Woldemariam Merid
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Anteneh Ayelign Kibret
- Department of Human Anatomy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Adugnaw Zeleke Alem
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Melaku Hunie Asratie
- Department of Women's and Family Health, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Fantu Mamo Aragaw
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Dagmawi Chilot
- Department of Human Physiology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Daniel Gashaneh Belay
- Department of Human Anatomy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Aragaw FM, Chilot D, Belay DG, Merid MW, Kibret AA, Alem AZ, Asratie MH. Spatial distribution and determinants of high-risk fertility behavior among reproductive-age women in Ethiopia. Trop Med Health 2023; 51:14. [PMID: 36872395 PMCID: PMC9987093 DOI: 10.1186/s41182-023-00506-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 02/18/2023] [Indexed: 03/07/2023] Open
Abstract
BACKGROUND In low-and-middle-income, including Ethiopia, high-risk fertility behavior is a major public health concern. High-risk fertility behavior has an adverse influence on maternal and child health, which hampered efforts to reduce maternal and child morbidity and mortality in Ethiopia. Therefore, this study aimed to assess the spatial distribution and associated factors of high-risk fertility behavior among reproductive-age women in Ethiopia using recent nationally representative data. METHODS Secondary data analysis was done with a total weighted sample of 5865 reproductive-aged women using the latest mini EDHS 2019. The spatial distribution of high-risk fertility behavior in Ethiopia was determined using spatial analysis. Multilevel multivariable regression analysis was used to identify predictors of high-risk fertility behavior in Ethiopia. RESULTS The prevalence of high-risk fertility behavior among reproductive-age women in Ethiopia was 73.50% (95% CI 72.36%, 74.62%). Women with primary education [AOR = 0.44; 95%CI; 0.37, 0.52], women with secondary and above education [AOR = 0.26; 95%CI; 0.20, 0.34], being Protestant religion followers [AOR = 1.47; 95%CI; 1.15, 1.89], being Muslim religion follower [AOR = 1.56; 95%CI; 1.20, 2.01], having television [AOR = 2.06; 95%CI; 1.54, 2.76], having ANC visit [AOR = 0.78; 95%CI; 0.61, 0.99], using contraception [AOR = 0.77; 95%CI; 0.65, 0.90], living in rural areas [AOR = 1.75; 95%CI; 1.22, 2.50] were significantly associated with high-risk fertility behavior. Significant hotspots of high-risk fertility behavior were detected in Somalia, SNNPR, Tigray region, and Afar regions of Ethiopia. CONCLUSIONS A significant proportion of women in Ethiopia engaged in high-risk fertility behavior. High-risk fertility behavior was distributed non-randomly across Ethiopian regions. Policymakers and stakeholders should design interventions that take into account the factors that predispose women to have high-risk fertility behaviors and women who reside in areas with a high proportion of high-risk fertility behaviors to reduce the consequences of high-risk fertility behaviors.
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Affiliation(s)
- Fantu Mamo Aragaw
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Dagmawi Chilot
- Department of Human Physiology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.,College of Health Sciences, Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), Addis Ababa University, Addis Ababa, Ethiopia
| | - Daniel Gashaneh Belay
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.,Department of Human Anatomy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mehari Woldemariam Merid
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Anteneh Ayelign Kibret
- Department of Human Anatomy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Adugnaw Zeleke Alem
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Melaku Hunie Asratie
- Department of Women's and Family Health, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Chilot D, Belay DG, Ferede TA, Shitu K, Asratie MH, Ambachew S, Shibabaw YY, Geberu DM, Deresse M, Alem AZ. Pooled prevalence and determinants of antenatal care visits in countries with high maternal mortality: A multi-country analysis. Front Public Health 2023; 11:1035759. [PMID: 36794067 PMCID: PMC9923119 DOI: 10.3389/fpubh.2023.1035759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 01/06/2023] [Indexed: 01/31/2023] Open
Abstract
Background Complications during pregnancy and childbirth are the leading causes of maternal and child deaths and disabilities, particularly in low- and middle-income countries. Timely and frequent antenatal care prevents these burdens by promoting existing disease treatments, vaccination, iron supplementation, and HIV counseling and testing during pregnancy. Many factors could contribute to optimal ANC utilization remaining below targets in countries with high maternal mortality. This study aimed to assess the prevalence and determinants of optimal ANC utilization by using nationally representative surveys of countries with high maternal mortality. Methods Secondary data analysis was done using recent Demographic and Health Surveys (DHS) data of 27 countries with high maternal mortality. The multilevel binary logistic regression model was fitted to identify significantly associated factors. Variables were extracted from the individual record (IR) files of from each of the 27 countries. Adjusted odds ratios (AOR) with a 95% confidence interval (CI) and p-value of ≤0.05 in the multivariable model were used to declare significant factors associated with optimal ANC utilization. Result The pooled prevalence of optimal ANC utilization in countries with high maternal mortality was 55.66% (95% CI: 47.48-63.85). Several determinants at the individual and community level were significantly associated with optimal ANC utilization. Mothers aged 25-34 years, mothers aged 35-49 years, mothers who had formal education, working mothers, women who are married, had media access, households of middle-wealth quintile, richest household, history of pregnancy termination, female household head, and high community education were positively associated with optimal ANC visits in countries with high maternal mortality, whereas being rural residents, unwanted pregnancy, having birth order 2-5, and birth order >5 were negatively associated. Conclusion and recommendations Optimal ANC utilization in countries with high maternal mortality was relatively low. Both individual-level factors and community-level factors were significantly associated with ANC utilization. Policymakers, stakeholders, and health professionals should give special attention and intervene by targeting rural residents, uneducated mothers, economically poor women, and other significant factors this study revealed.
