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Damanhuri NH, Hairi NN, Ismail M, Jeganathan R, Karalasingam SD, Nasir MJM, Soelar SA, Musa KI, Tengku Ismail TA. Spontaneous Preterm Births in Malaysia: Are There Modifiable Antenatal Risk Factors? Cureus 2024; 16:e59152. [PMID: 38680821 PMCID: PMC11055571 DOI: 10.7759/cureus.59152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2024] [Indexed: 05/01/2024] Open
Abstract
Background Spontaneous preterm birth (SPB) is a global public health concern with devastating health effects on SPB survivors. This study aimed to determine modifiable antenatal risk factors associated with SPB among women attending government healthcare facilities in Malaysia. Methodology A retrospective record review of 49,416 national obstetrics registry data from 2015 was conducted and analyzed using binary logistic regression based on six antenatal factor divisions. Results Mothers with pre-existing diabetes had higher odds (adjusted odds ratio (aOR) = 3.09) of delivering prematurely than mothers without diabetes. Mothers with chronic hypertension with superimposed pre-eclampsia (aOR = 2.51) and gestational hypertension (aOR = 1.44) had higher odds of experiencing preterm birth than mothers with no hypertension. Underweight mothers had higher odds (aOR = 1.27) of delivering prematurely than mothers with an ideal body mass index (18.5 to <25.0 kg/m2). Mothers with moderate anemia (hemoglobin level: 7 to <9 g/dL) had higher odds (aOR = 1.18) of preterm birth than mothers with normal hemoglobin levels (≥11 g/dL). Conclusions Maternal biomarkers, such as glucose level, blood pressure, BMI, and hemoglobin level, play an important role in reducing the rate of SPB in Malaysia. This study recommends strengthening pre-pregnancy, antenatal, and postpartum care through multidisciplinary and multi-agency team collaboration, addressing both modifiable and non-modifiable risk factors and adopting a dual approach that combines preventive and curative care.
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Affiliation(s)
- Narisa H Damanhuri
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, MYS
| | - Noran N Hairi
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, MYS
| | - Maslinor Ismail
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, MYS
| | | | | | | | | | - Kamarul Imran Musa
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, MYS
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Lesego A, Tsegaye T, Were LPO, Sakvarelidze G, Garg S, Morrison L, Nigussie S, Githendu P, Achoki T. Assessment of the Global Fund-supported procurement and supply chain reforms at the Ethiopian Pharmaceuticals Supply Agency: a mixed-methods study. BMJ Open 2023; 13:e073390. [PMID: 38101834 PMCID: PMC10729206 DOI: 10.1136/bmjopen-2023-073390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 11/28/2023] [Indexed: 12/17/2023] Open
Abstract
OBJECTIVE The Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) partnered with the Ethiopian Pharmaceutical Supply Agency (EPSA) in 2018-2019 to reform procurement and supply chain management (PSCM) procedures within the Ethiopian healthcare system. This assessment sought to determine the impact of the reforms and document the lessons learnt. DESIGN Mixed-methods study incorporating qualitative and quantitative analysis. Purposive and snowballing sampling techniques were applied for the qualitative methods, and the data collected was transcribed in full and subjected to thematic content analysis. Descriptive analysis was applied to quantitative data. SETTING The study was based in Ethiopia and focused on the EPSA operations nationally between 2017 and 2021. PARTICIPANTS Twenty-five Ethiopian healthcare decision-makers and health workers. INTERVENTION Global Fund training programme for health workers and infrastructural improvements OUTCOMES: Operational and financial measures for healthcare PSCM. RESULTS The availability of antiretrovirals, tuberculosis and malaria medicines, and other related commodities, remained consistently high. Line fill rate and forecast accuracy were average. Between 2018 and 2021, procurement lead times for HIV and malaria-related orders reduced by 43.0% relative to other commodities that reported an increase. Many interview respondents recognised the important role of the Global Fund support in improving the performance of EPSA and provided specific attributions to the observed successes. However, they were also clear that more needs to be done in specific critical areas such as financing, strategic reorganisation, data and information management systems. CONCLUSION The Global Fund-supported initiatives led to improvements in the EPSA performance, despite several persistent challenges. To sustain and secure the gains achieved so far through Global Fund support and make progress, it is important that various stakeholders, including the government and the donor community, work together to support EPSA in delivering on its core mandate within the Ethiopian health system.
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Affiliation(s)
| | - Tsion Tsegaye
- Ethiopian Procurement and Supply Agency, Addis Ababa, Ethiopia
| | | | - George Sakvarelidze
- The Global Fund to Fight AIDS Tuberculosis and Malaria, Grand-Saconnex, Switzerland
| | - Sunil Garg
- The Global Fund to Fight AIDS Tuberculosis and Malaria, Grand-Saconnex, Switzerland
| | - Linden Morrison
- The Global Fund to Fight AIDS Tuberculosis and Malaria, Grand-Saconnex, Switzerland
| | | | - Patrick Githendu
- The Global Fund to Fight AIDS Tuberculosis and Malaria, Grand-Saconnex, Switzerland
| | - Tom Achoki
- Africa Institute for Health Policy, Nairobi, Kenya
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Dolango B, Mesfin FB, Wondafrash M, Popp AJ. Establishing a Structured Neurosurgery Service and Residency Training Program in Ethiopia: The St. Paul's Hospital Millennium Medical College's Experience. World Neurosurg 2023; 180:88-90. [PMID: 37741332 DOI: 10.1016/j.wneu.2023.09.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 09/11/2023] [Accepted: 09/12/2023] [Indexed: 09/25/2023]
Affiliation(s)
- Birhanu Dolango
- Department of Neurosurgery, St Paul's Millennium Medical College, Monrovia, Maryland, USA.
| | - Fassil B Mesfin
- Division of Spine, Department of Neurosurgery-Long School of Medicine, UT Health San Antonio -MD Anderson Cancer Center, San Antonio, Texas, USA
| | - Mulualem Wondafrash
- Neurosurgery, St Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - A John Popp
- Department of Neurosurgery, Albany Medical College, Albany, New York, USA
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Gizachew S, Van Beeck W, Spacova I, Dekeukeleire M, Alemu A, Mihret W, Lebeer S, Engidawork E. Characterization of potential probiotic starter cultures of lactic acid bacteria isolated from Ethiopian fermented cereal beverages, Naaqe, and Cheka. J Appl Microbiol 2023; 134:lxad237. [PMID: 37858306 DOI: 10.1093/jambio/lxad237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 08/21/2023] [Accepted: 10/18/2023] [Indexed: 10/21/2023]
Abstract
AIMS To test the in vitro probiotic potential and starter culture capacity of lactic acid bacteria (LAB) isolated from Naaqe and Cheka, cereal-based Ethiopian traditional fermented beverages. METHODS AND RESULTS A total of 44 strains were isolated from spontaneously fermented Ethiopian cereal-based beverages, Naaqe and Cheka with 24 putatively identified as LAB and 14 identified up to the species level. The species Limosilactobacillus fermentum (6/12; 50%) and Weissella confusa (5/12, 41.67%) were the predominant species identified from Naaqe, while the two Cheka isolates were L. fermentum and Pediococcus pentosaceus. Six LAB strains inhibited eight of the nine gastrointestinal indicator key pathogens in Ethiopia, including Escherichia coli, Salmonella enterica subsp. enterica var. Typhimurium, Staphylococcus aureus, Shigella flexneri, and Listeria monocytogenes. Three of the LAB isolates exhibited strain-specific immunostimulation in human monocytes. Based on these probiotic properties and growth, six strains were selected for in situ evaluation in a mock fermentation of Naaqe and Cheka. During primary fermentations, L. fermentum 73B, P. pentosaceus 74D, L. fermentum 44B, W. confusa 44D, L. fermentum 82C, and Weissella cibaria 83E and their combinations demonstrated higher pH-lowering properties and colony-forming unit counts compared to the control spontaneous fermentation. The same pattern was also observed in the secondary mock fermentation by the Naaqe LAB isolates. CONCLUSIONS In this study, we selected six LAB strains with antipathogenic, immunostimulatory, and starter culture potentials that can be used as autochthonous probiotic starters for Naaqe and Cheka fermentations once their health benefit is ascertained in a clinical trial as a next step.
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Affiliation(s)
- Seyoum Gizachew
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, P.O. Box 9086, Addis Ababa, Ethiopia
- Department of Bioscience Engineering, Faculty of Sciences, University of Antwerp, Groenenborgerlaan 171, 2020 Antwerp, Belgium
| | - Wannes Van Beeck
- Department of Bioscience Engineering, Faculty of Sciences, University of Antwerp, Groenenborgerlaan 171, 2020 Antwerp, Belgium
| | - Irina Spacova
- Department of Bioscience Engineering, Faculty of Sciences, University of Antwerp, Groenenborgerlaan 171, 2020 Antwerp, Belgium
| | - Max Dekeukeleire
- Department of Bioscience Engineering, Faculty of Sciences, University of Antwerp, Groenenborgerlaan 171, 2020 Antwerp, Belgium
| | - Ashenafi Alemu
- Bacterial and Viral Diseases Research Directorate, Armauer Hansen Research Institute, P.O. Box 1005, Addis Ababa, Ethiopia
| | - Wude Mihret
- Bacterial and Viral Diseases Research Directorate, Armauer Hansen Research Institute, P.O. Box 1005, Addis Ababa, Ethiopia
| | - Sarah Lebeer
- Department of Bioscience Engineering, Faculty of Sciences, University of Antwerp, Groenenborgerlaan 171, 2020 Antwerp, Belgium
| | - Ephrem Engidawork
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, P.O. Box 9086, Addis Ababa, Ethiopia
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Antibacterial and Immunostimulatory Activity of Potential Probiotic Lactic Acid Bacteria Isolated from Ethiopian Fermented Dairy Products. FERMENTATION-BASEL 2023. [DOI: 10.3390/fermentation9030258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
Lactic acid bacteria (LAB) form a group of bacteria to which most probiotics belong and are commonly found in fermented dairy products. Fermented foods and beverages are foods made through desired microbial growth and enzymatic conversions of food components. In this study, 43 LAB were isolated from Ethiopian traditional cottage cheese, cheese, and yogurt and evaluated for their functional and safety properties as candidate probiotics. Twenty-seven isolates, representative of each fermented food type, were selected and identified to the species level. Limosilactobacillus fermentum was found to be the predominant species in all samples studied (70.4%), while 11.1% of isolates were identified as Lactiplantibacillus plantarum. All 27 isolates tested showed resistance to 0.5% bile salt, while 26 strains were resistant to pH 3. The LAB isolates were also evaluated for antagonistic properties against key pathogens, with strain-specific features observed for their antimicrobial activity. Five strains from cottage cheese (Lactiplantibacillus plantarum 54B, 54C, and 55A, Lactiplantibacillus pentosus 55B, and Pediococcus pentosaceus 95E) showed inhibitory activity against indicator pathogens that are key causes of gastrointestinal infections in Ethiopia, i.e., Escherichia coli, Salmonella enterica subsp. enterica var. Typhimurium, Staphylococcus aureus, Shigella flexneri, and Listeria monocytogenes. Strain-specific immunomodulatory activity monitored as nuclear factor kappa B (NF-κB) and interferon regulatory factor (IRF) activation was documented for Lactiplantibacillus plantarum 54B, 55A and P. pentosaceus 95E. Antibiotic susceptibility testing confirmed that all LAB isolates were safe concerning their antibiotic resistance profiles. Five isolates (especially Lactiplantibacillus plantarum 54B, 54C, and 55A, Lactiplantibacillus pentosus 55B, and P. pentosaceus 95E) showed promising results in all assays and are novel probiotic candidates of interest for clinical trial follow-up.
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Huang AA, Huang SY. Quantification of the Effect of Vitamin E Intake on Depressive Symptoms in United States Adults Using Restricted Cubic Splines. Curr Dev Nutr 2023; 7:100038. [PMID: 37180089 PMCID: PMC10111581 DOI: 10.1016/j.cdnut.2023.100038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 01/19/2023] [Accepted: 01/26/2023] [Indexed: 02/05/2023] Open
Abstract
Background Depression is a rapidly increasing public health concern, affecting >4% of the global population. Identification of new nutritional recommendations is needed to help combat this increasing public health concern. Objectives The study aimed to examine the association between vitamin E intake and depressive symptoms. Methods A retrospective study was conducted by using a nationally representative, modern cohort (NHANES 2017-2020). Depressive symptoms were assessed through the validated 9-item Patient Health Questionnaire (PHQ-9). All adult patients ([≥18 y old], 8091 total adults) who answered the PHQ-9 and daily nutritional values questionnaires were selected for this study. Per literature, patients with PHQ-9 scores ≥10 were considered to have depressive symptoms. Univariable and multivariable logistic regressions were used to investigate the effect of vitamin E on depressive symptoms as ascertained by PHQ-9. The acquisition and analysis of the data within this study was approved by the NCHS ethics review board. Results After controlling for potential confounders (age, race, sex, and income), we observed that increased vitamin E (up until 15 mg/d) was associated with decreased rates of depressive symptoms, with each 5 mg increase in vitamin E associated with 13% decreased odds of symptoms of depression (OR: 0.87; 95% CI: 0.77, 0.97; P < 0.01). Additional intake above 15 mg/d, the daily recommended amount by the Food and Nutrition Board, did not change the odds of depression (OR: 1.05; 95% CI: 0.92, 1.16; P = 0.44). Conclusions Increased vitamin E intake (up to 15 mg/d) is associated with decreased depressive symptoms. Further prospective studies are required to ascertain whether increased vitamin E can protect against depressive symptoms and the specific therapeutic dose-response relationship.
