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Ahmed KY, Dadi AF, Ogbo FA, Page A, Agho KE, Akalu TY, Baraki AG, Tesema GA, Teshale AB, Alamneh TS, Tessema ZT, Kabthymer RH, Tamirat KS, Ross AG. Population-Modifiable Risk Factors Associated With Childhood Stunting in Sub-Saharan Africa. JAMA Netw Open 2023; 6:e2338321. [PMID: 37851439 PMCID: PMC10585405 DOI: 10.1001/jamanetworkopen.2023.38321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 08/28/2023] [Indexed: 10/19/2023] Open
Abstract
Importance Identifying modifiable risk factors associated with childhood stunting in sub-Saharan Africa (SSA) is imperative for the development of evidence-based interventions and to achieve the Sustainable Development Goals. Objective To evaluate key modifiable risk factors associated with childhood stunting in SSA. Design, Setting, and Participants This cross-sectional study examined the most recent (2014-2021) Demographic and Health Surveys data for children younger than 5 years from 25 SSA countries. Exposures Modifiable risk factors included history of diarrhea within 2 weeks, consumption of dairy products, maternal body mass index, maternal educational level, antenatal care visits, place of birth, wealth index, type of toilet, and type of cooking fuel. Main Outcomes and Measures Stunting and severe stunting, measured using the height-for-age z score, were the main outcomes. Children who scored below -2.0 SDs or -3.0 SDs were classified as having stunted or severely stunted growth, respectively. Relative risks and 95% CIs were computed using generalized linear latent and mixed models and log-binomial link functions. Population-attributable fractions (PAFs) were calculated using adjusted relative risks and prevalence estimates for key modifiable risk factors. Results This study included 145 900 children from 25 SSA countries. The mean (SD) age of the children was 29.4 (17.3) months, and 50.6% were male. The highest PAFs of severe childhood stunting were observed for mothers lacking a formal education (PAF, 21.9%; 95% CI, 19.0%-24.8%), children lacking consumption of dairy products (PAF, 20.8%; 95% CI, 16.8%-24.9%), unclean cooking fuel (PAF, 9.5%; 95% CI, 2.6%-16.3%), home birth (PAF, 8.3%; 95% CI, 6.3%-10.0%), and low-income household (PAF, 5.8%; 95% CI, 3.4%-8.0%). These 5 modifiable risk factors were associated with 51.6% (95% CI, 40.5%-60.9%) of the severe childhood stunting in SSA. Conclusions and Relevance This cross-sectional study identified 5 modifiable risk factors that were associated with 51.6% of severe childhood stunting in SSA. These factors should be a priority for policy makers when considering future child health interventions to address chronic malnutrition in SSA.
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Affiliation(s)
- Kedir Y. Ahmed
- Rural Health Research Institute, Charles Sturt University, Orange, New South Wales, Australia
| | - Abel F. Dadi
- Charles Darwin University, Menzies School of Health Research, Northern Territory, Australia
- Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | - Felix Akpojene Ogbo
- Riverland Academy of Clinical Excellence, Riverland Mallee Coorong Local Health Network, South Australia Health, Government of South Australia, Berri, South Australia, Australia
- Translational Health Research Institute, Western Sydney University, Campbelltown Campus, Penrith, New South Wales, Australia
| | - Andrew Page
- Translational Health Research Institute, Western Sydney University, Campbelltown Campus, Penrith, New South Wales, Australia
| | - Kingsley E. Agho
- Translational Health Research Institute, Western Sydney University, Campbelltown Campus, Penrith, New South Wales, Australia
- School of Health Sciences, Western Sydney University, Campbelltown Campus, Penrith, New South Wales, Australia
| | - Temesgen Yihunie Akalu
- School of Population Health, Faculty of Health Sciences, Curtin University, Bentley, Western Australia, Australia
- Geospatial and Tuberculosis Research Team, Telethon Kids Institute, Perth, Western Australia, Australia
- Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Adhanom Gebreegziabher Baraki
- Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- School of Rehabilitation Therapy, Queen’s University, Kingston, Ontario, Canada
| | - Getayeneh Antehunegn Tesema
- Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Achamyeleh Birhanu Teshale
- Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Tesfa Sewunet Alamneh
- Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Zemenu Tadesse Tessema
- Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Robel Hussen Kabthymer
- Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, Victoria, Australia
- Department of Human Nutrition, School of Public Health, Dilla University, Dilla, Ethiopia
| | - Koku Sisay Tamirat
- Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- School of Rural Health, Monash University, Warragul, Victoria, Australia
| | - Allen G. Ross
- Rural Health Research Institute, Charles Sturt University, Orange, New South Wales, Australia
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Azanaw MM, Baraki AG, Yenit MK. Incidence and predictors of loss to follow-up among pregnant and lactating women in the Option B+ PMTCT program in Northwestern Ethiopia: a seven-year retrospective cohort study. Front Glob Womens Health 2023; 4:1128988. [PMID: 37529507 PMCID: PMC10389654 DOI: 10.3389/fgwh.2023.1128988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 06/21/2023] [Indexed: 08/03/2023] Open
Abstract
Introduction Although Ethiopia has implemented the Option B+ program over the past 7 years, loss to follow-up among HIV-positive women remains a major problem for antiretroviral therapy (ART) treatment. This study was conducted to investigate the number of women who dropped out of follow-up after the Option B+ program. Methods A retrospective follow-up study was conducted among 403 pregnant and lactating women between June 2013 and December 2019 at health facilities in Northwest Ethiopia. The Cox proportional hazards regression model was used to identify predictors of loss to follow-up. The results were reported as hazard ratios with 95% confidence intervals (CIs) at a significance level of p = 0.05. Results The overall incidence rate of loss to follow-up was 9.4 per 1,000 person-months of observation (95% CI: 7.40-11.90). According to the multivariable Cox regression, rural residency [adjusted hazard ratio (AHR): 2.30; 95% CI: 1.08-4.88], being a Muslim religion follower (AHR: 2.44; 95% CI: 1.23-4.81), having no baseline viral load measurement (AHR: 4.21; 95% CI: 2.23-7.96), being on ART before enrolment (AHR: 0.30; 95% CI: 0.15-0.62), having drug side effects (AHR:1.82; 95% CI: 1.01-3.33), same-day ART initiation (AHR: 3.23; 95% CI: 1.53-6.84), and having suboptimal adherence level (AHR: 3.96; 95% CI: 2.18-7.19) were significant predictors of loss to follow-up. Conclusion The incidence of loss to follow-up is lower as compared to evidence from most African countries but slightly higher than the WHO target. It is better to strengthen and expand viral load measurements for all women and to pay attention to women residing in rural areas with fair or poor adherence levels.