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Affiliation(s)
- Dagmawi Chilot
- Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia,Department of Human Physiology, College of Medicine and Health Science, School of Medicine, University of Gondar, Gondar, Ethiopia,*Correspondence: Dagmawi Chilot ✉
| | - Daniel Gashaneh Belay
- Department of Human Anatomy, College of Medicine and Health Science, School of Medicine, University of Gondar, Gondar, Ethiopia,Department of Epidemiology and Biostatistics, College of Medicine and Health Science, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Tigist Andargie Ferede
- Department of Epidemiology and Biostatistics, College of Medicine and Health Science, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Kegnie Shitu
- Department of Health Education and Behavioral Sciences, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Melaku Hunie Asratie
- Department of Women and Family Health, College of Medicine and Health Science, School of Midwifery, University of Gondar, Gondar, Ethiopia
| | - Sintayehu Ambachew
- Department of Clinical Chemistry, School of Biomedical and Laboratory, University of Gondar, Gondar, Ethiopia
| | - Yadelew Yimer Shibabaw
- Department of Biochemistry, College of Medicine and Health Science, School of Medicine, University of Gondar, Gondar, Ethiopia
| | - Demiss Mulatu Geberu
- Department of Health Systems and Policy, College of Medicine and Health Science, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Melkamu Deresse
- Department of Physiotherapy, St. Peter's Specialized Hospital, Addis Ababa, Ethiopia
| | - Adugnaw Zeleke Alem
- Department of Epidemiology and Biostatistics, College of Medicine and Health Science, Institute of Public Health, University of Gondar, Gondar, Ethiopia
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Chilot D, Diress M, Yismaw Gela Y, Sinamaw D, Simegn W, Andualem AA, Seid AM, Bitew DA, Seid MA, Eshetu HB, Kibret AA, Belay DG. Geographical variation of common childhood illness and its associated factors among under-five children in Ethiopia: spatial and multilevel analysis. Sci Rep 2023; 13:868. [PMID: 36650192 PMCID: PMC9845232 DOI: 10.1038/s41598-023-27728-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 01/06/2023] [Indexed: 01/19/2023] Open
Abstract
Although substantial progress has been made in reducing child mortality over the last three decades, the magnitude of the problem remains immense. Ethiopia is one of the countries with a high under-five mortality rate due to childhood illnesses including acute respiratory infections, diarrhea, and fever that varies from place to place. It is vital to have evidence of the factors associated with childhood illnesses and the spatial distribution across the country to prioritize and design targeted interventions. Thus, this study aimed to investigate the spatial cluster distribution and associated factors with common childhood illnesses. Secondary data analysis based on the 2016 Ethiopian Demographic and Health Survey data was carried out. A total weighted sample of 10,417 children was included. The study used ArcGIS and SaTScan software to explore spatial distribution. For associated factors, a multilevel binary logistic regression model was fitted using STATA V.14 software. Adjusted Odds Ratios (AOR) with a 95% Confidence Interval (CI) and p-value ≤ 0.05 in the multivariable model were used to declare significant factors associated with the problem. ICC, MOR, PCV, and deviance (-2LLR) were used to check model fitness and model comparison. In this study, the prevalence of common childhood illnesses among under-five children was 22.5% (95% CI: 21.6-23.3%). The spatial analysis depicted that common childhood illnesses have significant spatial variation across Ethiopia. The SaTScan analysis identified significant primary clusters in Tigray and Northern Amhara regions (log-likelihood ratio (LLR) = 60.19, p < 0.001). In the multilevel analysis, being rural residence [AOR = 1.39, 95% CI (1.01-1.98)], small child size at birth [AOR = 1.36, 95% CI (1.21-1.55)], high community poverty [AOR = 1.26, 95% CI (1.06-1.52)], mothers aged 35-49 [AOR = 0.81, 95% CI (0.69-0.94)], the household had electricity [AOR = 0.77, 95% CI (0.61-0.98)], the household had a refrigerator [AOR = 0.60, 95% CI (0.42-0.87)], improved drinking water [AOR = 0.82, 95% CI (0.70-0.95)], improved toilet [AOR = 0.72, 95% CI (0.54-0.94)], average child size at birth [AOR = 0.83, 95% CI (0.75-0.94)] were significantly associated with common childhood illnesses. Common childhood illnesses had spatial variations across Ethiopia. Hotspot areas of the problem were found in the Tigray, Northern Amhara, and Northeast SNNPR. Both individual and community-level factors affected common childhood illnesses distribution and prevalence in Ethiopia. Therefore, public health intervention should target the hotspot areas of common childhood illnesses to reduce their incidence in the country.