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Affiliation(s)
- Alexander A. Huang
- Cornell University, Ithaca, NY, USA
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Assessment of Knowledge, Attitudes, and Practices (KAP): Public Health and Economic Burden of Tuberculosis in Jarso District of West Wollega Zone, Oromia, Western Ethiopia. BIOMED RESEARCH INTERNATIONAL 2022; 2022:3314725. [DOI: 10.1155/2022/3314725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 11/02/2022] [Accepted: 11/14/2022] [Indexed: 12/14/2022]
Abstract
Tuberculosis is a communicable mycobacterial disease of humans and animals caused by members of Mycobacterium tuberculosis complex, highly impacting the public health and economy of the country in endemic areas. Retrospective and cross-sectional study was conducted between March and August 2021. For knowledge, attitude, and practices study, five villages were randomly selected using simple random sampling. To quantify the public health burden, one-year data were collected from Jarso Health Center, and unregistered patients were identified using snowball method, and the estimation was based on disability-adjusted life years. Younger age groups (18-40 years) had shown 105.8 times more odds of knowledge towards tuberculosis than the older (>60 years). Moreover, tertiary levels of education had 9395.1 times more odds of knowledge towards tuberculosis compared to illiterates. The estimated economic burden was 7,731.25US$. Of the 51 tuberculosis patients, two died from the disease, resulting in 45.03 disability-adjusted life years. Communities of the study district were heard about tuberculosis, however, unaware of the cause and sources of the infection. Therefore, further strategic and continuous community-based health education and awareness should be given for effective control and prevention of tuberculosis in the study area.
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Associations of percentage energy intake from total, animal and plant protein with overweight/obesity and underweight among adults in Addis Ababa, Ethiopia. Public Health Nutr 2022; 25:3107-3120. [PMID: 35570670 PMCID: PMC9991810 DOI: 10.1017/s1368980022001100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE This study investigated associations between types and food sources of protein with overweight/obesity and underweight in Ethiopia. DESIGN We conducted a cross-sectional dietary survey using a non-quantitative FFQ. Linear regression models were used to assess associations between percentage energy intake from total, animal and plant protein and BMI. Logistic regression models were used to examine the associations of percentage energy intake from total, animal and plant protein and specific protein food sources with underweight and overweight/obesity. SETTING Addis Ababa, Ethiopia. PARTICIPANTS 1624 Ethiopian adults (992 women and 632 men) aged 18-49 years in selected households sampled using multi-stage random sampling from five sub-cities of Addis Ababa. RESULTS Of the surveyed adults, 31 % were overweight or obese. The majority of energy intake was from carbohydrate with only 3 % from animal protein. In multivariable-adjusted linear models, BMI was not associated with percentage energy from total, plant or animal protein. Total and animal protein intake were both associated with lower odds of overweight/obesity (OR per 1 % energy increment of total protein 0·92; 95 % CI: 0·86, 0·99; P = 0·02; OR per 1 % energy increment of animal protein 0·89; 95 % CI: 0·82, 0·96; P = 0·004) when substituted for carbohydrate and adjusted for socio-demographic covariates. CONCLUSION Increasing proportion of energy intake from total protein or animal protein in place of carbohydrate could be a strategy to address overweight and obesity in Addis Ababa; longitudinal studies are needed to further examine this potential association.
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Kasa AS, Lee SC, Chang HC(R. Prevalence and factors associated with depression among older adults in the case of a low-income country, Ethiopia: a systematic review and meta-analysis. BMC Psychiatry 2022; 22:675. [PMID: 36320004 PMCID: PMC9624003 DOI: 10.1186/s12888-022-04282-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 09/12/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Depression is among the common mental health problems in late-life and an important public health problem. Studies from both middle- and high-income countries have shown that depression is more common among older people than in adolescents. Many older people with depression are overlooked, and fewer efforts are made to mitigate their suffering. Despite depression being a major public health problem among older adults, its overall magnitude, and its main predictors were not determined for the development of appropriate measures. Hence, the objective of this study was, therefore, to estimate the overall prevalence of depression and identify its predictors among older adults in Ethiopia. METHODS Available articles were searched by means of different databases using the PRISMA guideline. The quality of the included studies was assessed using a JBI quality appraisal tool. STATA version 14.0 (STATA Corporation, College Station, Texas, USA) statistical software was used to analyze the eligible studies. Subgroup and sensitivity analyses were performed. Cochran's Q and the I2 test were used to assess heterogeneity. The presence of publication bias was evaluated by using Egger's test and visual inspection of the symmetry in funnel plots. RESULT In this meta-analysis, we included 11 articles that assessed 6521 older adults. The overall prevalence of depression among older adults in Ethiopia was 41.85 (33.52, 50.18). The finding was higher in the Oromia region with a prevalence of 48.07% (95% CI: 35.62, 60.51). The finding also demonstrated that being female (AOR = 1.76, 95% CI: 1.17, 2.63), no formal education (AOR = 1.82, 95% CI: 1.03, 3.19), with chronic diseases (AOR = 2.46, 95% CI: 1.00-6.06), and no social support (AOR = 2.01, 95% CI: 1.06, 3.83) were found to be independent predictors of depression in older Ethiopian adults. CONCLUSION Our systematic review and meta-analysis showed that almost two out of five older adults had depression. Female sex, no formal education, having chronic diseases, and no social support were the independent predictors of depression among older adults in Ethiopia. The study emphasizes that depression among older adults in Ethiopia calls for appropriate screening and interventions to reduce the occurrence and its overwhelming consequences.
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Affiliation(s)
- Ayele Semachew Kasa
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, PO Box: 53, Porter St. North Wollongong, NSW Australia
- Illawarra Health and Medical Research Institute (IHMRI), Wollongong, New South Wales Australia
- Department of Adult Health Nursing, School of Health Science, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Shu-Chun Lee
- School of Gerontology Health Management, Taipei Medical University, Taipei, Taiwan
| | - Hui-Chen (Rita) Chang
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, PO Box: 53, Porter St. North Wollongong, NSW Australia
- Illawarra Health and Medical Research Institute (IHMRI), Wollongong, New South Wales Australia
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Tekalegn Y, Solomon D, Sahiledengle B, Assefa T, Negash W, Tahir A, Regassa T, Mamo A, Gezahegn H, Bekele K, Zenbaba D, Tasew A, Desta F, Atlaw D, Regassa Z, Nugusu F, Engida ZT, Tesfaye DG, Kene C, Nigussie WS, Chala D, Abdi AG, Beressa G, Woldeyohannes D, Rogers HL, Mwanri L. Prevalence of central obesity and its associated risk factors among adults in Southeast Ethiopia: A community-based cross-sectional study. PLoS One 2022; 17:e0265107. [PMID: 35930540 PMCID: PMC9355191 DOI: 10.1371/journal.pone.0265107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 07/21/2022] [Indexed: 11/18/2022] Open
Abstract
Background Obesity and overweight are known public health problems that affect populations across the world. These conditions have been associated with a wide range of chronic diseases including type 2 diabetes mellitus, cardiovascular disease, and cancers. In Ethiopia, the literature regarding the burden of central (abdominal) obesity is scarce. This study aimed to fill this gap by assessing the prevalence and risk factors associated with central obesity among adults in Ethiopia. Methods From May to July 2021, a community-based cross-sectional survey was conducted on a sample of 694 adults aged ≥18 years in administrative towns of Bale zone, Southeast Ethiopia. Multi-stage sampling followed by systematic random sampling was employed to identify study participants. Waist and hip circumferences were measured using standard protocols. The World Health Organization STEPS wise tool was used to assess risk factors associated with central obesity. Bi-variable and multi-variable binary logistic regression were used to identify factors associated with central obesity. Adjusted odds ratios (AOR) and their corresponding 95% confidence intervals (CI) have been reported to estimate the strength of associations. Results The overall prevalence of central obesity using waist circumference was 39.01% [(95% CI: 35.36–42.76; 15.44% for men and 53.12% for women)]. Multi-variable binary logistic regression analysis revealed that female sex (AOR = 12.93, 95% CI: 6.74–24.79), Age groups: 30–39 years old (AOR = 2.8, 95% CI: 1.59–4.94), 40–49 years (AOR = 7.66, 95% CI: 3.87–15.15), 50–59 years (AOR = 4.65, 95% CI: 2.19–9.89), ≥60 years (AOR = 12.67, 95% CI: 5.46–29.39), occupational status like: housewives (AOR = 5.21, 95% CI: 1.85–14.62), self-employed workers (AOR = 4.63, 95% CI: 1.62–13.24), government/private/non-government employees (AOR = 4.68, 95% CI: 1.47–14.88), and skipping breakfast (AOR = 0.46, 95% CI: 0.23–0.9) were significantly associated with central obesity. Conclusions Abdominal obesity has become an epidemic in Bale Zone’s towns in Southeastern Ethiopia. Female sex, age, being employed were positively associated with central obesity, while skipping breakfast was a protective factor.