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Affiliation(s)
- Melkalem Mamuye Azanaw
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Adhanom Gebreegziabher Baraki
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Melaku Kindie Yenit
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
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Akalu TY, Clements ACA, Baraki AG, Alene KA. Protocol for a systematic review of long-term physical sequelae and financial burden of multidrug-resistant and extensively drug-resistant tuberculosis. PLoS One 2023; 18:e0285404. [PMID: 37186609 PMCID: PMC10184907 DOI: 10.1371/journal.pone.0285404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 03/31/2023] [Indexed: 05/17/2023] Open
Abstract
INTRODUCTION Multidrug resistant (MDR) and extensively drug-resistant (XDR) tuberculosis (TB) are major public health threats that are significant causes of physical sequelae and financial consequences for infected people. Treatment for MDR- and XDR-TB are more toxic and take longer duration than for drug-susceptible-TB. As a result, the long-term sequelae are thought to be more common among patients with MDR- and XDR-TB than drug-susceptible-TB, but this is yet to be quantified. Hence, the aim of this systematic review and meta-analysis is to quantify the global burden and types of long-term physical sequelae and financial burden associated with both MDR- and XDR-TB. METHOD AND ANALYSIS We will search CINHAL, MEDLINE, Embase, Scopus, and Web of science for studies that report physical and financial sequelae associated with rifampicin-resistant (RR), MDR- and XDR-TB or their treatments. The search will be conducted without time, language, and place restrictions. A random-effects meta-analysis will be conducted to estimate the pooled prevalence of each physical sequela. Heterogeneity will be measured using the Higgins I2 statistics. We will assess publication bias visually using the funnel plot and statistically using Egger's test. Adjustments for publication basis will be made using Tweedie's and Duval Trim and Fill analysis. ETHICS AND DISSEMINATION Since the study is based on published evidence, ethics approval is not required. The findings of the systematic review will be presented at various conferences and will be published in a peer-reviewed journal. PROTOCOL REGISTRATION The protocol is published in the PROSPERO with registration number CRD42021250909.
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Affiliation(s)
- Temesgen Yihunie Akalu
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
- Geospatial and Tuberculosis Research Team, Telethon Kids Institute, Perth, Western Australia, Australia
- Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Archie C A Clements
- Geospatial and Tuberculosis Research Team, Telethon Kids Institute, Perth, Western Australia, Australia
- Peninsula Medical School, University of Plymouth, Plymouth, United Kingdom
| | | | - Kefyalew Addis Alene
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
- Geospatial and Tuberculosis Research Team, Telethon Kids Institute, Perth, Western Australia, Australia
- Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Gebresilassie KY, Baraki AG, Kassie BA, Wami SD. Midwifery-led researches for evidence-based practice: Clinical midwives engagement in research in Ethiopia, 2021. PLoS One 2022; 17:e0268697. [PMID: 35657804 PMCID: PMC9165898 DOI: 10.1371/journal.pone.0268697] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Accepted: 05/04/2022] [Indexed: 12/03/2022] Open
Abstract
Introduction Health workers involvement in research had an impact on studies and whole system. They influence the clinical practice and help to implement evidences. Although International Confederation of Midwives (ICM) put research as one of the midwifery competencies and professional development activity, clinical midwives are poorly involved in research. Therefore, this study is aimed to assess clinical midwives engagement in research and bridge the gap through applicable strategies. Method Institution-based cross-sectional study was conducted among clinical midwives working at public health facilities of Central and North Gondar Zone, Ethiopia from September to October, 2020 G.C. A structured and pre-tested self-administered questionnaire was used to collect data and entered into Epi-info version 7. Descriptive statistics was used to describe study population. Bi-variable and multi-variable logistic regression analysis was performed using STATA Version 14 and significance level declared at 95% confidence interval, p-value ≤ 0.05 and respective odds ratios. Result Out of 335 clinical midwives, 314 were participated making the response rate 93.7%. Among the midwives, one hundred seventy two (54.8%) (95% CI: 49.08%, 60.37) have good skill on conducting a research. Clinical midwives with mothers with formal education [AOR: 1.90, 95% CI: (1.03, 3.51), currently work on referral hospitals [AOR: 2.33, 95% CI: (1.19, 4.53)] and having good level of knowledge on research [AOR: 2.19, 95% CI: (1.25, 3.82)] have significant association with having good research skill. Forty eight (15.2%) (95% CI: 11.5%, 19.7%) ever participated in research during their clinical practice. Clinical midwives who have good knowledge on research [AOR: 0.31, 95% CI: (0.14, 0.70)] are about 0.3 times less likely to participate on research than who have poor knowledge [AOR: 0.31, 95% CI: (0.14, 0.70)]. Conclusion and recommendation Although more than half have good research skill, only a small proportion of midwives were involved in research. Capacity building activities are crucial to strengthen midwives skill on research and ensure their involvement.