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Affiliation(s)
- Dagmawi Chilot
- Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia. .,Department of Human Physiology, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia.
| | - Mengistie Diress
- Department of Human Physiology, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Yibeltal Yismaw Gela
- Department of Human Physiology, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Deresse Sinamaw
- Department of Biomedical Science, Debre Markos University, Debre Markos, Ethiopia
| | - Wudneh Simegn
- Department of Social and Administrative Pharmacy, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | | | - Abdulwase Mohammed Seid
- Department of Clinical Pharmacy, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | | | - Mohammed Abdu Seid
- Unit of Human Physiology, Department of Biomedical Science, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Habitu Birhan Eshetu
- Department of Health Education and Behavioral Sciences, University of Gondar, Gondar, Ethiopia
| | - Anteneh Ayelign Kibret
- Department of Human Anatomy, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Daniel Gashaneh Belay
- Department of Human Anatomy, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia.,Department of Epidemiology and Biostatistics, College of Medicine and Health Science, Institute of Public Health, University of Gondar, Gondar, Ethiopia
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Diress M, Getnet M, Akalu Y, Dagnew B, Belsti Y, Gela YY, Chilot D, Belay DG, Bitew DA, Terefe B, Getahun AB. Myopia and its associated factors among pregnant women at health institutions in Gondar District, Northwest Ethiopia: A multi-center cross-sectional study. Front Glob Womens Health 2023; 3:1078557. [PMID: 36727043 PMCID: PMC9884705 DOI: 10.3389/fgwh.2022.1078557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 12/28/2022] [Indexed: 01/18/2023] Open
Abstract
Background Myopia is the most common form of uncorrected refractive error with a growing burden worldwide. It is the principal complaint of most women during pregnancy. Although myopia has led to several consequences across the standard life of pregnant women, there is no previous study in Ethiopia regarding this topic. Thus, this study determined the prevalence of myopia and identifies its associated factors among pregnant women attending antenatal care units at governmental health institutions in Gondar City District, Northwest Ethiopia. Methods An institution-based cross-sectional study design was conducted from 08 February to 08 April 2021. From the selected health centres, study participants were recruited by systematic random sampling technique. A pre-tested, structured-interviewer-administered questionnaire consisting of socio-demographic variables, obstetric and clinical-related variables was used to collect the required data. Non-cycloplegic refraction was performed using trial lenses, trial frames, and retinoscopy in a semi-dark examination room. EpiData 3 and STATA 14 were used for data entry and statistical analysis respectively. Both bivariable and multivariable binary logistic regression analyses were executed to identify associated factors of myopia. Variables with a p-value ≤0.05 in the multivariable logistic regression analysis were declared as statistically significant with myopia. Model fitness was checked by Hosmer and Lemeshow goodness of test (at p > 0.05). Results A total of four-hundred and twenty-three pregnant women participated with a 100% response rate in this study. The overall prevalence of myopia among pregnant women was 26.48% (95% CI: 22.48-30.91). Eighty-Eight (20.81%) and Eighty-Four (19.85%) of the study participants had myopia in their right and left eyes respectively. The prevalence of myopia was significantly associated with age (AOR = 1.17; 95% CI: 1.09-1.28), the third trimester of gestation (AOR = 2.05, 95% CI: 1.08-3.90), multi & grand multipara (AOR = 3.15; 95% CI: 1.59-6.25), and history of contraceptive use (AOR = 3.30; 95% CI: 1. 50-7.28). Conclusion The finding of our study shows that there is a higher prevalence of myopia among pregnant women in our study area. Further prospective analytical studies regarding visual systems among pregnant women, particularly as a result of pregnancy, are strongly recommended.
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Affiliation(s)
- Mengistie Diress
- Department of Human Physiology, University of Gondar, Gondar, Ethiopia,Correspondence: Mengistie Diress
| | - Mihret Getnet
- Department of Human Physiology, University of Gondar, Gondar, Ethiopia
| | - Yonas Akalu
- Department of Human Physiology, University of Gondar, Gondar, Ethiopia
| | - Baye Dagnew
- Department of Human Physiology, University of Gondar, Gondar, Ethiopia
| | - Yitayeh Belsti
- Department of Human Physiology, University of Gondar, Gondar, Ethiopia,Department of Epidemiology and Biostatistics, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | | | - Dagmawi Chilot
- Department of Human Physiology, University of Gondar, Gondar, Ethiopia
| | - Daniel Gashaneh Belay
- Department of Epidemiology and Biostatistics, Institute of Public Health, University of Gondar, Gondar, Ethiopia,Department of Human Anatomy, School of Medicine, University of Gondar, Gondar, Ethiopia
| | - Desalegn Anmut Bitew
- Department of Reproductive Health, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Bewuketu Terefe
- Department of Community Health Nursing, School of Nursing, University of Gondar, Gondar, Ethiopia
| | - Amare Belete Getahun
- Department of Anesthesia, School of Medicine, University of Gondar, Gondar, Ethiopia