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Affiliation(s)
- Yohannes Tekalegn
- Public Health Department, Goba Referral Hospital, Madda Walabu University, Bale Goba, Ethiopia
- * E-mail:
| | - Damtew Solomon
- Biomedical Department, Goba Referral Hospital, Madda Walabu University, Bale Goba, Ethiopia
| | - Biniyam Sahiledengle
- Public Health Department, Goba Referral Hospital, Madda Walabu University, Bale Goba, Ethiopia
| | - Tesfaye Assefa
- Nursing Department, Goba Referral Hospital, Madda Walabu University, Bale Goba, Ethiopia
| | - Wogene Negash
- Nursing Department, Goba Referral Hospital, Madda Walabu University, Bale Goba, Ethiopia
| | - Anwar Tahir
- Nursing Department, Goba Referral Hospital, Madda Walabu University, Bale Goba, Ethiopia
| | - Tadele Regassa
- Biomedical Department, Goba Referral Hospital, Madda Walabu University, Bale Goba, Ethiopia
| | - Ayele Mamo
- Pharmacy Department, Goba Referral Hospital, Madda Walabu University, Bale Goba, Ethiopia
| | - Habtamu Gezahegn
- Biomedical Department, Goba Referral Hospital, Madda Walabu University, Bale Goba, Ethiopia
| | - Kebebe Bekele
- Surgery Department, Goba Referral Hospital, Madda Walabu University, Bale Goba, Ethiopia
| | - Demisu Zenbaba
- Public Health Department, Goba Referral Hospital, Madda Walabu University, Bale Goba, Ethiopia
| | - Alelign Tasew
- Public Health Department, Goba Referral Hospital, Madda Walabu University, Bale Goba, Ethiopia
| | - Fikreab Desta
- Public Health Department, Goba Referral Hospital, Madda Walabu University, Bale Goba, Ethiopia
| | - Daniel Atlaw
- Biomedical Department, Goba Referral Hospital, Madda Walabu University, Bale Goba, Ethiopia
| | - Zegeye Regassa
- Nursing Department, Goba Referral Hospital, Madda Walabu University, Bale Goba, Ethiopia
| | - Fikadu Nugusu
- Public Health Department, Goba Referral Hospital, Madda Walabu University, Bale Goba, Ethiopia
| | - Zinash Teferu Engida
- Public Health Department, Goba Referral Hospital, Madda Walabu University, Bale Goba, Ethiopia
| | - Degefa Gomora Tesfaye
- Midwifery Department, Goba Referral Hospital, Madda Walabu University, Bale Goba, Ethiopia
| | - Chala Kene
- Midwifery Department, Goba Referral Hospital, Madda Walabu University, Bale Goba, Ethiopia
| | | | - Dereje Chala
- Nursing Department, Goba Referral Hospital, Madda Walabu University, Bale Goba, Ethiopia
| | - Adisu Gemechu Abdi
- Nursing Department, Goba Referral Hospital, Madda Walabu University, Bale Goba, Ethiopia
| | - Girma Beressa
- Public Health Department, Goba Referral Hospital, Madda Walabu University, Bale Goba, Ethiopia
| | - Demelash Woldeyohannes
- School of Medicine and Health Science, Department of Public health, Wachemo University, Hosana, Ethiopia
| | - Heather L. Rogers
- Biocruces Bizkaia Health Research Institute, Barakaldo, Bizkaia, Spain
- Ikerbasque Basque Foundation for Science Bilbao, Bilbao, Bizkaia, Spain
| | - Lillian Mwanri
- Torrens University Australia, Adelaide, South Australia, Australia
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Misganaw A, Naghavi M, Walker A, Mirkuzie AH, Giref AZ, Berheto TM, Waktola EA, Kempen JH, Eticha GT, Wolde TK, Deguma D, Abate KH, Abegaz KH, Ahmed MB, Akalu Y, Aklilu A, Alemu BW, Asemahagn MA, Awedew AF, Balakrishnan S, Bekuma TT, Beyene AS, Beyene MG, Bezabih YM, Birhanu BT, Chichiabellu TY, Dachew BA, Dagnew AB, Demeke FM, Demissie GD, Derbew Molla M, Dereje N, Deribe K, Desta AA, Eshetu MK, Ferede TY, Gebreyohannes EA, Geremew A, Gesesew HA, Getacher L, Glenn SD, Hafebo AS, Hashi A, Hassen HY, Hay SI, Hordofa DF, Huluko DH, Kasa AS, Kassahun Azene G, Kebede EM, Kebede HK, Kelkay B, Kidane SZ, Legesse SM, Manamo WA, Melaku YAA, Mengesha EW, Mengesha SD, Merie HE, Mersha AM, Mersha AG, Mirutse MK, Mohammed AS, Mohammed H, Mohammed S, Netsere HB, Nigatu D, Obsa MS, Odo DB, Omer M, Regassa LD, Sahiledengle B, Shaka MF, Shiferaw WS, Sidemo NB, Sinke AH, Sintayehu Y, Sorrie MB, Tadesse BT, Tadesse EG, Tamir Z, Tamiru AT, Tareke AA, Tefera YG, Tekalegn Y, Tesema AK, Tesema TT, Tesfay FH, Tessema ZT, Tilahun T, Tsegaye GW, Tusa BS, Weledesemayat GT, Yazie TS, Yeshitila YG, Yirdaw BW, Zegeye DT, Murray CJL, Gebremedhin LT. Progress in health among regions of Ethiopia, 1990-2019: a subnational country analysis for the Global Burden of Disease Study 2019. Lancet 2022; 399:1322-1335. [PMID: 35294898 PMCID: PMC8987934 DOI: 10.1016/s0140-6736(21)02868-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 12/07/2021] [Accepted: 12/17/2021] [Indexed: 01/19/2023]
Abstract
BACKGROUND Previous Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) studies have reported national health estimates for Ethiopia. Substantial regional variations in socioeconomic status, population, demography, and access to health care within Ethiopia require comparable estimates at the subnational level. The GBD 2019 Ethiopia subnational analysis aimed to measure the progress and disparities in health across nine regions and two chartered cities. METHODS We gathered 1057 distinct data sources for Ethiopia and all regions and cities that included census, demographic surveillance, household surveys, disease registry, health service use, disease notifications, and other data for this analysis. Using all available data sources, we estimated the Socio-demographic Index (SDI), total fertility rate (TFR), life expectancy, years of life lost, years lived with disability, disability-adjusted life-years, and risk-factor-attributable health loss with 95% uncertainty intervals (UIs) for Ethiopia's nine regions and two chartered cities from 1990 to 2019. Spatiotemporal Gaussian process regression, cause of death ensemble model, Bayesian meta-regression tool, DisMod-MR 2.1, and other models were used to generate fertility, mortality, cause of death, and disability rates. The risk factor attribution estimations followed the general framework established for comparative risk assessment. FINDINGS The SDI steadily improved in all regions and cities from 1990 to 2019, yet the disparity between the highest and lowest SDI increased by 54% during that period. The TFR declined from 6·91 (95% UI 6·59-7·20) in 1990 to 4·43 (4·01-4·92) in 2019, but the magnitude of decline also varied substantially among regions and cities. In 2019, TFR ranged from 6·41 (5·96-6·86) in Somali to 1·50 (1·26-1·80) in Addis Ababa. Life expectancy improved in Ethiopia by 21·93 years (21·79-22·07), from 46·91 years (45·71-48·11) in 1990 to 68·84 years (67·51-70·18) in 2019. Addis Ababa had the highest life expectancy at 70·86 years (68·91-72·65) in 2019; Afar and Benishangul-Gumuz had the lowest at 63·74 years (61·53-66·01) for Afar and 64.28 (61.99-66.63) for Benishangul-Gumuz. The overall increases in life expectancy were driven by declines in under-5 mortality and mortality from common infectious diseases, nutritional deficiency, and war and conflict. In 2019, the age-standardised all-cause death rate was the highest in Afar at 1353·38 per 100 000 population (1195·69-1526·19). The leading causes of premature mortality for all sexes in Ethiopia in 2019 were neonatal disorders, diarrhoeal diseases, lower respiratory infections, tuberculosis, stroke, HIV/AIDS, ischaemic heart disease, cirrhosis, congenital defects, and diabetes. With high SDIs and life expectancy for all sexes, Addis Ababa, Dire Dawa, and Harari had low rates of premature mortality from the five leading causes, whereas regions with low SDIs and life expectancy for all sexes (Afar and Somali) had high rates of premature mortality from the leading causes. In 2019, child and maternal malnutrition; unsafe water, sanitation, and handwashing; air pollution; high systolic blood pressure; alcohol use; and high fasting plasma glucose were the leading risk factors for health loss across regions and cities. INTERPRETATION There were substantial improvements in health over the past three decades across regions and chartered cities in Ethiopia. However, the progress, measured in SDI, life expectancy, TFR, premature mortality, disability, and risk factors, was not uniform. Federal and regional health policy makers should match strategies, resources, and interventions to disease burden and risk factors across regions and cities to achieve national and regional plans, Sustainable Development Goals, and universal health coverage targets. FUNDING Bill & Melinda Gates Foundation.
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Wang M, Gao H, Wang J, Cao C, Ying X, Wei Y, Yu Z, Shao J, Dong H, Yang M. Global burden and inequality of iron deficiency: findings from the Global Burden of Disease datasets 1990-2017. Nutr J 2022; 21:16. [PMID: 35303854 PMCID: PMC8933942 DOI: 10.1186/s12937-022-00771-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 02/08/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Iron deficiency (ID) impairs patient physical activity, recognition and life quality, which is difficult to perceive but should not be underestimated. Worldwide efforts have been made to lower ID burden, however, whether it decreased equally in different regions and sexes is unclear. This study is to examine regional and sex inequalities in global ID from 1990 to 2017. METHODS We conducted a longitudinal, comparative burden-of-disease study. Disability-adjusted life-years (DALYs) of ID were obtained from Global Burden of Disease Report 2017. Human Development Index (HDI) data were obtained from Human Development Report 2017. Gini coefficient and the concentration index were calculated to assess the equities in global burden of ID. RESULTS A downward trend of global ID burden (from 569.3 (95% Uncertainty Interval [UI]: 387.8-815.6) to 403.0 (95% UI: 272.4-586.6), p < 0.001), age-adjusted DALYs per 100,000 population) but an uptrend of its inequalities (from 0.366 to 0.431, p < 0.001, Gini coefficients) was observed between 1990 and 2017. ID burden was heavier in women than that in men ([age-adjusted DALYs per 100,000 population from 742.2 to 514.3] vs [from 398.5 to 291.9]), but its inequalities were higher in men since 1990. The between-sex gap of ID burden was narrowed with higher HDI (β = - 364.11, p < 0.001). East Asia & Pacific and South Asia regions made a big stride for ID control in both sexes over decades [age-adjusted DALYs per 100,000 population from 378.7 (95% UI: 255.8-551.7) in 1990 to 138.9 (95%UI: 91.8-206.5) in 2017], while a heavy burden among Sub-Saharan African men was persistent[age-adjusted DALYs per 100,000 population, 572.5 (95% UI: 385.3-815) in 1990 and 562.6 (95% UI: 367.9-833.3) in 2017]. CONCLUSIONS Redistributing attention and resources to help countries with low HDI, especially take care of women with low socioeconomic status (SES) and men under high ID burden may help hold back the expanding ID inequality.
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Affiliation(s)
- Mengying Wang
- Department of Nutrition and Food Hygiene, School of Public Health, Zhejiang University School of Medicine, Hangzhou, China.,Department of Big Data in Health Science School of Public Health, and Center of Clinical Big Data and Analytics of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - He Gao
- Department of Nutrition, The Second Affiliated Hospital of Zhejiang University School of Medicine, Linping Campus, Hangzhou, China
| | - Jianing Wang
- Nutritional Department, Chongqing Health Center for Women and Children, Chongqing, China
| | - Chenliang Cao
- Sports Nutrition Center, National Institute of Sports Medicine, Beijing, China
| | - Xiaoling Ying
- Department of Nutrition and Food Hygiene, School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Yingming Wei
- Department of Periodontology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Zhiying Yu
- Department of Nutrition and Food Hygiene, School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Jie Shao
- Department of Pediatric Health Care Children's Hospital, Zhejiang University School of Medicine National Clinical Research Center for Child Health, Hangzhou, China.
| | - Hengjin Dong
- Center for Health Policy Studies, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China.
| | - Min Yang
- Department of Nutrition and Food Hygiene, School of Public Health, Zhejiang University School of Medicine, Hangzhou, China.
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Yalew AW. Achievements, Gaps, and Emerging Challenges in Controlling Malaria in Ethiopia. FRONTIERS IN TROPICAL DISEASES 2022. [DOI: 10.3389/fitd.2021.771030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Controlling malaria is one of the top health sector priorities in Ethiopia. The concrete prevention, control, and treatment interventions undertaken in the past two decades have substantially reduced the morbidity and mortality attributable to malaria. Emboldened by these past achievements, Ethiopia envisages to eliminate malaria by 2030. Realizing this ambition, however, needs to further strengthen the financial, technical, and institutional capacities to address the current as well as emerging challenges. It particularly needs to step up measures pertaining to diagnosis, domestic resource mobilization, vector surveillance, and seasonal weather forecasting.
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Linking poverty-targeted social protection and Community Based Health Insurance in Ethiopia: Enrolment, linkages, and gaps. Soc Sci Med 2021; 286:114312. [PMID: 34454128 DOI: 10.1016/j.socscimed.2021.114312] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 07/06/2021] [Accepted: 08/10/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Community-Based Health Insurance (CBHI) has received increasing attention in low and middle-income countries as a pathway toward universal health coverage. In 2011, the government of Ethiopia piloted CBHI and subsequently integrated CBHI with its flagship social protection programme, the Productive Safety Net Program (PSNP) which was established in 2005. We examined enrolment decisions by PSNP households, including, understanding of the programme, reasons for non-coverage, and factors associated with enrolment decisions. METHODS Cross-sectional data for this study come from an Integrated Safety Net Program (ISNP) baseline survey implemented in four rural woredas in Amhara region, Ethiopia between December 2018 and February 2019. We collected data from 5398 PSNP beneficiary households, categorized as either Public Work (PW) or Permanent Direct Support (PDS) types. We used descriptive methods to characterize sample households and fitted binary logistic regression to identify factors associated with households' CBHI enrolment decisions. RESULTS Current CBHI enrolment is higher among PW households (70.1 %) than PDS clients (50.3 %). The most common reason for not enrolling in both PW and PDS households is cost. Results further show that the following characteristics are positively associated with CBHI enrolment: the number of children and working-age adults in the household, older household head, female household head, married household head, having been food insecure in the previous 12 months, heads having experienced illness in the past month, and increasing household wealth status. CONCLUSION While demographic factors are important in households' decisions to enrol in CBHI, various mechanisms could be used to increase enrolment among vulnerable households such as PDS clients. In this regard, while better communication about CBHI could increase enrolment for some households, other poor and vulnerable households will need fee waivers to induce enrolment.
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15
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Alemayehu AM, Sisay MM. Attitude towards diabetes mellitus among adult communities in Gondar city, Ethiopia. PLoS One 2021; 16:e0251777. [PMID: 34014991 PMCID: PMC8136679 DOI: 10.1371/journal.pone.0251777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 05/03/2021] [Indexed: 12/03/2022] Open
Abstract
Background Diabetes mellitus is a metabolic disorder characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. Diabetes and its complications can be reduced by enhancing the attitude of the community. However, there is limited information regarding attitude towards diabetes in northwest Ethiopia. Therefore, this study determined the attitude and associated factors of diabetes mellitus among adult non-diabetic participants in Gondar city. Methods A community-based cross-sectional study was conducted in Gondar city. Systematic random sampling was employed to select 626 non-diabetic participants. The data were collected using a pre-tested structured questionnaire. Descriptive statistics, processing, and analysis were done using STATA version 14. Both bivariable and multivariable binary logistic regressions were used to identify the associated factors. An adjusted odds ratio with a 95% confidence interval was used to calculate a level of significance. Results Of 626 participants, 572 (91.37%) study subjects heard about diabetes mellitus. Three hundred and fifteen participants (55.07%) (95% CI: 50.9% - 59.1%) had a favorable attitude towards diabetes mellitus. Having good knowledge about diabetes (adjusted odds ratio = 2.69, 95% CI: 1.88, 3.87), and higher educational status (adjusted odds ratio = 1.69, 95% CI: 1.04, 2.78) were positively associated with a favorable attitude towards diabetes mellitus. Female gender (adjusted odds ratio = 0.68, 95% CI: 0.47, 0.98), on the other hand, had poor attitude towards diabetes mellitus. Conclusion In this study, a favorable attitude towards diabetes was low among adult non-diabetic participants. Good knowledge, higher educational status, and being male were the factors associated with a favorable attitude towards diabetes.