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Affiliation(s)
| | | | | | - Sintayehu Daba Wami
- Department of Environmental and Occupational Health and Safety, University of Gondar, Gondar, Ethiopia
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Tamirat KS, Kebede FB, Baraki AG, Akalu TY. The Role of GeneXpert MTB/RIF in Reducing Treatment Delay Among Multidrug Resistance Tuberculosis Patients: A Propensity Score Matched Analysis. Infect Drug Resist 2022; 15:285-294. [PMID: 35115796 PMCID: PMC8803608 DOI: 10.2147/idr.s345619] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 01/11/2022] [Indexed: 11/23/2022] Open
Abstract
Background Methods Results Conclusion
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Affiliation(s)
- Koku Sisay Tamirat
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Correspondence: Koku Sisay Tamirat, Email
| | | | - Adhanom Gebreegziabher Baraki
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Temesgen Yihunie Akalu
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Takele WW, Baraki AG, Wolde HF, Desyibelew HD, Derseh BT, Dadi AF, Mekonnen EG, Akalu TY. Anemia and Contributing Factors in Severely Malnourished Infants and Children Aged between 0 and 59 Months Admitted to the Treatment Centers of the Amhara Region, Ethiopia: A Multicenter Chart Review Study. Anemia 2021; 2021:6636043. [PMID: 33854799 PMCID: PMC8019621 DOI: 10.1155/2021/6636043] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 02/25/2021] [Accepted: 03/16/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Anemia among severely malnourished children is a double burden that could make the treatment outcome of severe acute malnutrition (SAM) more unfavorable. The burden and the factors are, however, uncovered among children in the Amhara region. Therefore, the study was aimed at determining the prevalence of anemia and identifying contributing factors in severely malnourished children aged between 0 and 59 months admitted to the treatment centers of the Amhara region referral hospitals. METHODS A facility-based cross-sectional study was conducted that included 1,301 infants and children, who developed SAM and were admitted to the three referral hospitals of the Amhara region. Data were extracted using a data extraction checklist. The binary logistic regression analysis was employed to show an association between the dependent and independent variables. Multicollinearity was assessed using the variance inflation factor (VIF) and no problem was detected (overall VIF = 1.67). The presence of association was declared based on the p-value (≤0.05), and the adjusted odds ratio with its respective 95% confidence interval was used to report the direction, as well as the strength of association. RESULTS About 41.43% (95% CI: 38.78%-44.13%) of severely malnourished infants and children have developed anemia, of which around half (47%) of them were under six months old. Rural residence (AOR = 1.56; 95% CI: 1.14-2.12) and HIV infection (AOR = 2.00; 95% CI: 1.04-3.86) were significantly associated with higher odds of anemia. Furthermore, being exclusively breastfed (AOR = 0.57; 95% CI 0.39-0.83) remarkably reduced the likelihood of anemia. CONCLUSIONS This data confirms that anemia among severely malnourished infants and children is a public health problem in the Amhara region. Infants younger than six months were at a higher risk of anemia. Being a rural resident and contracting HIV infection have elevated the occurrence of anemia, whereas being exclusively breastfed decreased the risk. Therefore, the study gives an insight to policymakers and planners to strengthen the existing exclusive breastfeeding practice. Strategies being practiced to prevent HIV transmission and early detection, as well as treatment, should also be strengthened. Furthermore, mothers/caretakers of infants and children residing in the rural areas deserve special attention through delivering nutrition education.
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Affiliation(s)
- Wubet Worku Takele
- Department of Community Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Adhanom Gebreegziabher Baraki
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Haileab Fekadu Wolde
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Hanna Demelash Desyibelew
- Department of Human Nutrition, College of Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Behailu Tariku Derseh
- Department of Public Health, College of Medicine and Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia
| | - Abel Fekadu Dadi
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Department of Epidemiology and Biostatistics, Flinders University, Health Sciences Building, Sturt Road, Bedford Park, Adelaide, SA 5001, Australia
| | - Eskedar Getie Mekonnen
- Departent of Reproductive and Child Health, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Temesgen Yihunie Akalu
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Gelaye SS, Yenit MK, Baraki AG. Rural Vaccination Coverage Among Children Aged 12-23 Months Was Higher Than the Urban Counterparts: A Comparative Cross-Sectional Study in Pawi District, Ethiopia. Pediatric Health Med Ther 2021; 12:119-127. [PMID: 33776507 PMCID: PMC7989052 DOI: 10.2147/phmt.s299064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 03/01/2021] [Indexed: 11/23/2022]
Abstract
Background In developing countries like Ethiopia, about 3 million children's deaths are attributed to vaccine-preventable diseases. Studies especially that try to explain the urban to rural vaccination coverage discrepancy are limited in the study area. This study aimed to assess full vaccination coverage and associated factors among children aged 12-23 months in rural and urban kebeles of Pawi district. Methods A community-based comparative cross-sectional study among urban and rural kebeles was conducted. A multistage sampling method was used to select 456 rural and 229 urban. Data were collected from mothers/caregivers using interviewer-administered questionnaires and vaccination cards. Full vaccination coverage was estimated for both urban and rural kebeles. Multivariable logistic regression analysis was used to identify factors associated with full vaccination. Adjusted Odds Ratio with a 95% confidence interval was reported. Results Full vaccination coverage was 67% (95% CI 63% -71%) and 60% (95% CI: 54% -66%) among rural and urban residents, respectively. Educational status of the father (AOR=2.69; 95% CI, 1.61-4.48), using postnatal care (PNC) (AOR=2.60; 95% CI, 1.58-4.29), discussion on side effect and contraindications of vaccines (AOR=1.82 95% CI, 1.16-2.88), and Institutional delivery (AOR=4.39, 95% CI 2.17-8.87) were factors significantly associated with full vaccination among rural children, whereas using Knowledge on immunization schedules (AOR=1.92 95% CI, 1.03-3.60), PNC (AOR=3.19; 95% CI, 1.57-6.47), discussion on side effects and contraindications of vaccines (AOR=2.75; 95% CI, 1.4-5.3) were notably associated with full vaccination among urban children. Conclusion The study reveals vaccination coverage was higher in rural compared to urban kebeles but it is still far below the WHO recommended target. Therefore interventions shall be made to improve the coverage especially by using the identified factors like improving PNC service and promoting institutional delivery and health education.