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Eshetu HB, Diress M, Belay DG, Seid MA, Chilot D, Sinamaw D, Simegn W, Tareke AA, Seid AM, Andualem AA, Bitew DA, Gela YY, Kibret AA. Individual and community-level factors associated with iron-rich food consumption among children aged 6-23 months in Rwanda: A multilevel analysis of Rwanda Demographic and Health Survey. PLoS One 2023; 18:e0280466. [PMID: 36656868 PMCID: PMC9851500 DOI: 10.1371/journal.pone.0280466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Accepted: 12/31/2022] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Iron-rich food consumption has an invaluable effect for neonatal and fetal brain development as well as metabolic activities. Despite the public health importance of the consumption of iron-rich foods, there was no study, that assessed iron-rich food consumption in Rwanda. Therefore this study aimed to assess iron-rich food consumption and associated factors among children aged 6-23 months using Rwanda Demographic and Health Survey (RDHS). METHODS Secondary data analysis was done using RDHS-2019/20. Total weighted samples of 2455 children aged 6-23 months were included. Data coding, cleaning, and analysis were performed using Stata 16. Multilevel binary logistic regression were performed to identify factors associated with iron-rich food consumption. Adjusted Odds Ratio (AOR) with a 95% CI, and p-value <0.05 were used to declare statistical significance. RESULTS The prevalence of good iron-rich food consumption was 23.56%(95% CI: 21.92,25.28). Northern province of Rwanda (AOR = 0.26,95%CI: 0.15,0.46), mothers secondary education and above (AOR: 2.37, 95% CI: 1.41, 4.01), married mothers (AOR:1.31, 95% CI: 1.01,1.71), rich wealth status (AOR = 2.06, 95% CI: 1.48, 2.86), having post-natal visit (AOR = 1.45, 95% CI: 1.10,1.91), mothers media exposure (AOR: 1.75, 95% CI: 1.22, 2.52) and drugs given for intestinal parasite (AOR = 1.37, 95% CI: 1.04, 1.80) were associated with iron-rich food consumption. CONCLUSIONS This study shows that overall iron-rich foods consumption was low in Rwanda. The residing in the North province, mother's secondary and higher educational status, married marital status, rich and middle wealth status, having media exposure, drugs given for intestinal parasites, and having child's post-natal checkup were variables significantly associated with iron-rich food consumption. The region-based intervention will improve the consumption of iron-rich food. In addition, health policies and programs should target educating mothers/caregivers, encouraging parents to live together, improving their wealth status, working on mass media access by the women, and encouraging mothers post-natal checkups to improve iron-rich food consumption.
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Affiliation(s)
- Habitu Birhan Eshetu
- Department of Health Promotion and Health Behavior, Institute of Public Health, University of Gondar, Gondar, Ethiopia
- * E-mail:
| | - Mengistie Diress
- Department of Human Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Daniel Gashaneh Belay
- Department of Human Anatomy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Department of Epidemiology and Biostatistics, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Mohammed Abdu Seid
- Unit of Human Physiology, Department of Biomedical Science, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Dagmawi Chilot
- Department of Human Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- College of Health Sciences, Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), Addis Ababa University, Addis Ababa, Ethiopia
| | - Deresse Sinamaw
- Unit of Human Physiology, Department of Biomedical Science, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Wudneh Simegn
- Department of Social and Administrative Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Abiyu Abadi Tareke
- Amref Health Africa in Ethiopia, SLL Project, COVID-19 Vaccine /EPI Technical Assistant at West Gondar, Addis Ababa, Ethiopia
| | - Abdulwase Mohammed Seid
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | | | - Desalegn Anmut Bitew
- Department of Reproductive Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Yibeltal Yismaw Gela
- Department of Human Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Anteneh Ayelign Kibret
- Department of Human Anatomy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Simegn W, Diress M, Gela YY, Belay DG, Ayelign Kibret A, Chilot D, Sinamaw D, Abdu Seid M, Andualem AA, Anmut Bitew D, Eshetu HB, Mohammed Seid A. Childhood vaccination practices and associated factors among mothers/caregivers in Debre Tabor town, Northwest Ethiopia: A cross-sectional study. Front Pediatr 2023; 11:1070722. [PMID: 36793335 PMCID: PMC9922988 DOI: 10.3389/fped.2023.1070722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 01/02/2023] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Incomplete immunization and non-immunization increase the risk of disease and death among children. This study aims to assess childhood vaccination practices and associated factors among mothers and caregivers in Debre Tabor town, Amhara region, Ethiopia. METHODS A community-based cross-sectional study design was conducted between February 30 and April 30, 2022. The study participants were proportionally allocated to all six kebeles found in the town. A systematic random sampling technique was used to select the study participants. The collected data were checked and coded and then entered into EpiData Version 3.1 and exported into SPSS Version 26. The results were organized using frequency tables, graphs, and charts, and bivariate and multivariable logistic regression were used to test the association of covariates with childhood vaccination practices. RESULT Approximately 422 study mothers and caregivers participated in the study, with a response rate of 100%. The mean age was 30.63 years (11.74), which ranged from 18 to 58 years. More than half of the study participants (56.4%) expressed fears about the side effects of vaccination. A majority (78.4%) of the study participants availed of counseling services about vaccination, and 71.1% of them received regular antenatal care. This study found that approximately 280 [66.4%, 95% confidence interval (CI): 61.8-70.6] mothers/caregivers had a history of good childhood vaccination practices. The factors of the fear of side effects [adjusted odds ratio (AOR) = 3.34; 95% CI: 1.72-6.49], no workload (AOR = 6.08; 95% CI: 1.74-21.22), medium workload (AOR = 4.80; 95% CI: 1.57-14.71), being a mother of child/children (AOR = 2.55; 95% CI: 1.27-5.13), positive attitude (AOR = 2.25; 95% CI: 1.32-3.82), and sound knowledge (AOR = 3.88; 95% CI: 2.26-6.68) were significantly associated with childhood vaccination practices. CONCLUSION More than half of the study participants had a history of good childhood vaccination practices. However, the rate of such practices was low among mothers and caregivers. The fear of side effects, workload, motherhood, attitude, and knowledge were all factors associated with childhood vaccination practices. Awareness creation and a consideration of the workload of mothers would be helpful in dispelling fears and increasing the rate of good practices among mothers and caregivers.