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Affiliation(s)
- Abiy Maru Alemayehu
- Department of Optometry, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- * E-mail:
| | - Malede Mequanent Sisay
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Kiross GT, Chojenta C, Barker D, Loxton D. Optimum maternal healthcare service utilization and infant mortality in Ethiopia. BMC Pregnancy Childbirth 2021; 21:390. [PMID: 34011300 PMCID: PMC8136182 DOI: 10.1186/s12884-021-03860-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 05/06/2021] [Indexed: 01/05/2023] Open
Abstract
Background Ethiopia has one of the highest rates of infant mortality in the world. Utilization of maternal healthcare during pregnancy, at delivery, and after delivery is critical to reducing the risk of infant mortality. Studies in Ethiopia have shown how infant survival is affected by utilization of maternal healthcare services, however, no studies to date have investigated the relationship between optimum utilization of maternal healthcare services utilization and infant mortality. Therefore, this study examined the effect of optimum utilization of maternal healthcare service on infant mortality in Ethiopia based on the World Health Organization (WHO, 2010) guidelines. Methods We used nationally representative cross-sectional data from the Ethiopian Demographic and Health Survey (EDHS). Sampling weights were applied to adjust for the non-proportional allocation of the sample to the nine regions and two city administrations as well as the sample difference across urban and rural areas. A total of 7193 most recent births from mothers who had provided complete information on infant mortality, ANC visits, tetanus injections, place of delivery and skilled birth attendance during pregnancy were included. The EDHS was conducted from January to June 2016. We applied a multivariate logistic regression analysis to estimate the relationship between optimum maternal healthcare service utilization and infant mortality in Ethiopia. Results The findings from this study showed that optimum maternal healthcare service utilization had a significant association with infant mortality after adjusting for other socioeconomic characteristics. This implies that increased maternal healthcare service utilization decreases the rate of infant mortality in Ethiopia. The main finding from this study indicated that infant mortality was reduced by approximately 66% among mothers who had high utilization of maternal healthcare services compared to mothers who had not utilized maternal healthcare services (AOR = 0.34; 95%CI: 0.16–0.75; p-value = 0.007). Furthermore, infant mortality was reduced by approximately 46% among mothers who had low utilization of maternal healthcare services compared to mothers who had not utilized any maternal healthcare services (AOR = 0.54; 95%CI: 0.31–0.97; p-value = 0.040). Conclusions From this study, we concluded that optimum utilization of maternal healthcare services during pregnancy, at delivery and after delivery might reduce the rate of infant mortality in Ethiopia.
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Affiliation(s)
- Girmay Tsegay Kiross
- Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia. .,Research Centre for Generational Health and Ageing, Faculty of Health and Medicine, University of Newcastle, Newcastle, New South Wales, Australia.
| | - Catherine Chojenta
- Research Centre for Generational Health and Ageing, Faculty of Health and Medicine, University of Newcastle, Newcastle, New South Wales, Australia
| | - Daniel Barker
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Newcastle, New South Wales, Australia
| | - Deborah Loxton
- Research Centre for Generational Health and Ageing, Faculty of Health and Medicine, University of Newcastle, Newcastle, New South Wales, Australia
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Blakstad MM, Danaei G, Tadesse AW, Damerau K, Bellows AL, Canavan CR, Bliznashka L, Zack R, Myers SS, Berhane Y, Fawzi WW. Life expectancy and agricultural environmental impacts in Addis Ababa can be improved through optimized plant and animal protein consumption. NATURE FOOD 2021; 2:291-298. [PMID: 37118473 DOI: 10.1038/s43016-021-00264-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 03/17/2021] [Indexed: 04/30/2023]
Abstract
In Ethiopia, children and adults face a double burden of malnutrition, with undernutrition and stunting coexisting with non-communicable diseases. Here we use a framework of comparative risk assessment, local dietary surveys and relative risks from large observational studies to quantify the health and environmental impacts of meeting adult and child recommended daily protein intakes in urban Addis Ababa. We find that plant-based foods, especially legumes, would have the lowest environmental impact and substantially increase life expectancy in adults, while animal-source proteins could be beneficial for children. This context-specific approach-accounting for regional constraints and trade-offs-could aid policymakers in developing culturally appropriate, nutritionally adequate and sustainable dietary recommendations.
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Affiliation(s)
- Mia M Blakstad
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Goodarz Danaei
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Amare W Tadesse
- Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Kerstin Damerau
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Institute of Vocational Education and Work Studies, Technische Universität Berlin, Berlin, Germany
| | - Alexandra L Bellows
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Chelsey R Canavan
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Lilia Bliznashka
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Rachel Zack
- The Greater Boston Food Bank, Boston, MA, USA
| | - Samuel S Myers
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Yemane Berhane
- Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | - Wafaie W Fawzi
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Shumet S, Azale T, Angaw DA, Tesfaw G, Wondie M, Getinet Alemu W, Amare T, Kassew T, Mesafint G. Help-Seeking Preferences to Informal and Formal Source of Care for Depression: A Community-Based Study in Northwest Ethiopia. Patient Prefer Adherence 2021; 15:1505-1513. [PMID: 34267506 PMCID: PMC8275152 DOI: 10.2147/ppa.s311601] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 06/11/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Globally, 350 million people are suffering from depression. Many people suffering from depression use different sources of help for their problems. People with different mental health problems seek help from formal and/or informal sources. This gives crucial information on community beliefs and perception regarding their preference for help. This study helps to guide effective planning and provision of mental health services, and health policy of the country to explore the community's preference to different sources of help. OBJECTIVE The aim was to contrast patterns of formal and informal help-seeking preferences for depression among residents of Aykel town, Northwest Ethiopia. METHODS This cross-sectional population-based study included 832 participants. We used a major depressive disorder case vignette and general help-seeking questionnaire (GHSQ) to assess preference to seek help. Study participants were selected by multistage cluster sampling technique. An independent sample t-test and analysis of variance test (ANOVA) was performed. RESULTS A total of 656 subjects (78.8%) showed high propensity to intimate partner, and 655 (78.7%) of the study subjects had high propensity to mental health professional. The mean score of the residents' preference to seek help from informal sources was 3.41±0.60. The mean score of preference to seek help from formal sources was 3.18±0.75. A total of 276 (33.2%) subjects showed high propensity to both informal and formal sources of help. The results also showed there was a mean score difference in preference for informal help between subjects with strong social support and low and moderate social support (P<0.001). CONCLUSION The result suggests that the majority of the residents had a higher preference to seek help from informal sources than formal sources of care. Providing and strengthening both formal and informal sources of help in conjunction are crucial to get a more qualified and effective care for depressed patients.
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Affiliation(s)
- Shegaye Shumet
- Department of Psychiatry, University of Gondar, Gondar, Ethiopia
| | - Telake Azale
- Department of Health Education and Behavioral Science, University of Gondar, Gondar, Ethiopia
| | - Dessie Abebaw Angaw
- Department of Epidemiology and Biostatistics, University of Gondar, Gondar, Ethiopia
| | - Getachew Tesfaw
- Department of Psychiatry, University of Gondar, Gondar, Ethiopia
| | - Messele Wondie
- Department of Psychiatry, University of Gondar, Gondar, Ethiopia
| | | | - Tadele Amare
- Department of Psychiatry, University of Gondar, Gondar, Ethiopia
| | - Tilahun Kassew
- Department of Psychiatry, University of Gondar, Gondar, Ethiopia
| | - Gebremeskel Mesafint
- Mizan-Tapi University, College of Health Science, Department of Nursing, Mizan Aman, Ethiopia
- Correspondence: Gebremeskel Mesafint Mizan-Tapi University, College of Health Science, Department of Nursing, Mizan Aman, EthiopiaTel +251918209867 Email
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Hsieh PL, Yang FC, Hu YF, Chiu YW, Chao SY, Pai HC, Chen HM. Continuity of Care and the Quality of Life among Patients with Type 2 Diabetes Mellitus: A Cross-Sectional Study in Taiwan. Healthcare (Basel) 2020; 8:healthcare8040486. [PMID: 33202699 PMCID: PMC7712194 DOI: 10.3390/healthcare8040486] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 11/11/2020] [Accepted: 11/12/2020] [Indexed: 11/16/2022] Open
Abstract
Background: Understanding factors associated with the quality of life (QoL) of patients with type 2 diabetes (T2DM) is an important health issue. This study aimed to explore the correlation between continuity of care and quality of life in patients with T2DM and to probe for important explanatory factors affecting quality of life. Methods: This study used a cross-sectional correlation research design. Convenience sampling was adopted to recruit 157 patients, aged 20–80 years and diagnosed with T2DM in the medical ward of a regional hospital in central Taiwan. Results: The overall mean (standard deviation, SD) QOL score was 53.42 (9.48). Hierarchical regression linear analysis showed that age, depression, two variables of potential disability (movement and depression), and the inability to see a specific physician or maintain relational continuity with medical providers were important predictors that could effectively explain 62.0% of the variance of the overall QoL. Conclusions: The relationship between patients and physicians and maintaining relational continuity with the medical providers directly affect patients’ QoL during hospitalization and should be prioritized clinically. Timely interventions should be provided for older adult patients with T2DM, depression, or an inability to exercise to maintain their QoL.
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Affiliation(s)
- Pei-Lun Hsieh
- Department of Nursing, College of Health, National Taichung University of Science and Technology, Taichung City 40343, Taiwan;
| | - Fu-Chi Yang
- College of General Education, National Chin-Yi University of Technology, Taichung City 41170, Taiwan;
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
| | - Yi-Fang Hu
- Kuang Tien General Hospital, Taichung, Taichung City 433401, Taiwan;
| | - Yi-Wen Chiu
- Department of Nursing, Chung Shan Medical University, Taichung City 40201, Taiwan; (Y.-W.C.); (H.-C.P.)
| | - Shu-Yuan Chao
- Department of Nursing, Hungkuang University, Taichung City 43302; Taiwan;
| | - Hsiang-Chu Pai
- Department of Nursing, Chung Shan Medical University, Taichung City 40201, Taiwan; (Y.-W.C.); (H.-C.P.)
| | - Hsiao-Mei Chen
- Department of Nursing, Chung Shan Medical University, Taichung City 40201, Taiwan; (Y.-W.C.); (H.-C.P.)
- Correspondence: ; Tel.: +886-4-24730022 (ext. 12103); Fax: +886-4-23248173
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Wachamo D, Geleta D, Woldesemayat EM. Undiagnosed Hypertension and Associated Factors Among Adults in Hawela Tula Sub-City, Hawassa, Southern Ethiopia: A Community-Based Cross-Sectional Study. Risk Manag Healthc Policy 2020; 13:2169-2177. [PMID: 33116995 PMCID: PMC7573300 DOI: 10.2147/rmhp.s276955] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 09/15/2020] [Indexed: 01/12/2023] Open
Abstract
Background Hypertension (HTN) is a major public health problem and often it is unnoticed. Undiagnosed HTN may lead to a high burden of cardiovascular diseases and complications such as stroke and heart attack. In this study, we aimed to assess the prevalence and associated factors of undiagnosed HTN. Methods From February to June 2019, a community-based cross-sectional study was conducted on 383 randomly selected adults in Hawela Tulla Sub-city, Hawassa, southern Ethiopia. Data were collected by pretested questionnaires, and physical measurements of weight, height and blood pressure were collected through standardized procedures adapted from WHO STEPS survey tools. Data entry and analysis were carried out using SPSS version 23 statistical software. Descriptive analysis and logistic regression models were used to describe the results. Logistic regression analysis results were declared statistically significant if the P-value was below 0.05 and the 95% CI did not cross the null value. Results The prevalence of undiagnosed HTN among the respondents was 12.3%. Only 152 (39.7%) of the study population knew the symptoms of HTN. Males (adjusted odds ratio [AOR] =2.5, 95% CI: 1.2, 5.2; P=0.016), people with a family history of HTN (AOR=2.7, 95% CI: 1.0, 7.0; P= 0.044), people who chewed khat (AOR=4.6, 95% CI: 2.0, 10.2; P<0.001), overweight or obese individuals (AOR=3.5, 95% CI: 1.7, 7.3; P=0.001) and people with diabetes mellitus (AOR=3.2, 95% CI: 1.1, 9.3; P=0.036) had a higher risk of undiagnosed HTN than their counterparts. Conclusion Identification of people with the risk factors of undiagnosed HTN and delivering health education to reduce the risky behaviors could reduce the burden and consequences of HTN. Integrating interventions at the community level may be important.