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Affiliation(s)
- Smeneh Sintayehu Gelaye
- Department of Maternal and Child Health, BenshangulGumuz Health Office, BenshangulGumuz, Ethiopia
| | - Melaku Kindie Yenit
- Department of Epidemiology and Biostatistics, College of Medicine and Health Sciences, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Adhanom Gebreegziabher Baraki
- Department of Epidemiology and Biostatistics, College of Medicine and Health Sciences, Institute of Public Health, University of Gondar, Gondar, Ethiopia
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Geremew BM, Gelaye KA, Melesse AW, Akalu TY, Baraki AG. Factors Affecting Under-Five Mortality in Ethiopia: A Multilevel Negative Binomial Model. Pediatric Health Med Ther 2021; 11:525-534. [PMID: 33408551 PMCID: PMC7781031 DOI: 10.2147/phmt.s290715] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 12/18/2020] [Indexed: 12/03/2022] Open
Abstract
Purpose Even though remarkable declines in under-five mortality rates noticed globally, nearly 5.6 million children still die annually before celebrating their fifth birthday. The 2016 Ethiopian Demographic and Health Survey (EDHS) report revealed that 67 children per 1000 live births died before the fifth birthday. This study aimed at determining factors affecting under-five mortality in Ethiopia using EDHS, 2016. Materials and Methods The data were retrieved from the EDHS 2016, and a total weighted number of 11,023 under-five children were included. Descriptive statistics were reported using tables, graphs, and texts. A multilevel negative binomial regression model was fitted, and adjusted incidence rate (ARR) with a 95% confidence interval (CI) and a p-value <0.05 were reported. The deviance test was used to check the goodness of fit. Results Mother attained higher education (ARR=0.25, 95% CI: 0.10–0.66), female-headed household (ARR=1.32, 95% CI: 1.05–1.66), age of household head (AIRR=1.07, 95% CI: 1.03,1.11), preceding birth interval ≥48 months (ARR=0.51, 95% CI: 0.42–0.61), child who had history of diarrhea (ARR=1.23, 95% CI: 1.08–1.41), multiple birth type (ARR=1.80, 95% CI: 1.34–2.42), mothers who delivered in health facility (ARR=0.86, 95% CI: 0.73,0.94), residents of Addis Ababa (ARR=0.52, 95% CI: 0.28–0.98), and Amhara region (ARR=1.43, 95% CI: 1.09, 1.88) were statistically significant with the number of under-five mortality. Conclusion In this study, under-five mortality remains a public health problem in Ethiopia. Educational status of the mother, women delivered at health institution, preceding birth interval 24–35 and ≥48, and residents of Addis Ababa reduced the incidence of under-five mortality. On the other hand, being a female household head, age of mother at first giving birth, being employed, having multiple births, and childhood diarrhea were associated with a higher incidence of under-five mortality. This finding suggests that enhancing opportunities to female education, addressing regional disparities, and encouraging mothers to deliver at health institutions will help to reduce the burden of under-five mortality.
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Affiliation(s)
- Bisrat Misganew Geremew
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Kassahun Alemu Gelaye
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Alemakef Wagnew Melesse
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Temesgen Yihunie Akalu
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Adhanom Gebreegziabher Baraki
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Berhe DA, Yenit MK, Baraki AG. The Burden of Hypertension and Associated Factors Among Adults Visiting the Adult Outpatient Department at Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia, 2016. Vasc Health Risk Manag 2020; 16:545-552. [PMID: 33364773 PMCID: PMC7751300 DOI: 10.2147/vhrm.s285900] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Accepted: 12/09/2020] [Indexed: 01/13/2023] Open
Abstract
Background Hypertension is a global health concern that can lead to cardiovascular disease and death. In Ethiopia, the risks for cardiovascular disease have been increasing dramatically. But due to the high burden of communicable diseases, less emphasis is given to non-communicable diseases like hypertension. This study aimed to fill the information gap by determining the prevalence and the key determinants of hypertension in the study area. Methods Institution-based cross-sectional study was conducted in Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia from September to October 2016. A total of 414 adults visiting medical OPDs were selected using systematic random sampling. Data were collected by blood pressure measurements and a pre-tested structured questionnaire. Descriptive statistics were computed. Multivariable logistic regression analysis was used to determine the adjusted odds ratio with a 95% confidence interval. The goodness of fit of the model was also checked by Hosmer and Lemeshow test. Results The overall prevalence of hypertension in the study area was 38.9% (95% CI: 34.1-43.7). Age above 55 years (AOR = 3.33, 95% CI: 1.88-5.90), family history of hypertension (AOR = 2.71, 95% CI: 1.37-5.36), diabetes (AOR = 4.15, 95% CI 1.77-9.72), obesity (AOR = 5.50, 95% CI: 2.07-14.62), knee arthritis (AOR = 1.71, 95% CI: 1.24, 2.36), and not walking at least for 10 minutes continuously on daily basis (AOR = 2.86, 95% CI: 1.15 -7.12) were found to be independent predictors of hypertension. Conclusion Prevalence of hypertension was high in the study area, and a large proportion of them were also newly diagnosed. Factors like age, family history of hypertension, diabetes, obesity, knee arthritis, and exercise were found to be independent predictors of hypertension. Therefore, we recommend people who have these risk factors to have screening for hypertension.