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Affiliation(s)
- Wudneh Simegn
- Department of Social and Administrative Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mengistie Diress
- Department of Human Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Yibeltal Yismaw Gela
- Department of Human Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Daniel Gashaneh Belay
- Department of Human Anatomy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.,Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Anteneh Ayelign Kibret
- Department of Human Anatomy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Dagmawi Chilot
- Department of Human Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.,Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), Addis Ababa University, College of Health Sciences, Addis Ababa, Ethiopia
| | - Deresse Sinamaw
- Department of Biomedical Science, Debre Markos University, Debre Markos, Ethiopia
| | - Mohammed Abdu Seid
- Unit of Human Physiology, Department of Biomedical Science, College of Health Sciences, Debre Tabor University, Debre tabor, Ethiopia
| | | | - Desalegn Anmut Bitew
- Department of Reproductive Health, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Habitu Birhan Eshetu
- Department of Health Promotion and Health Behavior, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Abdulwase Mohammed Seid
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Chilot D, Shitu K, Gela YY, Getnet M, Mulat B, Diress M, Belay DG. Factors associated with healthcare-seeking behavior for symptomatic acute respiratory infection among children in East Africa: a cross-sectional study. BMC Pediatr 2022; 22:662. [PMID: 36380283 PMCID: PMC9664707 DOI: 10.1186/s12887-022-03680-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 10/18/2022] [Indexed: 11/16/2022] Open
Abstract
Background Although there has been promising progress in the reduction of child mortality from ARI, the magnitude is high yet, especially in East Africa. Since mothers/guardians decide upon the type and frequency of healthcare services for children, their good healthcare-seeking behavior could prevent acute respiratory infections (ARI) related mortality and morbidity. This study aimed to investigate the pooled prevalence and factors associated with healthcare-seeking behavior of children younger than five years with ARI symptoms by using data from nationally representative surveys of East Africa. Methods We analyzed secondary data based on the eleven East African Demographic and Health Survey data. Both Individual and community level variables were considered for this study and a multilevel binary logistic regression model was fitted to identify associated factors of children’s healthcare-seeking behavior for ARI symptoms. STATA V.14 software was used to clean, recode and analyze the data. All variables with a p-value = 0.2 in the bi-variable analysis were considered for the multivariable multilevel analysis. Adjusted OR (AOR) with 95% CI was reported to reveal significantly associated factors in the multivariable multilevel analysis. Result The overall prevalence of healthcare-seeking behavior of under-five children for ARI symptoms was 64.4% in East Africa. In the multilevel analysis, the following characteristics were found to be the most important factors of children healthcare seeking behavior for ARI symptoms (P < 0.05): Rural residence [AOR = 0.51, 95% CI (0.37–0.65)], high community level media usage [AOR = 1.63, 95% CI (1.49–1.79)], high community level women education [AOR = 1.51, 95% CI (1.39–1.66)], primary education [AOR = 1.62, 95% CI (1.45–1.82)], secondary education and above [AOR = 1.99, 95% CI (1.71–2.32)], working mother [AOR = 1.33, 95% CI (1.20–1.48)], unmarried women [AOR = 1.15, 95% CI (1.04–1.27)], media access [AOR = 1.43, 95% CI (1.20–1.58)], richest [AOR = 1.39, 95% CI (1.29–1.51)], distance to health facility not a big problem [AOR = 1.11, 95% CI (1.02–1.21)], Place of delivery at health facilities [AOR = 1.77, 95% CI (1.60–1.95)], age of child 7–23 months [AOR = 1.59, 95% CI (1.39–1.82)], age of child 24–59 months [AOR = 1.24, 95% CI (1.09–1.41)] in comparison with children aged 0–6 months, family size > 10 [AOR = 1.53, 95% CI (1.22–1.92)]. Conclusions and recommendations The overall prevalence of children’s healthcare-seeking behavior for ARI symptoms was found relatively low in East Africa, ARI symptoms were determined by individual-level variables and community-level factors. Targeted interventions are needed to improve socioeconomic and health systems to overcome the problem of acute respiratory infection in children. Special attention is required to empower local health staff and health facilities to provide proper diagnosis and management of ARI cases in East Africa.