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Affiliation(s)
- Demelash Wachamo
- Hawassa College of Health Sciences, Department of Public Health, Hawassa, Ethiopia
| | - Dereje Geleta
- Hawassa University, College of Medicine and Health Sciences, School of Public Health, Hawassa, Ethiopia
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Keba A, Rolon ML, Tamene A, Dessie K, Vipham J, Kovac J, Zewdu A. Review of the prevalence of foodborne pathogens in milk and dairy products in Ethiopia. Int Dairy J 2020; 109:104762. [PMID: 33013007 PMCID: PMC7430047 DOI: 10.1016/j.idairyj.2020.104762] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Food safety is a significant barrier to social and economic development throughout the world, particularly in developing countries. Here, we reviewed the prevalence of major bacterial foodborne pathogens (Salmonella spp., Listeria monocytogenes, Escherichia coli O157:H7 and Campylobacter spp.) in the rapidly growing Ethiopian dairy supply-chain. We identified 15, 9, 5 and 0 studies that had reported the prevalence of Salmonella spp., L. monocytogenes, E. coli O157:H7, and Campylobacter spp. in dairy foods, respectively. The studies reviewed reported a median prevalence of Salmonella, L. monocytogenes, and E. coli O157:H7 of 6, 9 and 10%, respectively, in raw cow milk in Ethiopia, indicating a concerning occurrence of bacterial foodborne pathogens in raw milk. Implementation of good hygiene and production practices and assessment of interventions targeting the reduction of contamination in the dairy supply chain is needed to inform coordinated efforts focused on improvement of dairy food safety in Ethiopia.
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Affiliation(s)
- Abdi Keba
- Ethiopian Institute of Agricultural Research, Holeta Agricultural Centre, PO Box 036, Addis Ababa, Ethiopia
| | - M. Laura Rolon
- Department of Food Science, The Pennsylvania State University, 202 Rodney A. Erickson Food Science Building, University Park, PA 16802, USA
| | - Aynadis Tamene
- Centre for Food Science and Nutrition, Addis Ababa University, New Graduate Building, College of Natural Sciences, PO Box 1176, Addis Ababa, Ethiopia
| | - Kindinew Dessie
- Department of Plant Science, University of Aksum, PO Box 314, Aksum, Ethiopia
| | - Jessie Vipham
- Department of Animal Science and Industry, Kansas State University, 108 Waters Hall, Manhattan, KS 66506, USA
| | - Jasna Kovac
- Department of Food Science, The Pennsylvania State University, 202 Rodney A. Erickson Food Science Building, University Park, PA 16802, USA
| | - Ashagrie Zewdu
- Centre for Food Science and Nutrition, Addis Ababa University, New Graduate Building, College of Natural Sciences, PO Box 1176, Addis Ababa, Ethiopia
- Corresponding author. Tel.: +251 911194508.
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Nomura S, Yoneoka D, Tanaka S, Ishizuka A, Ueda P, Nakamura K, Uneyama H, Hayashi N, Shibuya K. Forecasting disability-adjusted life years for chronic diseases: reference and alternative scenarios of salt intake for 2017-2040 in Japan. BMC Public Health 2020; 20:1475. [PMID: 32993606 PMCID: PMC7526266 DOI: 10.1186/s12889-020-09596-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Accepted: 09/22/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND In Japan, a high-sodium diet is the most important dietary risk factor and is known to cause a range of health problems. This study aimed to forecast Japan's disability-adjusted life year (DALYs) for chronic diseases that would be associated with high-sodium diet in different future scenarios of salt intake. We modelled DALY forecast and alternative future scenarios of salt intake for cardiovascular diseases (CVDs), chronic kidney diseases (CKDs), and stomach cancer (SC) from 2017 to 2040. METHODS We developed a three-component model of disease-specific DALYs: a component on the changes in major behavioural and metabolic risk predictors including salt intake; a component on the income per person, educational attainment, and total fertility rate under 25 years; and an autoregressive integrated moving average model to capture the unexplained component correlated over time. Data on risk predictors were obtained from Japan's National Health and Nutrition Surveys and from the Global Burden of Disease Study 2017. To generate a reference forecast of disease-specific DALY rates for 2017-2040, we modelled the three diseases using the data for 1990-2016. Additionally, we generated better, moderate, and worse scenarios to evaluate the impact of change in salt intake on the DALY rate for the diseases. RESULTS In our reference forecast, the DALY rates across all ages were predicted to be stable for CVDs, continuously increasing for CKDs, and continuously decreasing for SC. Meanwhile, the age group-specific DALY rates for these three diseases were forecasted to decrease, with some exceptions. Except for the ≥70 age group, there were remarkable differences in DALY rates between scenarios, with the best scenario having the lowest DALY rates in 2040 for SC. This represents a wide scope of future trajectories by 2040 with a potential for tremendous decrease in SC burden. CONCLUSIONS The gap between scenarios provides some quantification of the range of policy impacts on future trajectories of salt intake. Even though we do not yet know the policy mix used to achieve these scenarios, the result that there can be differences between scenarios means that policies today can have a significant impact on the future DALYs.
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Affiliation(s)
- Shuhei Nomura
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
- Department of Health Policy and Management, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan.
| | - Daisuke Yoneoka
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Department of Health Policy and Management, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
- Graduate School of Public Health, St. Luke's International University, Tokyo, Japan
| | - Shiori Tanaka
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Aya Ishizuka
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Peter Ueda
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Clinical Epidemiology Division, Department of Medicine, Karolinska Institutet, Solna, Stockholm, Sweden
| | - Keiji Nakamura
- Graduate School of Environmental and Information Studies, Tokyo City University, Yokohama, Japan
- Ajinomoto Co., Inc., Tokyo, Japan
| | | | - Naoki Hayashi
- Ajinomoto Co., Inc., Tokyo, Japan
- Department of Applied Biological Chemistry, Graduate School of Agriculture and Life Sciences, The University of Tokyo, Tokyo, Japan
| | - Kenji Shibuya
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Institute for Population Health, King's College London, London, UK
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Abera SF, Kantelhardt EJ, Bezabih AM, Tsadik M, Lauvai J, Ejeta G, Wienke A, Frank J, Scherbaum V. What factors are associated with maternal undernutrition in eastern zone of Tigray, Ethiopia? Evidence for nutritional well-being of lactating mothers. BMC Public Health 2020; 20:1214. [PMID: 32770979 PMCID: PMC7414570 DOI: 10.1186/s12889-020-09313-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 07/29/2020] [Indexed: 12/20/2022] Open
Abstract
Background Maternal undernutrition is a pervasive health problem among Ethiopian mothers. This study aims at identifying the level of maternal undernutrition and its associated factors in Kilte Awaleo-Health and Demographic Surveillance Site (KA-HDSS), Tigray region, Ethiopia. Methods Nutritional status of 2260 lactating mothers was evaluated using the mid-upper-arm circumference (MUAC). Data from the vital events and verbal autopsy databases were linked to the survey and baseline recensus data to investigate the association of adult mortality from chronic causes of death (CoD) on maternal undernutrition. We employed a generalized log-binomial model to estimate the independent effects of the fitted covariates. Results The overall prevalence of maternal undernutrition based on MUAC < 23 cm was 38% (95% CI: 36.1, 40.1%). Recent occurrence of household morbidity (adjusted prevalence ratio (adjPR) = 1.49; 95%CI: 1.22, 1.81) was associated with increased risk of maternal undernutrition. In addition, there was a 28% higher risk (adjPR = 1.28; 95%CI: 0.98, 1.67) of maternal undernutrition for those mothers who lived in households with history of adult mortality from chronic diseases. Especially, its association with severe maternal undernutrition was strong (adjusted OR = 3.27; 95%CI: 1.48, 7.22). In contrast, good maternal health-seeking practice (adjPR = 0.86; 95%CI: 0.77, 0.96) and production of diverse food crops (adjPR = 0.72; 95%CI: 0.64, 0.81) were associated with a lower risk of maternal undernutrition. Relative to mothers with low scores of housing and environmental factors index (HAEFI), those with medium and higher scores of HAEFI had 0.81 (adjPR = 0.81; 95%CI: 0.69, 0.95) and 0.82 (adjPR = 0.82; 95%CI: 0.72, 0.95) times lower risk of maternal undernutrition, respectively. Conclusions Efforts to ameliorate maternal undernutrition need to consider the influence of the rising epidemiology of adult mortality from chronic diseases. Our data clearly indicate the need for channeling the integrated intervention power of nutrition-sensitive development programs with that of nutrition-specific sectoral services.
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Affiliation(s)
- Semaw Ferede Abera
- Institute of Nutritional Sciences, University of Hohenheim, Stuttgart, Germany. .,Food Security Center, University of Hohenheim, Stuttgart, Germany. .,School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia. .,Kilte Awlaelo - Health and Demographic Surveillance Site, College of Health Sciences, Mekelle University, Mekelle, Ethiopia.
| | - Eva Johanna Kantelhardt
- Institute of Medical Epidemiology, Biostatistics, and Informatics, Faculty of Medicine, Martin-Luther-University, Halle, Germany.,Department of Gynaecology, Faculty of Medicine, Martin-Luther-University, Halle, Germany
| | - Afework Mulugeta Bezabih
- School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia.,Kilte Awlaelo - Health and Demographic Surveillance Site, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Mache Tsadik
- School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia.,Kilte Awlaelo - Health and Demographic Surveillance Site, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Judith Lauvai
- Institute of Nutritional Sciences, University of Hohenheim, Stuttgart, Germany
| | - Gebisa Ejeta
- Department of Agronomy, Purdue University, West Lafayette, IN, USA
| | - Andreas Wienke
- Institute of Medical Epidemiology, Biostatistics, and Informatics, Faculty of Medicine, Martin-Luther-University, Halle, Germany
| | - Jan Frank
- Institute of Nutritional Sciences, University of Hohenheim, Stuttgart, Germany.,Food Security Center, University of Hohenheim, Stuttgart, Germany
| | - Veronika Scherbaum
- Institute of Nutritional Sciences, University of Hohenheim, Stuttgart, Germany.,Food Security Center, University of Hohenheim, Stuttgart, Germany
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Necho M, Belete A, Tsehay M, Zenebe Y. A meta-analysis of depressive symptoms among Ethiopian prisoners and a narrative description of its associated factors: a country based systematic review and meta-analysis study. BMC Psychiatry 2020; 20:281. [PMID: 32503475 PMCID: PMC7275530 DOI: 10.1186/s12888-020-02662-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 05/11/2020] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND The burden of depression in prisoners is increasing and factors such as co-existence of medical illness, lack of social support and longer duration of sentences are contributing to it. However, no pooled evidence on the magnitude and factors of depression in prisoners existed in Ethiopia. The current meta-analysis was therefore aimed to have aggregate evidence on the magnitude and factors of depression in prisoners of Ethiopia. METHODS A search of databases on PubMed, Scopus, and EMBASE was carried out systematically. Besides, grey literature sources were extensively investigated. Moreover, the reference lists of the articles selected were searched. Random effects and quality-effects models were used to describe the pooled prevalence of depressive symptoms with 95% CI. We also detect heterogeneity between studies using Cochran's Q- statistic and the Higgs I2 test. A sensitivity analysis was also implemented. Publication bias was checked with Egger's test and funnel plots visually. RESULTS Among 232 papers identified through the specified database searches only 17 full-text articles were assessed for eligibility and only nine (9) studies fulfilled the prespecified criteria and incorporated in the final meta-analysis. The pooled prevalence of Depressive symptoms among prisoners was 53.40%(95% CI: 41.33, 65.46). The pooled prevalence of Depressive symptoms in prisoners was 41.9% in Southwest Ethiopia, 44.43% in North West of Ethiopia, 59.05% in Addis Ababa, and 72.7% Southern Ethiopia. Besides, the pooled Depression symptoms prevalence among prisoners was 51.24% as measured with PHQ-9 and 56.15% with BDI-II. Besides, studies that utilized a relatively large sample size (≥350) yields a smaller pooled prevalence of Depression symptoms, 51.93% than those which utilized smaller sample sizes (< 350); 54.13%. CONCLUSION The pooled magnitude of depression in prisoner's population is very high, 53.40%. This pooled effect size for the Depression symptoms was significantly higher in the southern region of the country than in the southwest region. Besides, the pooled prevalence was significantly higher as measured by the BDI-II tool than by PHQ-9. Also, studies that utilized a larger sample size provided a significantly lower pooled magnitude of symptoms of depression than studies that utilized a smaller sample size.