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Affiliation(s)
- Daniel Awraris Berhe
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Melaku Kindie Yenit
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Adhanom Gebreegziabher Baraki
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Vos T, Lim SS, Abbafati C, Abbas KM, Abbasi M, Abbasifard M, Abbasi-Kangevari M, Abbastabar H, Abd-Allah F, Abdelalim A, Abdollahi M, Abdollahpour I, Abolhassani H, Aboyans V, Abrams EM, Abreu LG, Abrigo MRM, Abu-Raddad LJ, Abushouk AI, Acebedo A, Ackerman IN, Adabi M, Adamu AA, Adebayo OM, Adekanmbi V, Adelson JD, Adetokunboh OO, Adham D, Afshari M, Afshin A, Agardh EE, Agarwal G, Agesa KM, Aghaali M, Aghamir SMK, Agrawal A, Ahmad T, Ahmadi A, Ahmadi M, Ahmadieh H, Ahmadpour E, Akalu TY, Akinyemi RO, Akinyemiju T, Akombi B, Al-Aly Z, Alam K, Alam N, Alam S, Alam T, Alanzi TM, Albertson SB, Alcalde-Rabanal JE, Alema NM, Ali M, Ali S, Alicandro G, Alijanzadeh M, Alinia C, Alipour V, Aljunid SM, Alla F, Allebeck P, Almasi-Hashiani A, Alonso J, Al-Raddadi RM, Altirkawi KA, Alvis-Guzman N, Alvis-Zakzuk NJ, Amini S, Amini-Rarani M, Aminorroaya A, Amiri F, Amit AML, Amugsi DA, Amul GGH, Anderlini D, Andrei CL, Andrei T, Anjomshoa M, Ansari F, Ansari I, Ansari-Moghaddam A, Antonio CAT, Antony CM, Antriyandarti E, Anvari D, Anwer R, Arabloo J, Arab-Zozani M, Aravkin AY, Ariani F, Ärnlöv J, Aryal KK, Arzani A, Asadi-Aliabadi M, Asadi-Pooya AA, Asghari B, Ashbaugh C, Atnafu DD, Atre SR, Ausloos F, Ausloos M, Ayala Quintanilla BP, Ayano G, Ayanore MA, Aynalem YA, Azari S, Azarian G, Azene ZN, Babaee E, Badawi A, Bagherzadeh M, Bakhshaei MH, Bakhtiari A, Balakrishnan S, Balalla S, Balassyano S, Banach M, Banik PC, Bannick MS, Bante AB, Baraki AG, Barboza MA, Barker-Collo SL, Barthelemy CM, Barua L, Barzegar A, Basu S, Baune BT, Bayati M, Bazmandegan G, Bedi N, Beghi E, Béjot Y, Bello AK, Bender RG, Bennett DA, Bennitt FB, Bensenor IM, Benziger CP, Berhe K, Bernabe E, Bertolacci GJ, Bhageerathy R, Bhala N, Bhandari D, Bhardwaj P, Bhattacharyya K, Bhutta ZA, Bibi S, Biehl MH, Bikbov B, Bin Sayeed MS, Biondi A, Birihane BM, Bisanzio D, Bisignano C, Biswas RK, Bohlouli S, Bohluli M, Bolla SRR, Boloor A, Boon-Dooley AS, Borges G, Borzì AM, Bourne R, Brady OJ, Brauer M, Brayne C, Breitborde NJK, Brenner H, Briant PS, Briggs AM, Briko NI, Britton GB, Bryazka D, Buchbinder R, Bumgarner BR, Busse R, Butt ZA, Caetano dos Santos FL, Cámera LLAA, Campos-Nonato IR, Car J, Cárdenas R, Carreras G, Carrero JJ, Carvalho F, Castaldelli-Maia JM, Castañeda-Orjuela CA, Castelpietra G, Castle CD, Castro F, Catalá-López F, Causey K, Cederroth CR, Cercy KM, Cerin E, Chandan JS, Chang AR, Charlson FJ, Chattu VK, Chaturvedi S, Chimed-Ochir O, Chin KL, Cho DY, Christensen H, Chu DT, Chung MT, Cicuttini FM, Ciobanu LG, Cirillo M, Collins EL, Compton K, Conti S, Cortesi PA, Costa VM, Cousin E, Cowden RG, Cowie BC, Cromwell EA, Cross DH, Crowe CS, Cruz JA, Cunningham M, Dahlawi SMA, Damiani G, Dandona L, Dandona R, Darwesh AM, Daryani A, Das JK, Das Gupta R, das Neves J, Dávila-Cervantes CA, Davletov K, De Leo D, Dean FE, DeCleene NK, Deen A, Degenhardt L, Dellavalle RP, Demeke FM, Demsie DG, Denova-Gutiérrez E, Dereje ND, Dervenis N, Desai R, Desalew A, Dessie GA, Dharmaratne SD, Dhungana GP, Dianatinasab M, Diaz D, Dibaji Forooshani ZS, Dingels ZV, Dirac MA, Djalalinia S, Do HT, Dokova K, Dorostkar F, Doshi CP, Doshmangir L, Douiri A, Doxey MC, Driscoll TR, Dunachie SJ, Duncan BB, Duraes AR, Eagan AW, Ebrahimi Kalan M, Edvardsson D, Ehrlich JR, El Nahas N, El Sayed I, El Tantawi M, Elbarazi I, Elgendy IY, Elhabashy HR, El-Jaafary SI, Elyazar IRF, Emamian MH, Emmons-Bell S, Erskine HE, Eshrati B, Eskandarieh S, Esmaeilnejad S, Esmaeilzadeh F, Esteghamati A, Estep K, Etemadi A, Etisso AE, Farahmand M, Faraj A, Fareed M, Faridnia R, Farinha CSES, Farioli A, Faro A, Faruque M, Farzadfar F, Fattahi N, Fazlzadeh M, Feigin VL, Feldman R, Fereshtehnejad SM, Fernandes E, Ferrari AJ, Ferreira ML, Filip I, Fischer F, Fisher JL, Fitzgerald R, Flohr C, Flor LS, Foigt NA, Folayan MO, Force LM, Fornari C, Foroutan M, Fox JT, Freitas M, Fu W, Fukumoto T, Furtado JM, Gad MM, Gakidou E, Galles NC, Gallus S, Gamkrelidze A, Garcia-Basteiro AL, Gardner WM, Geberemariyam BS, Gebrehiwot AM, Gebremedhin KB, Gebreslassie AAAA, Gershberg Hayoon A, Gething PW, Ghadimi M, Ghadiri K, Ghafourifard M, Ghajar