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Chilot D, Belay DG, Shitu K, Mulat B, Alem AZ, Geberu DM. Prevalence and associated factors of common childhood illnesses in sub-Saharan Africa from 2010 to 2020: a cross-sectional study. BMJ Open 2022; 12:e065257. [PMID: 36379651 PMCID: PMC9668010 DOI: 10.1136/bmjopen-2022-065257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE This study aimed to assess the prevalence and determinants of common childhood illnesses in sub-Saharan Africa. DESIGN Cross-sectional study. SETTING Sub-Saharan Africa. PARTICIPANTS Under-5 children. PRIMARY OUTCOME Common childhood illnesses. METHODS Secondary data analysis was conducted using data from recent Demographic and Health Survey datasets from 33 sub-Saharan African countries. We used the Kids Record dataset file and we included only children under the age of 5 years. A total weighted sample size of 208 415 from the pooled (appended) data was analysed. STATA V.14.2 software was used to clean, recode and analyse the data. A multilevel binary logistic regression model was fitted, and adjusted OR with a 95% CI and p value of ≤0.05 were used to declare significantly associated factors. To check model fitness and model comparison, intracluster correlation coefficient, median OR, proportional change in variance and deviance (-2 log-likelihood ratio) were used. RESULT In this study, the prevalence of common childhood illnesses among under-5 children was 50.71% (95% CI: 44.18% to 57.24%) with a large variation between countries which ranged from Sierra Leone (23.26%) to Chad (87.24%). In the multilevel analysis, rural residents, mothers who are currently breast feeding, educated mothers, substandard floor material, high community women education and high community poverty were positively associated with common childhood illnesses in the sub-Saharan African countries. On the other hand, children from older age mothers, children from the richest household and children from large family sizes, and having media access, electricity, a refrigerator and improved toilets were negatively associated. CONCLUSIONS The prevalence of common illnesses among under-5 children was relatively high in sub-Saharan African countries. Individual-level and community-level factors were associated with the problem. Improving housing conditions, interventions to improve toilets and strengthening the economic status of the family and the communities are recommended to reduce common childhood diseases.
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Affiliation(s)
- Dagmawi Chilot
- Physiology, University of Gondar College of Medicine and Health Sciences, Gondar, Amara, Ethiopia
- CDT Africa, Addis Ababa University College of Health Sciences, Addis Ababa, Ethiopia
| | - Daniel Gashaneh Belay
- Epidemiology, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia
- Anatomy, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia
| | - Kegnie Shitu
- Department of Health Education and Behavioral Sciences, University of Gondar, Gondar, Ethiopia
| | - Bezawit Mulat
- Physiology, University of Gondar College of Medicine and Health Sciences, Gondar, Amara, Ethiopia
| | - Adugnaw Zeleke Alem
- Epidemiology and Biostatistics, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia
| | - Demiss Mulatu Geberu
- Health Systems and Policy, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia
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Chilot D, Belay DG, Shitu K, Gela YY, Getnet M, Mulat B, Muluneh AG, Merid MW, Bitew DA, Alem AZ. Measles second dose vaccine utilization and associated factors among children aged 24–35 months in Sub-Saharan Africa, a multi-level analysis from recent DHS surveys. BMC Public Health 2022; 22:2070. [PMID: 36371164 PMCID: PMC9655865 DOI: 10.1186/s12889-022-14478-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 10/27/2022] [Indexed: 11/13/2022] Open
Abstract
Background Although a safe and effective vaccine is available, measles remains an important cause of mortality and morbidity among young children in Sub-Saharan Africa (SSA). The WHO and UNICEF recommended measles-containing vaccine dose 2 (MCV2) in addition to measles-containing vaccine dose 1 (MCV1) through routine services strategies. Many factors could contribute to the routine dose of MCV2 coverage remaining far below targets in many countries of this region. This study aimed to assess the prevalence of MCV2 utilization among children aged 24–35 months and analyze factors associated with it by using recent nationally representative surveys of SSA countries. Methods Secondary data analysis was done based on recent Demographic and Health Surveys (DHS) data from eight Sub-Saharan African countries. In this region, only eight countries have a record of routine doses of measles-containing vaccine dose 2 in their DHS dataset. The multilevel binary logistic regression model was fitted to identify significantly associated factors. Variables were extracted from each of the eight country’s KR files. Adjusted Odds Ratios (AOR) with a 95% Confidence Interval (CI) and p-value ≤ 0.05 in the multivariable model were used to declare significant factors associated with measles-containing vaccine dose 2 utilization. Result The pooled prevalence of MCV2 utilization in SSA was 44.77% (95% CI: 27.10–62.43%). In the multilevel analysis, mothers aged 25–34 years [AOR = 1.15,95% CI (1.05–1.26), mothers aged 35 years and above [AOR = 1.26, 95% CI (1.14–1.41)], maternal secondary education and above [AOR = 1.27, 95% CI (1.13–1.43)], not big problem to access health facilities [AOR = 1.21, 95% CI (1.12–1.31)], four and above ANC visit [AOR = 2.75, 95% CI (2.35–3.24)], PNC visit [AOR = 1.13, 95% CI (1.04–1.23)], health facility delivery [AOR = 2.24, 95% CI (2.04–2.46)], were positively associated with MCV2 utilization. In contrast, multiple twin [AOR = 0.70, 95% CI (0.53–0.95)], rural residence [AOR = 0.69, 95% CI (0.57–0.82)] and high community poverty [AOR = 0.66, 95% CI (0.54–0.80)] were found to be negatively associated with MCV2 utilization. Conclusions and recommendations Measles-containing vaccine doses 2 utilization in Sub-Saharan Africa was relatively low. Individual-level factors and community-level factors were significantly associated with low measles-containing vaccine dose 2 utilization. The MCV2 utilization could be improved through public health intervention by targeting rural residents, children of uneducated mothers, economically poor women, and other significant factors this study revealed.