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Affiliation(s)
- Mogesie Necho
- Department of Psychiatry, Wollo University, College of Medicine and Health Sciences, Dessie, Ethiopia.
| | - Asmare Belete
- grid.467130.70000 0004 0515 5212Department of Psychiatry, Wollo University, College of Medicine and Health Sciences, Dessie, Ethiopia
| | - Mekonnen Tsehay
- grid.467130.70000 0004 0515 5212Department of Psychiatry, Wollo University, College of Medicine and Health Sciences, Dessie, Ethiopia
| | - Yosef Zenebe
- grid.467130.70000 0004 0515 5212Department of Psychiatry, Wollo University, College of Medicine and Health Sciences, Dessie, Ethiopia
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Nomura S, Yoneoka D, Tanaka S, Makuuchi R, Sakamoto H, Ishizuka A, Nakamura H, Kubota A, Shibuya K. Limited alignment of publicly competitive disease funding with disease burden in Japan. PLoS One 2020; 15:e0228542. [PMID: 32040510 PMCID: PMC7010241 DOI: 10.1371/journal.pone.0228542] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 01/18/2020] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE The need to align investments in health research and development (R&D) with public health needs is one of the most important public health challenges in Japan. We examined the alignment of disease-specific publicly competitive R&D funding to the disease burden in the country. METHODS We analyzed publicly available data on competitive public funding for health in 2015 and 2016 and compared it to disability-adjusted life year (DALYs) in 2016, which were obtained from the Global Burden of Disease (GBD) 2017 study. Their alignment was assessed as a percentage distribution among 22 GBD disease groups. Funding was allocated to the 22 disease groups based on natural language processing, using textual information such as project title and abstract for each research project, while considering for the frequency of information. RESULTS Total publicly competitive funding in health R&D in 2015 and 2016 reached 344.1 billion JPY (about 3.0 billion USD) for 32,204 awarded projects. About 49.5% of the funding was classifiable for disease-specific projects. Five GDB disease groups were significantly and relatively well-funded compared to their contributions to Japan's DALY, including neglected tropical diseases and malaria (funding vs DALY = 1.7% vs 0.0%, p<0.01) and neoplasms (28.5% vs 19.2%, p<0.001). In contrast, four GDB disease groups were significantly under-funded, including cardiovascular diseases (8.0% vs 14.8%, p<0.001) and musculoskeletal disorders (1.0% vs 11.9%, p<0.001). These percentages do not include unclassifiable funding. CONCLUSIONS While caution is necessary as this study was not able to consider public in-house funding and the methodological uncertainties could not be ruled out, the analysis may provide a snapshot of the limited alignment between publicly competitive disease-specific funding and the disease burden in the country. The results call for greater management over the allocation of scarce resources on health R&D. DALYs will serve as a crucial, but not the only, consideration in aligning Japan's research priorities with the public health needs. In addition, the algorithms for natural language processing used in this study require continued efforts to improve accuracy.
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Affiliation(s)
- Shuhei Nomura
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
- * E-mail:
| | - Daisuke Yoneoka
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Graduate School of Public Health, St. Luke's International University, Tokyo, Japan
| | - Shiori Tanaka
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Ryoko Makuuchi
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Faculty of Medicine, Charles University, Hradec Kralove, Czech Republic
| | - Haruka Sakamoto
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Aya Ishizuka
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Haruyo Nakamura
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Anna Kubota
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan
| | - Kenji Shibuya
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Beyera GK, O’Brien J, Campbell S. The development and validation of a measurement instrument to investigate determinants of health care utilisation for low back pain in Ethiopia. PLoS One 2020; 15:e0227801. [PMID: 31945105 PMCID: PMC6964895 DOI: 10.1371/journal.pone.0227801] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 12/31/2019] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTION AND OBJECTIVES Low back pain (LBP) is a highly prevalent and disabling public health problem globally. However, little is known about factors affecting health care utilisation for optimal management of the pain, and there is no validated instrument to derive epidemiological data for a better understanding of these factors. The aim of this study was to develop and validate an instrument used to measure determinants of health care utilisation for LBP in Ethiopia. METHODS The relevant domains of potential determinants of health care utilisation for LBP were identified following a comprehensive review of the literature. Items relating to each domain were then generated by considering the context of Ethiopia, and where necessary, existing items were adapted. The instrument was then translated, and an expert panel reviewed the instrument for content validity, clarity and any other suggestions. Using the data collected from 1303 adults with LBP, factorial validity was assessed by conducting principal component and parallel analyses. Internal consistency reliability was also assessed using Cronbach's alpha. Intraclass correlation coefficient (ICC) and Cohen Kappa statistic were calculated to evaluate temporal stability of the instrument. RESULTS Parallel analysis showed that there were six components with Eigenvalues (obtained from principal component analysis) exceeding the corresponding criterion values for a randomly generated data matrix of the same size. Cronbach's alpha for the internal consistency reliability ranged from 0.65 to 0.82. In assessing temporal stability, ICC ranged from 0.60, 95% CI: 0.23-0.98 to 0.95, 95% CI: 0.81-1.00 while Cohen Kappa ranged from 0.72, 95% CI: 0.49-0.94 to 0.93, 95% CI: 0.85-1.00. CONCLUSIONS This study demonstrated that the newly developed instrument has an overall good level of content and factorial validity, internal consistency reliability, and temporal stability. In this way, this instrument is appropriate for measuring determinants of health care utilisation among people with LBP in Ethiopia.
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Affiliation(s)
- Getahun Kebede Beyera
- School of Nursing, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia
- Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- * E-mail:
| | - Jane O’Brien
- School of Nursing, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia
| | - Steven Campbell
- School of Nursing, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia
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Eregata GT, Hailu A, Memirie ST, Norheim OF. Measuring progress towards universal health coverage: national and subnational analysis in Ethiopia. BMJ Glob Health 2019; 4:e001843. [PMID: 31798996 PMCID: PMC6861121 DOI: 10.1136/bmjgh-2019-001843] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 09/06/2019] [Accepted: 09/28/2019] [Indexed: 11/04/2022] Open
Abstract
Introduction Aiming for universal health coverage (UHC) as a country-level goal requires that progress is measured and tracked over time. However, few national and subnational studies monitor UHC in low-income countries and there is none for Ethiopia. This study aimed to estimate the 2015 national and subnational UHC service coverage status for Ethiopia. Methods The UHC service coverage index was constructed from the geometric means of component indicators: first, within each of four major categories and then across all components to obtain the final summary index. Also, we estimated the subnational level UHC service coverage. We used a variety of surveys data and routinely collected administrative data. Results Nationally, the overall Ethiopian UHC service coverage for the year 2015 was 34.3%, ranging from 52.2% in the Addis Ababa city administration to 10% in the Afar region. The coverage for non-communicable diseases, reproductive, maternal, neonatal and child health and infectious diseases were 35%, 37.5% and 52.8%, respectively. The national UHC service capacity and access coverage was only 20% with large variations across regions, ranging from 3.7% in the Somali region to 41.1% in the Harari region. Conclusion The 2015 overall UHC service coverage for Ethiopia was low compared with most of the other countries in the region. Also, there was a substantial variation among regions. Therefore, Ethiopia should rapidly scale up promotive, preventive and curative health services through increasing investment in primary healthcare if Ethiopia aims to reach the UHC service coverage goals. Also, policymakers at the regional and federal levels should take corrective measures to narrow the gap across regions, such as redistribution of the health workforce, increase resources allocated to health and provide focused technical and financial support to low-performing regions.
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Affiliation(s)
- Getachew Teshome Eregata
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Ministry of Health of Ethiopia, Addis Ababa, Ethiopia
| | - Alemayehu Hailu
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Ministry of Health of Ethiopia, Addis Ababa, Ethiopia
| | - Solomon Tessema Memirie
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Department of Paediatrics and Child Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Ole Frithjof Norheim
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Department of Global Health and Population, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
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Berhane Defaye F, Danis M, Wakim P, Berhane Y, Norheim OF, Miljeteig I. Bedside Rationing Under Resource Constraints-A National Survey of Ethiopian Physicians' Use of Criteria for Priority Setting. AJOB Empir Bioeth 2019; 10:125-135. [PMID: 31002289 DOI: 10.1080/23294515.2019.1583691] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
In low-income settings resource constraints force clinicians to make harsh choices. We examine the criteria Ethiopian physicians use in their bedside rationing decisions through a national survey at 49 public hospitals in Ethiopia. Substantial variation in weight given to different criteria were reported by the 587 participating physicians (response rate 91.7%). Young age, primary prevention, or the patient being the family's economic provider increased likelihood of offering treatment to a patient, while small expected benefit or low chance of success diminished likelihood. More than 50% of responding physicians were indifferent to patient's position in society, unhealthy behavior, and residence, while they varied widely in weight they gave to patient's poverty, ability to work, and old age. While the majority of Ethiopian physicians reported allocation of resources that was compatible with national priorities, more contested criteria were also frequently reported. This might affect distributional justice and equity in health care access.
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Affiliation(s)
- Frehiwot Berhane Defaye
- a Research Group in Global Health Priorities, Department of Global Public Health and Primary Care , University of Bergen , Norway.,b Center for Medical Ethics and Priority Setting , Addis Ababa University , Ethiopia
| | - Marion Danis
- c Department of Bioethics , National Institutes of Health , USA
| | - Paul Wakim
- d Biostatistics and Clinical Epidemiology Service, Clinical Center , National Institutes of Health , USA
| | - Yemane Berhane
- e Addis Continental Institute of Public Health , Ethiopia
| | - Ole Frithjof Norheim
- a Research Group in Global Health Priorities, Department of Global Public Health and Primary Care , University of Bergen , Norway.,b Center for Medical Ethics and Priority Setting , Addis Ababa University , Ethiopia
| | - Ingrid Miljeteig
- a Research Group in Global Health Priorities, Department of Global Public Health and Primary Care , University of Bergen , Norway.,b Center for Medical Ethics and Priority Setting , Addis Ababa University , Ethiopia
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The Situation of Cervical Cancers in the Context of Female Genital Cancer Clustering and Burden of Disease in Arad County, Romania. J Clin Med 2019; 8:jcm8010096. [PMID: 30650666 PMCID: PMC6351929 DOI: 10.3390/jcm8010096] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Revised: 01/10/2019] [Accepted: 01/14/2019] [Indexed: 01/08/2023] Open
Abstract
Romania has the highest incidence of cervical cancer morbidity and mortality in Europe. This study identifies the major clusters for genital cancers, observes the features of genital and cervical cancer, and determines the extent to which cancer is a contributor to total Disability-Adjusted Life Year (DALY). Spatial analysis used Besag and Newell’s method for genital cancer distribution, prevalence considered Arad County patients records (2008–2017), and DALY was determined according to WHO methodology and GLOBOCAN 2013 data. Diagnosis was established by histopathological examination of diagnostic biopsies or tissues obtained by surgical procedures, followed by clinical staging. 1695 women were recorded with genital cancer. Of these, 14.9% of lesions were in situ (n = 252) and 74.20% of cases were recorded in stage III or IV (n = 1258) (p < 0.0001). Over 90% of cervical cancers were squamous cell carcinomas (n = 728), 33.76% of endometrial cancers were adenocarcinomas in situ (n = 131), 32.42% of ovarian cancers were serous adenocarcinomas (n = 131), and 70.58% of vulvar cancers were squamous cell carcinomas (n = 48) (p < 0.0001). DALY/1000 was 67.2 for genital cancers and 33 for cervical cancers. From the point of view of Romanian women, cervical cancer remains one of the major problems that need to be dealt with and access to optimal treatment proves to be extremely limited.
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Dejene D, Yigzaw T, Mengistu S, Wolde Z, Hiruy A, Woldemariam D, Awol M. Practice analysis of junior doctors in Ethiopia: implications for strengthening medical education, practice and regulation. Glob Health Res Policy 2018; 3:31. [PMID: 30456305 PMCID: PMC6223018 DOI: 10.1186/s41256-018-0086-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 10/21/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A high performing physician workforce is critical to attain nationally set health sector goals. Ethiopia has expanded training of medical doctors. However, little is known about junior doctors' performance. Understanding medical practice is essential to inform medical education and practice, establish licensure examination and guide workforce management decisions. We conducted a practice analysis study to identify gaps in Ethiopian medical education and practice, and to determine composition of subjects in national licensing examination. METHODS We conducted a cross-sectional study with national representative sample of junior doctors. After calculating a sample size of 198, we used a two-stage stratified cluster sampling method to select study participants. We collected data using a structured questionnaire comprising 222 tasks. Study participants reported in interviews on frequency of, competence at, and importance of doing each task for improved health outcome. We developed proportions, averages, graphs and tables. Using the results of practice analysis and experts' ratings, relative weights of subjects in the national licensing examination for medical undergraduates were determined. RESULTS A total of 191 junior doctors participated. Most were males (74.6%) and had less than 2 years of experience (69.8%). Junior doctors frequently performed tasks of internal medicine and pediatrics. Their participation in obstetrics and gynecology, ophthalmology, psychiatry and dentistry services was infrequent. Junior doctors had competency gaps to conduct clinical procedures, research and health programming tasks. Practice analysis results and expert ratings generated comparable recommendations for composition of a national licensing examination, with more than three-quarters of the items focusing on internal medicine, pediatrics, surgery, obstetrics and gynecology, and public health. CONCLUSION Junior doctors in Ethiopia rarely managed psychiatry, ophthalmology and dental patients. They had competence gaps in clinical procedures, research and health programming skills. The findings have implications for establishing licensing examination, and reviewing curriculum, continuing professional development, placement and rotation policy, and distribution of responsibilities.