A, Ghamari F, Ghashghaee A, Ghiasvand H, Ghith N, Gholamian A, Gilani SA, Gill PS, Gitimoghaddam M, Giussani G, Goli S, Gomez RS, Gopalani SV, Gorini G, Gorman TM, Gottlich HC, Goudarzi H, Goulart AC, Goulart BNG, Grada A, Grivna M, Grosso G, Gubari MIM, Gugnani HC, Guimaraes ALS, Guimarães RA, Guled RA, Guo G, Guo Y, Gupta R, Haagsma JA, Haddock B, Hafezi-Nejad N, Hafiz A, Hagins H, Haile LM, Hall BJ, Halvaei I, Hamadeh RR, Hamagharib Abdullah K, Hamilton EB, Han C, Han H, Hankey GJ, Haro JM, Harvey JD, Hasaballah AI, Hasanzadeh A, Hashemian M, Hassanipour S, Hassankhani H, Havmoeller RJ, Hay RJ, Hay SI, Hayat K, Heidari B, Heidari G, Heidari-Soureshjani R, Hendrie D, Henrikson HJ, Henry NJ, Herteliu C, Heydarpour F, Hird TR, Hoek HW, Hole MK, Holla R, Hoogar P, Hosgood HD, Hosseinzadeh M, Hostiuc M, Hostiuc S, Househ M, Hoy DG, Hsairi M, Hsieh VCR, Hu G, Huda TM, Hugo FN, Huynh CK, Hwang BF, Iannucci VC, Ibitoye SE, Ikuta KS, Ilesanmi OS, Ilic IM, Ilic MD, Inbaraj LR, Ippolito H, Irvani SSN, Islam MM, Islam M, Islam SMS, Islami F, Iso H, Ivers RQ, Iwu CCD, Iyamu IO, Jaafari J, Jacobsen KH, Jadidi-Niaragh F, Jafari H, Jafarinia M, Jahagirdar D, Jahani MA, Jahanmehr N, Jakovljevic M, Jalali A, Jalilian F, James SL, Janjani H, Janodia MD, Jayatilleke AU, Jeemon P, Jenabi E, Jha RP, Jha V, Ji JS, Jia P, John O, John-Akinola YO, Johnson CO, Johnson SC, Jonas JB, Joo T, Joshi A, Jozwiak JJ, Jürisson M, Kabir A, Kabir Z, Kalani H, Kalani R, Kalankesh LR, Kalhor R, Kamiab Z, Kanchan T, Karami Matin B, Karch A, Karim MA, Karimi SE, Kassa GM, Kassebaum NJ, Katikireddi SV, Kawakami N, Kayode GA, Keddie SH, Keller C, Kereselidze M, Khafaie MA, Khalid N, Khan M, Khatab K, Khater MM, Khatib MN, Khayamzadeh M, Khodayari MT, Khundkar R, Kianipour N, Kieling C, Kim D, Kim YE, Kim YJ, Kimokoti RW, Kisa A, Kisa S, Kissimova-Skarbek K, Kivimäki M, Kneib CJ, Knudsen AKS, Kocarnik JM, Kolola T, Kopec JA, Kosen S, Koul PA, Koyanagi A, Kravchenko MA, Krishan K, Krohn KJ, Kuate Defo B, Kucuk Bicer B, Kumar GA, Kumar M, Kumar P, Kumar V, Kumaresh G, Kurmi OP, Kusuma D, Kyu HH, La Vecchia C, Lacey B, Lal DK, Lalloo R, Lam JO, Lami FH, Landires I, Lang JJ, Lansingh VC, Larson SL, Larsson AO, Lasrado S, Lassi ZS, Lau KMM, Lavados PM, Lazarus JV, Ledesma JR, Lee PH, Lee SWH, LeGrand KE, Leigh J, Leonardi M, Lescinsky H, Leung J, Levi M, Lewington S, Li S, Lim LL, Lin C, Lin RT, Linehan C, Linn S, Liu HC, Liu S, Liu Z, Looker KJ, Lopez AD, Lopukhov PD, Lorkowski S, Lotufo PA, Lucas TCD, Lugo A, Lunevicius R, Lyons RA, Ma J, MacLachlan JH, Maddison ER, Maddison R, Madotto F, Mahasha PW, Mai HT, Majeed A, Maled V, Maleki S, Malekzadeh R, Malta DC, Mamun AA, Manafi A, Manafi N, Manguerra H, Mansouri B, Mansournia MA, Mantilla Herrera AM, Maravilla JC, Marks A, Martins-Melo FR, Martopullo I, Masoumi SZ, Massano J, Massenburg BB, Mathur MR, Maulik PK, McAlinden C, McGrath JJ, McKee M, Mehndiratta MM, Mehri F, Mehta KM, Meitei WB, Memiah PTN, Mendoza W, Menezes RG, Mengesha EW, Mengesha MB, Mereke A, Meretoja A, Meretoja TJ, Mestrovic T, Miazgowski B, Miazgowski T, Michalek IM, Mihretie KM, Miller TR, Mills EJ, Mirica A, Mirrakhimov EM, Mirzaei H, Mirzaei M, Mirzaei-Alavijeh M, Misganaw AT, Mithra P, Moazen B, Moghadaszadeh M, Mohamadi E, Mohammad DK, Mohammad Y, Mohammad Gholi Mezerji N, Mohammadian-Hafshejani A, Mohammadifard N, Mohammadpourhodki R, Mohammed S, Mokdad AH, Molokhia M, Momen NC, Monasta L, Mondello S, Mooney MD, Moosazadeh M, Moradi G, Moradi M, Moradi-Lakeh M, Moradzadeh R, Moraga P, Morales L, Morawska L, Moreno Velásquez I, Morgado-da-Costa J, Morrison SD, Mosser JF, Mouodi S, Mousavi SM, Mousavi Khaneghah A, Mueller UO, Munro SB, Muriithi MK, Musa KI, Muthupandian S, Naderi M, Nagarajan AJ, Nagel G, Naghshtabrizi B, Nair S, Nandi AK, Nangia V, Nansseu JR, Nayak VC, Nazari J, Negoi I, Negoi RI, Netsere HBN, Ngunjiri JW, Nguyen CT, Nguyen J, Nguyen M, Nguyen M, Nichols E, Nigatu D, Nigatu YT, Nikbakhsh R, Nixon MR, Nnaji CA, Nomura S, Norrving B, Noubiap JJ, Nowak C, Nunez-Samudio V, Oţoiu A, Oancea B, Odell CM, Ogbo FA, Oh IH, Okunga EW, Oladnabi M, Olagunju AT, Olusanya BO, Olusanya JO, Oluwasanu MM, Omar Bali A, Omer MO, Ong KL, Onwujekwe OE, Orji AU, Orpana HM, Ortiz A, Ostroff SM, Otstavnov N, Otstavnov SS, Øverland S, Owolabi MO, P A M, Padubidri JR, Pakhare AP, Palladino R, Pana A, Panda-Jonas S, Pandey A, Park EK, Parmar PGK, Pasupula