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Mulat B, Tsegaw M, Chilot D, Shitu K. Assessment of domestic violence and its associated factors among ever-married reproductive-age women in Cameroon: a cross-sectional survey. BMC Womens Health 2022; 22:397. [PMID: 36183059 PMCID: PMC9526281 DOI: 10.1186/s12905-022-01907-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 07/26/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Domestic violence (DV) against women is a global issue that affects women in all countries and is a significant contributor to their poor health. Women who have experienced DV, in particular, suffer from the gynecological, nervous system, and stress-related issues. Despite such devastating implications, there is a paucity of data on the prevalence of DV and its associated factors among married reproductive-age women in Cameroon. METHOD The data were analyzed by using STATA version 14 from a demographic and health survey conducted in Cameroon in 2018. Both bivariable and multivariable logistic regression analyses were done. Statistical significance was determined using a p-value of less than 0.05 and a 95% confidence range. RESULT A total of 4,903 ever-married women were included in the study. The mean age ± standard deviation, of the participants was 31.3 (± 8.4) years with an age range of 15-49 years. The prevalence of DV among ever-married Cameroonian women was 30.5% with 95%CI (29.3%, 31.8%). Women's educational attainment (higher educational level) (AOR = 0.58, 95% CI (0.37, 0.92), p value = 0.02), Husband's educational level (husbands who attended primary educational level (AOR = 1.30, 95% CI (1.01, 1.68), p value = 0.04), a woman who had media exposure regarding DV ( AOR = 0.83, 95% CI (0.0, 0.99), p value = 0.04), a woman whose husband drinks alcohol (AOR = 3.00, 95% CI (2.56, 3.53), p value < 0.001), and the region where the women reside (center without Yaoundé (AOR = 2.48, 95% CI (1.75, 3.52), p value < 0.001), west (AOR = 1.49, 95% CI (1.05, 2.11), p value = 0.02), South (AOR = 1.89, 95% CI (1.31, 2.72), p-value = 0.001), and Yaoundé (AOR = 1.65. 95% CI (1.14, 2.39), p value = 0.009) were factors that were significantly associated to DV committed by a husband in the previous 12 months against ever-married women. CONCLUSION The present study revealed that the prevalence of DV among ever-married women in Cameroon is high. Women's educational level, husband's educational level, husband's alcohol drinking status, women's exposure to mass-media about DV, and the region where the woman resides in the country were factors significantly associated with DV.
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Affiliation(s)
- Bezawit Mulat
- grid.59547.3a0000 0000 8539 4635Department of Human Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Menen Tsegaw
- grid.427581.d0000 0004 0439 588XDepartment of Public Health, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
| | - Dagmawi Chilot
- grid.59547.3a0000 0000 8539 4635Department of Human Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Kegnie Shitu
- grid.59547.3a0000 0000 8539 4635Department of Health, Education and Behavioral Sciences, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Chilot D, Woldeamanuel Y, Manyazewal T. COVID-19 Burden on HIV Patients Attending Antiretroviral Therapy in Addis Ababa, Ethiopia: A Multicenter Cross-Sectional Study. Front Med (Lausanne) 2022; 9:741862. [PMID: 35308528 PMCID: PMC8924523 DOI: 10.3389/fmed.2022.741862] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 01/07/2022] [Indexed: 12/18/2022] Open
Abstract
Background There has been promising progress toward screening, testing, and retaining patients with HIV in care in Ethiopia. Concern exists that possible disruptions in HIV programs due to coronavirus disease 2019 (COVID-19) could result in a more HIV-related mortality and new HIV infections. This study aimed to investigate the real-time burden of COVID-19 on patients with HIV attending antiretroviral therapy. Methods We conducted a facility-based, multicenter, and cross-sectional study among patients with HIV attending antiretroviral therapy in 10 healthcare facilities in Addis Ababa, Ethiopia, in the COVID-19 pandemic period. Data were collected using adapted, interviewer-based questionnaires, and entered into EpiInfo version 7 and exported to SPSS version 26 for analysis. Result A total of 212 patients with HIV were included. The participants who missed visits for refill were 58 (27.4%). When the effects of other independent variables on appointments/visits for refill were controlled, the following characteristics were found to be the most important predictors of missed appointments (p< 0.05): age ≥ 55 [adjusted odds ratio (AOR) = 6.73, 95% CI (1.495-30.310)], fear of COVID-19 [AOR = 24.93, 95% CI (2.798-222.279)], transport disruption [AOR = 4.90, 95% CI (1.031-23.174)], reduced income for traveling to a health facility [AOR = 5.64, 95% CI (1.234-25.812)], limited access to masks [AOR = 7.67, 95% CI (1.303-45.174)], sanitizer [AOR = 0.07, 95% CI (0.007-0.729)], and non-medical support [AOR = 2.32, 95% CI (1.547-12.596)]. The participants were well