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Affiliation(s)
- Daniel Dejene
- Jhpiego, Kirkos Subcity, Box 2881, Code, 1250 Addis Ababa, PO Ethiopia
| | - Tegbar Yigzaw
- Jhpiego, Kirkos Subcity, Box 2881, Code, 1250 Addis Ababa, PO Ethiopia
| | - Samuel Mengistu
- Jhpiego, Kirkos Subcity, Box 2881, Code, 1250 Addis Ababa, PO Ethiopia
| | - Zerihun Wolde
- University of Maryland Prince George’s Hospital center, Cheverly, Maryland USA
| | - Abiy Hiruy
- Federal Ministry of Health, Addis Ababa, Ethiopia
| | | | - Miftah Awol
- Ethiopian Medical Association, Addis Ababa, Ethiopia
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Soriano JB, Rojas-Rueda D, Alonso J, Antó JM, Cardona PJ, Fernández E, Garcia-Basteiro AL, Benavides FG, Glenn SD, Krish V, Lazarus JV, Martínez-Raga J, Masana MF, Nieuwenhuijsen MJ, Ortiz A, Sánchez-Niño MD, Serrano-Blanco A, Tortajada-Girbés M, Tyrovolas S, Haro JM, Naghavi M, Murray CJL. The burden of disease in Spain: Results from the Global Burden of Disease 2016. Med Clin (Barc) 2018; 151:171-190. [PMID: 30037695 DOI: 10.1016/j.medcle.2018.05.043] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 04/27/2018] [Accepted: 05/03/2018] [Indexed: 05/27/2023]
Abstract
BACKGROUND AND OBJECTIVES The global burden of disease (GBD) project measures the health of populations worldwide on an annual basis, and results are available by country. We used the estimates of the GBD to summarise the state of health in Spain in 2016 and report trends in mortality and morbidity from 1990 to 2016. MATERIAL AND METHODS GBD 2016 estimated disease burden due to 333 diseases and injuries, and 84 risk factors. The GBD list of causes is hierarchical and includes 3 top level categories, namely: 1) communicable, maternal, neonatal, and nutritional diseases; 2) non-communicable diseases (NCDs), and 3) injuries. Mortality and disability-adjusted life-years (DALYs), risk factors, and progress towards the sustainable development goals (SDGs) are presented based on the GBD 2016 data in Spain. RESULTS There were 418,516 deaths in Spain in 2016, from a total population of 46.5 million, and 80.5% of them occurred in those aged 70 years and older. Overall, NCDs were the main cause of death: 388,617 (95% uncertainty interval 374,959-402,486), corresponding to 92.8% of all deaths. They were followed by 3.6% due to injuries with 15,052 (13,902-17,107) deaths, and 3.5% communicable diseases with 14,847 (13,208-16,482) deaths. The 5 leading specific causes of death were ischaemic heart disease (IHD, 14.6% of all deaths), Alzheimer disease and other dementias (13.6%), stroke (7.1%), chronic obstructive pulmonary disease (6.9%), and lung cancer (5.0%). Remarkable increases in mortality from 1990 to 2016 were observed in other cancers, lower respiratory infections, chronic kidney disease, and other cardiovascular disease, among others. On the contrary, road injuries moved down from 8th to 32nd position, and diabetes from 6th to 10th. Low back and neck pain became the number one cause of DALYs in Spain in 2016, just surpassing IHD, while Alzheimer disease moved from 9th to 3rd position. The greatest changes in DALYs were observed for road injuries dropping from 4th to 16th position, and congenital disorders from 17th to 35th; conversely, oral disorders rose from 25th to 17th. Overall, smoking is by far the most relevant risk factor in Spain, followed by high blood pressure, high body mass index, alcohol use, and high fasting plasma glucose. Finally, Spain scored 74.3 of 100 points in the SDG index classification in 2016, and the main national drivers of detrimental health in SDGs were alcohol consumption, smoking and child obesity. An increase to 80.3 points is projected in 2030. CONCLUSION Low back and neck pain was the most important contributor of disability in Spain in 2016. There has seen a remarkable increase in the burden due to Alzheimer disease and other dementias. Tobacco remains the most important health issue to address in Spain.
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Affiliation(s)
- Joan B Soriano
- Instituto de Investigación Hospital Universitario de la Princesa, Universidad Autónoma de Madrid, Madrid, España; SEPAR, Barcelona, España.
| | - David Rojas-Rueda
- Instituto de Salud Global de Barcelona, Barcelona, España; IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, España; Universitat Pompeu Fabra (UPF), Barcelona, España; Biomedical Research Networking Center in Epidemiology & Public (CIBERESP), Barcelona, España; Centre for Research in Environmental Epidemiology (CREAL), Barcelona, España
| | - Jordi Alonso
- IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, España; Universitat Pompeu Fabra (UPF), Barcelona, España; Biomedical Research Networking Center in Epidemiology & Public (CIBERESP), Barcelona, España
| | - Josep M Antó
- Instituto de Salud Global de Barcelona, Barcelona, España; IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, España; Universitat Pompeu Fabra (UPF), Barcelona, España; Biomedical Research Networking Center in Epidemiology & Public (CIBERESP), Barcelona, España; Centre for Research in Environmental Epidemiology (CREAL), Barcelona, España
| | - Pere-Joan Cardona
- Institut Germans Trias i Pujol, Badalona, Barcelona, España; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Madrid, España; Universitat Autònoma de Barcelona, Barcelona, España
| | - Esteve Fernández
- Institut Català d'Oncologia (ICO)-Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, España; Facultat de Medicina, Universitat de Barcelona, Barcelona, España
| | - Alberto L Garcia-Basteiro
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique; Amsterdam Institute for Global Health and Development (AIGHD), Amsterdam, Países Bajos; Instituto de Salud Global de Barcelona, Barcelona, España; Facultat de Medicina, Universitat de Barcelona, Barcelona, España
| | - Fernando G Benavides
- Center for Research in Occupational Health, Universitat Pompeu Fabra (UPF), Barcelona, España; Universitat Pompeu Fabra (UPF), Barcelona, España; Biomedical Research Networking Center in Epidemiology & Public (CIBERESP), Barcelona, España
| | - Scott D Glenn
- Institute of Health Metrics and Evaluation, University of Washington, Seattle, WA, Estados Unidos
| | - Varsha Krish
- Institute of Health Metrics and Evaluation, University of Washington, Seattle, WA, Estados Unidos
| | - Jeffrey V Lazarus
- Instituto de Salud Global de Barcelona, Barcelona, España; Facultat de Medicina, Universitat de Barcelona, Barcelona, España
| | - José Martínez-Raga
- Hospital Universitario Doctor Peset, Valencia, España; Universitat de Valencia, Valencia, España; University Cardenal Herrera CEU, Valencia, España
| | - Maria F Masana
- Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, España; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, España; Facultat de Medicina, Universitat de Barcelona, Barcelona, España
| | - Mark J Nieuwenhuijsen
- Instituto de Salud Global de Barcelona, Barcelona, España; IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, España; Universitat Pompeu Fabra (UPF), Barcelona, España; Biomedical Research Networking Center in Epidemiology & Public (CIBERESP), Barcelona, España; Centre for Research in Environmental Epidemiology (CREAL), Barcelona, España
| | - Alberto Ortiz
- IIS-Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Madrid, España
| | | | - Antoni Serrano-Blanco
- Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, España; Biomedical Research Networking Center in Epidemiology & Public (CIBERESP), Barcelona, España
| | - Miguel Tortajada-Girbés
- Hospital Universitario Doctor Peset, Valencia, España; Departamento de Pediatría, Obstetricia y Ginecología, Universidad de Valencia, Valencia, España
| | - Stefanos Tyrovolas
- Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, España; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, España; Institute of Health Metrics and Evaluation, University of Washington, Seattle, WA, Estados Unidos
| | - Josep Maria Haro
- Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, España; Facultat de Medicina, Universitat de Barcelona, Barcelona, España; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, España
| | - Mohsen Naghavi
- Institute of Health Metrics and Evaluation, University of Washington, Seattle, WA, Estados Unidos
| | - Christopher J L Murray
- Institute of Health Metrics and Evaluation, University of Washington, Seattle, WA, Estados Unidos
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Soriano JB, Rojas-Rueda D, Alonso J, Antó JM, Cardona PJ, Fernández E, Garcia-Basteiro AL, Benavides FG, Glenn SD, Krish V, Lazarus JV, Martínez-Raga J, Masana MF, Nieuwenhuijsen MJ, Ortiz A, Sánchez-Niño MD, Serrano-Blanco A, Tortajada-Girbés M, Tyrovolas S, Haro JM, Naghavi M, Murray CJL. The burden of disease in Spain: Results from the Global Burden of Disease 2016. Med Clin (Barc) 2018; 151:171-190. [PMID: 30037695 DOI: 10.1016/j.medcli.2018.05.011] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 04/27/2018] [Accepted: 05/03/2018] [Indexed: 12/29/2022]
Abstract
BACKGROUND AND OBJECTIVES The global burden of disease (GBD) project measures the health of populations worldwide on an annual basis, and results are available by country. We used the estimates of the GBD to summarise the state of health in Spain in 2016 and report trends in mortality and morbidity from 1990 to 2016. MATERIAL AND METHODS GBD 2016 estimated disease burden due to 333 diseases and injuries, and 84 risk factors. The GBD list of causes is hierarchical and includes 3 top level categories, namely: 1) communicable, maternal, neonatal, and nutritional diseases; 2) non-communicable diseases (NCDs), and 3) injuries. Mortality and disability-adjusted life-years (DALYs), risk factors, and progress towards the sustainable development goals (SDGs) are presented based on the GBD 2016 data in Spain. RESULTS There were 418,516 deaths in Spain in 2016, from a total population of 46.5 million, and 80.5% of them occurred in those aged 70 years and older. Overall, NCDs were the main cause of death: 388,617 (95% uncertainty interval 374,959-402,486), corresponding to 92.8% of all deaths. They were followed by 3.6% due to injuries with 15,052 (13,902-17,107) deaths, and 3.5% communicable diseases with 14,847 (13,208-16,482) deaths. The 5 leading specific causes of death were ischaemic heart disease (IHD, 14.6% of all deaths), Alzheimer disease and other dementias (13.6%), stroke (7.1%), chronic obstructive pulmonary disease (6.9%), and lung cancer (5.0%). Remarkable increases in mortality from 1990 to 2016 were observed in other cancers, lower respiratory infections, chronic kidney disease, and other cardiovascular disease, among others. On the contrary, road injuries moved down from 8th to 32nd position, and diabetes from 6th to 10th. Low back and neck pain became the number one cause of DALYs in Spain in 2016, just surpassing IHD, while Alzheimer disease moved from 9th to 3rd position. The greatest changes in DALYs were observed for road injuries dropping from 4th to 16th position, and congenital disorders from 17th to 35th; conversely, oral disorders rose from 25th to 17th. Overall, smoking is by far the most relevant risk factor in Spain, followed by high blood pressure, high body mass index, alcohol use, and high fasting plasma glucose. Finally, Spain scored 74.3 of 100 points in the SDG index classification in 2016, and the main national drivers of detrimental health in SDGs were alcohol consumption, smoking and child obesity. An increase to 80.3 points is projected in 2030. CONCLUSION Low back and neck pain was the most important contributor of disability in Spain in 2016. There has seen a remarkable increase in the burden due to Alzheimer disease and other dementias. Tobacco remains the most important health issue to address in Spain.