DK, Patel SK, Paternina-Caicedo AJ, Pathak A, Pathak M, Patten SB, Patton GC, Paudel D, Pazoki Toroudi H, Peden AE, Pennini A, Pepito VCF, Peprah EK, Pereira A, Pereira DM, Perico N, Pham HQ, Phillips MR, Pigott DM, Pilgrim T, Pilz TM, Pirsaheb M, Plana-Ripoll O, Plass D, Pokhrel KN, Polibin RV, Polinder S, Polkinghorne KR, Postma MJ, Pourjafar H, Pourmalek F, Pourmirza Kalhori R, Pourshams A, Poznańska A, Prada SI, Prakash V, Pribadi DRA, Pupillo E, Quazi Syed Z, Rabiee M, Rabiee N, Radfar A, Rafiee A, Rafiei A, Raggi A, Rahimi-Movaghar A, Rahman MA, Rajabpour-Sanati A, Rajati F, Ramezanzadeh K, Ranabhat CL, Rao PC, Rao SJ, Rasella D, Rastogi P, Rathi P, Rawaf DL, Rawaf S, Rawal L, Razo C, Redford SB, Reiner RC, Reinig N, Reitsma MB, Remuzzi G, Renjith V, Renzaho AMN, Resnikoff S, Rezaei N, Rezai MS, Rezapour A, Rhinehart PA, Riahi SM, Ribeiro ALP, Ribeiro DC, Ribeiro D, Rickard J, Roberts NLS, Roberts S, Robinson SR, Roever L, Rolfe S, Ronfani L, Roshandel G, Roth GA, Rubagotti E, Rumisha SF, Sabour S, Sachdev PS, Saddik B, Sadeghi E, Sadeghi M, Saeidi S, Safi S, Safiri S, Sagar R, Sahebkar A, Sahraian MA, Sajadi SM, Salahshoor MR, Salamati P, Salehi Zahabi S, Salem H, Salem MRR, Salimzadeh H, Salomon JA, Salz I, Samad Z, Samy AM, Sanabria J, Santomauro DF, Santos IS, Santos JV, Santric-Milicevic MM, Saraswathy SYI, Sarmiento-Suárez R, Sarrafzadegan N, Sartorius B, Sarveazad A, Sathian B, Sathish T, Sattin D, Sbarra AN, Schaeffer LE, Schiavolin S, Schmidt MI, Schutte AE, Schwebel DC, Schwendicke F, Senbeta AM, Senthilkumaran S, Sepanlou SG, Shackelford KA, Shadid J, Shahabi S, Shaheen AA, Shaikh MA, Shalash AS, Shams-Beyranvand M, Shamsizadeh M, Shannawaz M, Sharafi K, Sharara F, Sheena BS, Sheikhtaheri A, Shetty RS, Shibuya K, Shiferaw WS, Shigematsu M, Shin JI, Shiri R, Shirkoohi R, Shrime MG, Shuval K, Siabani S, Sigfusdottir ID, Sigurvinsdottir R, Silva JP, Simpson KE, Singh A, Singh JA, Skiadaresi E, Skou ST, Skryabin VY, Sobngwi E, Sokhan A, Soltani S, Sorensen RJD, Soriano JB, Sorrie MB, Soyiri IN, Sreeramareddy CT, Stanaway JD, Stark BA, Ştefan SC, Stein C, Steiner C, Steiner TJ, Stokes MA, Stovner LJ, Stubbs JL, Sudaryanto A, Sufiyan MB, Sulo G, Sultan I, Sykes BL, Sylte DO, Szócska M, Tabarés-Seisdedos R, Tabb KM, Tadakamadla SK, Taherkhani A, Tajdini M, Takahashi K, Taveira N, Teagle WL, Teame H, Tehrani-Banihashemi A, Teklehaimanot BF, Terrason S, Tessema ZT, Thankappan KR, Thomson AM, Tohidinik HR, Tonelli M, Topor-Madry R, Torre AE, Touvier M, Tovani-Palone MRR, Tran BX, Travillian R, Troeger CE, Truelsen TC, Tsai AC, Tsatsakis A, Tudor Car L, Tyrovolas S, Uddin R, Ullah S, Undurraga EA, Unnikrishnan B, Vacante M, Vakilian A, Valdez PR, Varughese S, Vasankari TJ, Vasseghian Y, Venketasubramanian N, Violante FS, Vlassov V, Vollset SE, Vongpradith A, Vukovic A, Vukovic R, Waheed Y, Walters MK, Wang J, Wang Y, Wang YP, Ward JL, Watson A, Wei J, Weintraub RG, Weiss DJ, Weiss J, Westerman R, Whisnant JL, Whiteford HA, Wiangkham T, Wiens KE, Wijeratne T, Wilner LB, Wilson S, Wojtyniak B, Wolfe CDA, Wool EE, Wu AM, Wulf Hanson S, Wunrow HY, Xu G, Xu R, Yadgir S, Yahyazadeh Jabbari SH, Yamagishi K, Yaminfirooz M, Yano Y, Yaya S, Yazdi-Feyzabadi V, Yearwood JA, Yeheyis TY, Yeshitila YG, Yip P, Yonemoto N, Yoon SJ, Yoosefi Lebni J, Younis MZ, Younker TP, Yousefi Z, Yousefifard M, Yousefinezhadi T, Yousuf AY, Yu C, Yusefzadeh H, Zahirian Moghadam T, Zaki L, Zaman SB, Zamani M, Zamanian M, Zandian H, Zangeneh A, Zastrozhin MS, Zewdie KA, Zhang Y, Zhang ZJ, Zhao JT, Zhao Y, Zheng P, Zhou M, Ziapour A, Zimsen SRM, Naghavi M, Murray CJL. Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 2020; 396:1204-1222. [PMID: 33069326 PMCID: PMC7567026 DOI: 10.1016/s0140-6736(20)30925-9] [Citation(s) in RCA: 6299] [Impact Index Per Article: 1574.