aware of the COVID-19 preventive measures. The most costly COVID-19 preventive measures that cause financial burden to the patients were the costs for buying face masks (63.7%), disinfectants (55.2%), and soap for handwashing (22.2%). The participants who missed follow-up diagnostic tests were 56 (26.4%). Variables, which were found to be statistically significant, include the following: age ≥ 55 [AOR = 0.22, 95% CI (0.076-0.621)], partial lockdown [AOR = 0.10, 95% CI (0.011-0.833)], limited access to health services [AOR = 0.15, 95% CI (0.045-0.475)], reduced income for traveling to health facility [AOR = 0.18, 95% CI (0.039-0.784)], and unable to get masks [AOR = 0.12, 95% CI (0.026-0.543)]. The participants who missed counseling services were 55 (25.9%). In multivariate logistic regression, the following were statistically significant: age ≥ 55 [AOR = 0.21, 95% CI (0.078-0.570)], fear of COVID-19 [AOR = 0.11, 95% CI (0.013-0.912)], reduced income [AOR = 0.17, 95% CI (0.041-0.699)], unable to get face masks [AOR = 0.19, 95% CI (0.039-0.959)], and partial lockdown [AOR = 0.08, 95% CI (0.008-0.790)]. Conclusions The COVID-19 had a significant burden on patients with HIV to attend their routine clinical care and treatment, which may lead to treatment failure and drug resistance. The impact was on their appointments for medication refills and clinical and laboratory follow-ups. Targeted initiatives are needed to sustain HIV clinical care and treatment services and improve the well-being of people living with HIV.
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Affiliation(s)
- Dagmawi Chilot
- Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Yimtubezinash Woldeamanuel
- Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Tsegahun Manyazewal
- Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Chilot D, Woldeamanuel Y, Manyazewal T. COVID-19 Burden on HIV Patients Attending Antiretroviral Therapy in Addis Ababa, Ethiopia: A Multicenter Cross-Sectional Study. Res Sq 2021. [PMID: 34341785 PMCID: PMC8328071 DOI: 10.21203/rs.3.rs-699963/v1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Background There has been promising progress towards screening, testing, and retaining HIV patients in care in Ethiopia. Concern exists that possible disruptions in HIV programs due to COVID-19 could result in more HIV-related mortality and new HIV infections. This study aimed to investigate the real-time burden of COVID-19 on HIV patients attending antiretroviral therapy. Methods We conducted a facility-based, multicentre, cross-sectional study among HIV patients attending antiretroviral therapy in 10 healthcare facilities in Addis Ababa, Ethiopia, in the COVID-19 pandemic period. Data was collected using adapted, interviewer-based questionnaires, and entered into Epi Info version 7 and exported to SPSS version 26 for analysis. Result A total of 212 patients with HIV were included. Participants who missed visits for refill were 58 (27.4%). When the effects of other independent variables on appointments/visits for refill were controlled, the following characteristics were found to be the most important pridictors of missed appointments (P < 0.05): age ≥ 55 [AOR = 6.73, 95% CI (1.495–30.310)], fear of COVID-19 [AOR = 24.93, 95% CI (2.798-222.279)], transport disruption [AOR = 4.90, 95% CI (1.031–23.174)], reduced income for traveling to health facility [AOR = 5.64, 95% CI (1.234–25.812)], and limited access to mask [AOR = 7.67, 95% CI (1.303–45.174)], sanitizer [AOR = 0.07, 95% CI (0.007–0.729)] and non-medical support [AOR = 2.32, 95% CI (1.547–12.596)]. The participants were well aware of the COVID-19 preventive measures. The most costly COVID-19 preventive measures that cause financial burden to the patients were costs for buying facemasks (63.7%), disinfectants (55.2) and sops for handwashing (22.2). Participants who missed follow-up diagnostic tests were 56 (26.4%). Variables which were found to be statistically significant include the following: age ≥ 55 [AOR = 0.22, 95% CI (0.076–0.621)], partial lockdown [AOR = 0.10, 95% CI (0.011–0.833)], limited access to health services [AOR = 0.15, 95% CI (0.045–0.475)], reduced income for traveling to health facility [AOR = 0.18, 95% CI (0.039–0.784)], and unable to get mask [AOR = 0.12, 95% CI (0.026–0.543)]. Participants who missed counseling services were 55 (25.9%). In multivariate logistic regression the following were statisticaly significant: age ≥ 55 [AOR = 0.21, 95% CI (0.078–0.570)], fear of COVID-19 [AOR = 0.11, 95% CI (0.013–0.912)], reduced income [AOR = 0.17, 95% CI (0.041–0.699)], unable to get face mask [AOR = 0.19, 95%CI (0.039–0.959)], and partial lockdown [AOR = 0.08, 95% CI (0.008–0.790)]. Conclusions COVID-19 had a significant burden on HIV patients to attend their routine clinical care and treatment, which may lead to treatment failure and drug resistance. The impact was on their appointments for medication refills and clinical and laboratory follow-ups. Targeted initiatives are needed to sustain HIV clinical care and treatment services and improve the wellbeing of people living with HIV.
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