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Affiliation(s)
- Joan B Soriano
- Instituto de Investigación Hospital Universitario de la Princesa, Universidad Autónoma de Madrid, Madrid, España; SEPAR, Barcelona, España.
| | - David Rojas-Rueda
- Instituto de Salud Global de Barcelona, Barcelona, España; IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, España; Universitat Pompeu Fabra (UPF), Barcelona, España; Biomedical Research Networking Center in Epidemiology & Public (CIBERESP), Barcelona, España; Centre for Research in Environmental Epidemiology (CREAL), Barcelona, España
| | - Jordi Alonso
- IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, España; Universitat Pompeu Fabra (UPF), Barcelona, España; Biomedical Research Networking Center in Epidemiology & Public (CIBERESP), Barcelona, España
| | - Josep M Antó
- Instituto de Salud Global de Barcelona, Barcelona, España; IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, España; Universitat Pompeu Fabra (UPF), Barcelona, España; Biomedical Research Networking Center in Epidemiology & Public (CIBERESP), Barcelona, España; Centre for Research in Environmental Epidemiology (CREAL), Barcelona, España
| | - Pere-Joan Cardona
- Institut Germans Trias i Pujol, Badalona, Barcelona, España; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Madrid, España; Universitat Autònoma de Barcelona, Barcelona, España
| | - Esteve Fernández
- Institut Català d'Oncologia (ICO)-Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, España; Facultat de Medicina, Universitat de Barcelona, Barcelona, España
| | - Alberto L Garcia-Basteiro
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique; Amsterdam Institute for Global Health and Development (AIGHD), Amsterdam, Países Bajos; Instituto de Salud Global de Barcelona, Barcelona, España; Facultat de Medicina, Universitat de Barcelona, Barcelona, España
| | - Fernando G Benavides
- Center for Research in Occupational Health, Universitat Pompeu Fabra (UPF), Barcelona, España; Universitat Pompeu Fabra (UPF), Barcelona, España; Biomedical Research Networking Center in Epidemiology & Public (CIBERESP), Barcelona, España
| | - Scott D Glenn
- Institute of Health Metrics and Evaluation, University of Washington, Seattle, WA, Estados Unidos
| | - Varsha Krish
- Institute of Health Metrics and Evaluation, University of Washington, Seattle, WA, Estados Unidos
| | - Jeffrey V Lazarus
- Instituto de Salud Global de Barcelona, Barcelona, España; Facultat de Medicina, Universitat de Barcelona, Barcelona, España
| | - José Martínez-Raga
- Hospital Universitario Doctor Peset, Valencia, España; Universitat de Valencia, Valencia, España; University Cardenal Herrera CEU, Valencia, España
| | - Maria F Masana
- Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, España; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, España; Facultat de Medicina, Universitat de Barcelona, Barcelona, España
| | - Mark J Nieuwenhuijsen
- Instituto de Salud Global de Barcelona, Barcelona, España; IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, España; Universitat Pompeu Fabra (UPF), Barcelona, España; Biomedical Research Networking Center in Epidemiology & Public (CIBERESP), Barcelona, España; Centre for Research in Environmental Epidemiology (CREAL), Barcelona, España
| | - Alberto Ortiz
- IIS-Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Madrid, España
| | | | - Antoni Serrano-Blanco
- Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, España; Biomedical Research Networking Center in Epidemiology & Public (CIBERESP), Barcelona, España
| | - Miguel Tortajada-Girbés
- Hospital Universitario Doctor Peset, Valencia, España; Departamento de Pediatría, Obstetricia y Ginecología, Universidad de Valencia, Valencia, España
| | - Stefanos Tyrovolas
- Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, España; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, España; Institute of Health Metrics and Evaluation, University of Washington, Seattle, WA, Estados Unidos
| | - Josep Maria Haro
- Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, España; Facultat de Medicina, Universitat de Barcelona, Barcelona, España; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, España
| | - Mohsen Naghavi
- Institute of Health Metrics and Evaluation, University of Washington, Seattle, WA, Estados Unidos
| | - Christopher J L Murray
- Institute of Health Metrics and Evaluation, University of Washington, Seattle, WA, Estados Unidos
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Bed nets used to protect against malaria do not last long in a semi-arid area of Ethiopia: a cohort study. Malar J 2018; 17:239. [PMID: 29925371 PMCID: PMC6011348 DOI: 10.1186/s12936-018-2391-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2018] [Accepted: 06/14/2018] [Indexed: 11/29/2022] Open
Abstract
Background Long-lasting insecticidal nets (LLINs) are a key tool for malaria prevention and control. Currently, the recommended serviceable life of an LLIN is 3 years under field conditions. However, field studies show considerable variation in LLIN lifespan, from less than 2 years to more than 4 years. This study aimed to determine the attrition, physical integrity, functional survival, and bio-efficacy of LLINs under field conditions in south-central Ethiopia. Methods In October 2014, 7740 LLINs (PermaNet® 2.0) were distributed to 3006 households. Among the distributed LLINs, a cohort study involving 1532 LLINs in 659 households was carried out from October 2014 to November 2016. Data were collected every 6 months by observation, and through interviews with the heads of households. The proportional hole index was used to categorize LLINs as either serviceable or torn. In addition, 120 randomly selected LLINs were tested for bio-efficacy. Results The overall attrition of LLINs was 96% (n = 993) during the study period. The nets’ attrition was mainly due to disposal (64.2%; n = 638). The proportion of LLINs with a hole size 0.5 cm or larger was 79.5% after 24 months. The use of the net on the previous night and having a clean net were associated with a good physical integrity. However, living in a household more than 1 km away from the mosquitoes’ breeding site was associated with poor physical integrity. By the 24th month, only 4% of the nets met the criteria for functional survival. The median functional survival time of the nets was 12 months. A longer functional survival was associated with having a clean net, and shorter survival was associated with living in a household more than 1 km away from the mosquitoes’ breeding site. The PermaNet® 2.0 met the criteria of effective bio-efficacy up to month 24 after distribution. Conclusions The study showed that the median serviceable life of LLINs is only 12 months. However, the bio-efficacy of the LLINs is acceptable for at least 24 months. Therefore, stronger and more efficient LLINs need to be developed for conditions similar to those studied here.
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Melaku YA, Wassie MM, Gill TK, Zhou SJ, Tessema GA, Amare AT, Lakew Y, Hiruye A, Bekele TH, Worku A, Seid O, Endris K, Lemma F, Tesfay FH, Yirsaw BD, Deribe K, Adams R, Shi Z, Misganaw A, Deribew A. Burden of disease attributable to suboptimal diet, metabolic risks and low physical activity in Ethiopia and comparison with Eastern sub-Saharan African countries, 1990-2015: findings from the Global Burden of Disease Study 2015. BMC Public Health 2018; 18:552. [PMID: 29699588 PMCID: PMC5922000 DOI: 10.1186/s12889-018-5438-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Accepted: 04/11/2018] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Twelve of the 17 Sustainable Development Goals (SDGs) are related to malnutrition (both under- and overnutrition), other behavioral, and metabolic risk factors. However, comparative evidence on the impact of behavioral and metabolic risk factors on disease burden is limited in sub-Saharan Africa (SSA), including Ethiopia. Using data from the Global Burden of Disease (GBD) Study, we assessed mortality and disability-adjusted life years (DALYs) attributable to child and maternal undernutrition (CMU), dietary risks, metabolic risks and low physical activity for Ethiopia. The results were compared with 14 other Eastern SSA countries. METHODS Databases from GBD 2015, that consist of data from 1990 to 2015, were used. A comparative risk assessment approach was utilized to estimate the burden of disease attributable to CMU, dietary risks, metabolic risks and low physical activity. Exposure levels of the risk factors were estimated using spatiotemporal Gaussian process regression (ST-GPR) and Bayesian meta-regression models. RESULTS In 2015, there were 58,783 [95% uncertainty interval (UI): 43,653-76,020] or 8.9% [95% UI: 6.1-12.5] estimated all-cause deaths attributable to CMU, 66,269 [95% UI: 39,367-106,512] or 9.7% [95% UI: 7.4-12.3] to dietary risks, 105,057 [95% UI: 66,167-157,071] or 15.4% [95% UI: 12.8-17.6] to metabolic risks and 5808 [95% UI: 3449-9359] or 0.9% [95% UI: 0.6-1.1] to low physical activity in Ethiopia. While the age-adjusted proportion of all-cause mortality attributable to CMU decreased significantly between 1990 and 2015, it increased from 10.8% [95% UI: 8.8-13.3] to 14.5% [95% UI: 11.7-18.0] for dietary risks and from 17.0% [95% UI: 15.4-18.7] to 24.2% [95% UI: 22.2-26.1] for metabolic risks. In 2015, Ethiopia ranked among the top four countries (of 15 Eastern SSA countries) in terms of mortality and DALYs based on the age-standardized proportion of disease attributable to dietary and metabolic risks. CONCLUSIONS In Ethiopia, while there was a decline in mortality and DALYs attributable to CMU over the last two and half decades, the burden attributable to dietary and metabolic risks have increased during the same period. Lifestyle and metabolic risks of NCDs require more attention by the primary health care system of the country.
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Affiliation(s)
- Yohannes Adama Melaku
- Department of Human Nutrition, Institute of Public Health, The University of Gondar, Gondar, Ethiopia
- Adelaide Medical School, The University of Adelaide, Adelaide, Australia
| | - Molla Mesele Wassie
- Department of Human Nutrition, Institute of Public Health, The University of Gondar, Gondar, Ethiopia
- School of Agriculture, Food and Wine, Faculty of Sciences, University of Adelaide, Adelaide, Australia
| | - Tiffany K. Gill
- Adelaide Medical School, The University of Adelaide, Adelaide, Australia
| | - Shao Jia Zhou
- School of Agriculture, Food and Wine, Faculty of Sciences, University of Adelaide, Adelaide, Australia
| | - Gizachew Assefa Tessema
- Department of Reproductive Health, Institute of Public Health, University of Gondar, Gondar, Ethiopia
- School of Public Health, The University of Adelaide, Adelaide, Australia
| | - Azmeraw T. Amare
- Discipline of Psychiatry, School of Medicine, The University of Adelaide, Adelaide, Australia
- School of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
- Department of Epidemiology, University Medical Center Groningen, the University of Groningen, Groningen, The Netherlands
| | - Yihunie Lakew
- Ethiopian Public Health Association, Addis Ababa, Ethiopia
| | - Abiy Hiruye
- Federal Ministry of Health, Addis Ababa, Ethiopia
| | - Tesfaye Hailu Bekele
- Food Science and Nutrition Research Directorate, Ethiopian Public Health Institue, Addis Ababa, Ethiopia
| | - Amare Worku
- Department of Public Health Sciences, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | - Oumer Seid
- Department of Nutrition and Dietetics, School of Public Health, Mekelle University, Mekelle, Ethiopia
| | - Kedir Endris
- Department of Nutrition and Dietetics, School of Public Health, Mekelle University, Mekelle, Ethiopia
| | - Ferew Lemma
- Federal Ministry of Health, Addis Ababa, Ethiopia
| | - Fisaha Haile Tesfay
- Department of Epidemiology and Biostatics, School of Public Health, Mekelle University, Mekelle, Ethiopia
- Flinders University, Southgate Institute for Health, Society and Equity, Adelaide, Australia
| | | | - Kebede Deribe
- Wellcome Trust Brighton and Sussex Centre for Global Health Research, Brighton and Sussex Medical School, Brighton, BN1 9PX UK
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Robert Adams
- Health Observatory, Discipline of Medicine, The Queen Elizabeth Hospital, The University of Adelaide, Adelaide, Australia
| | - Zumin Shi
- Adelaide Medical School, The University of Adelaide, Adelaide, Australia
- Human Nutrition Department, College of Health Sciences, Qatar University, Doha, Qatar
| | - Awoke Misganaw
- Institute of Health Metrics and Evaluation, University of Washington, Seattle, USA
| | - Amare Deribew
- Nutrition International, Addis Ababa, Ethiopia
- St. Paul Millennium Medical College, Addis Ababa, Ethiopia
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Depression and Its Help Seeking Behaviors: A Systematic Review and Meta-Analysis of Community Survey in Ethiopia. DEPRESSION RESEARCH AND TREATMENT 2018; 2018:1592596. [PMID: 30662771 PMCID: PMC6312598 DOI: 10.1155/2018/1592596] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2018] [Accepted: 12/05/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Depression is one of the most common mental illnesses affecting around 322 million individual in the world. Although the prevalence of depression is high and its treatment is effective, little is known about its pooled prevalence and help seeking behaviors in the community settings of Ethiopia. Thus, this study aimed to determine the pooled prevalence of depression and its help seeking behaviors in Ethiopia. METHODS A systematic literature search in the databases of Pub-Med, Cochrane, and Google Scholar was performed. The quality of studies was assessed using the Newcastle-Ottawa quality assessment tool adapted for cross-sectional studies. Heterogeneity test and evidence of publication bias were assessed. Moreover, sensitivity test was also performed. Pooled prevalence of depression and its help seeking behavior were calculated using random effects model. RESULTS A total 13 studies for depression, 4 studies for help seeking intention, and 5 studies for help seeking behaviour were included in this review. The pooled prevalence of depression and help seeking intention and behaviour was found to be 20.5% (95% CI; 16.5% -24.4%), 42% (95% CI; 23%-60%), and 38% (95% CI; 23%-52%), respectively. There is no significant heterogeneity for depression (I2 = 0%, p =0.620), help seeking intention (I2 = 0%, p =0.996), and behaviour (I2 = 0%, p =0.896). There is no publication bias for depression egger's test (p =0.689). CONCLUSION More than one in every five individuals were experiencing depression. Less than one-third of individuals with depression seek help from modern treatment. Authors suggest community based mental health screening and treatment.
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