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Revised: 02/27/2020] [Accepted: 04/14/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries. METHODS GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw values of the posterior distribution. FINDINGS Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates. After taking into account population growth and ageing, the absolute number of DALYs has remained stable. Since 2010, the pace of decline in global age-standardised DALY rates has accelerated in age groups younger than 50 years compared with the 1990-2010 time period, with the greatest annualised rate of decline occurring in the 0-9-year age group. Six infectious diseases were among the top ten causes of DALYs in children younger than 10 years in 2019: lower respiratory infections (ranked second), diarrhoeal diseases (third), malaria (fifth), meningitis (sixth), whooping cough (ninth), and sexually transmitted infections (which, in this age group, is fully accounted for by congenital syphilis; ranked tenth). In adolescents aged 10-24 years, three injury causes were among the top causes of DALYs: road injuries (ranked first), self-harm (third), and interpersonal violence (fifth). Five of the causes that were in the top ten for ages 10-24 years were also in the top ten in the 25-49-year age group: road injuries (ranked first), HIV/AIDS (second), low back pain (fourth), headache disorders (fifth), and depressive disorders (sixth). In 2019, ischaemic heart disease and stroke were the top-ranked causes of DALYs in both the 50-74-year and 75-years-and-older age groups. Since 1990, there has been a marked shift towards a greater proportion of burden due to YLDs from non-communicable diseases and injuries. In 2019, there were 11 countries where non-communicable disease and injury YLDs constituted more than half of all disease burden. Decreases in age-standardised DALY rates have accelerated over the past decade in countries at the lower end of the SDI range, while improvements have started to stagnate or even reverse in countries with higher SDI. INTERPRETATION As disability becomes an increasingly large component of disease burden and a larger component of health expenditure, greater research and development investment is needed to identify new, more effective intervention strategies. With a rapidly ageing global population, the demands on health services to deal with disabling outcomes, which increase with age, will require policy makers to anticipate these changes. The mix of universal and more geographically specific influences on health reinforces the need for regular reporting on population health in detail and by underlying cause to help decision makers to identify success stories of disease control to emulate, as well as opportunities to improve. FUNDING Bill & Melinda Gates Foundation.
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Murray CJL, Aravkin AY, Zheng P, Abbafati C, Abbas KM, Abbasi-Kangevari M, Abd-Allah F, Abdelalim A, Abdollahi M, Abdollahpour I, Abegaz KH, Abolhassani H, Aboyans V, Abreu LG, Abrigo MRM, Abualhasan A, Abu-Raddad LJ, Abushouk AI, Adabi M, Adekanmbi V, Adeoye AM, Adetokunboh OO, Adham D, Advani SM, Agarwal G, Aghamir SMK, Agrawal A, Ahmad T, Ahmadi K, Ahmadi M, Ahmadieh H, Ahmed MB, Akalu TY, Akinyemi RO, Akinyemiju T, Akombi B, Akunna CJ, Alahdab F, Al-Aly Z, Alam K, Alam S, Alam T, Alanezi FM, Alanzi TM, Alemu BW, Alhabib KF, Ali M, Ali S, Alicandro G, Alinia C, Alipour V, Alizade H, Aljunid SM, Alla F, Allebeck P, Almasi-Hashiani A, Al-Mekhlafi HM, Alonso J, Altirkawi KA, Amini-Rarani M, Amiri F, Amugsi DA, Ancuceanu R, Anderlini D, Anderson JA, Andrei CL, Andrei T, Angus C, Anjomshoa M, Ansari F, Ansari-Moghaddam A, Antonazzo IC, Antonio CAT, Antony CM, Antriyandarti E, Anvari D, Anwer R, Appiah SCY, Arabloo J, Arab-Zozani M, Ariani F, Armoon B, Ärnlöv J, Arzani A, Asadi-Aliabadi M, Asadi-Pooya AA, Ashbaugh C, Assmus M, Atafar Z, Atnafu DD, Atout MMW, Ausloos F, Ausloos M, Ayala Quintanilla BP, Ayano G, Ayanore MA, Azari S, Azarian G, Azene ZN, Badawi A, Badiye AD, Bahrami MA, Bakhshaei MH, Bakhtiari A, Bakkannavar SM, Baldasseroni A, Ball K, Ballew SH, Balzi D, Banach M, Banerjee SK, Bante AB, Baraki AG, Barker-Collo SL, Bärnighausen TW, Barrero LH, Barthelemy CM, Barua L, Basu S, Baune BT, Bayati M, Becker JS, Bedi N, Beghi E, Béjot Y, Bell ML, Bennitt FB, Bensenor IM, Berhe K, Berman AE, Bhagavathula AS, Bhageerathy R, Bhala N, Bhandari D, Bhattacharyya K, Bhutta ZA, Bijani A, Bikbov B, Bin Sayeed MS, Biondi A, Birihane BM, Bisignano C, Biswas RK, Bitew H, Bohlouli S, Bohluli M, Boon-Dooley AS, Borges G, Borzì AM, Borzouei S, Bosetti C, Boufous S, Braithwaite D, Breitborde NJK, Breitner S, Brenner H, Briant PS, Briko AN, Briko NI, Britton GB, Bryazka D, Bumgarner BR, Burkart K, Burnett RT, Burugina Nagaraja S, Butt ZA, Caetano dos Santos FL, Cahill LE, Cámera LLAA, Campos-Nonato IR, Cárdenas R, Carreras G, Carrero JJ, Carvalho F, Castaldelli-Maia JM, Castañeda-Orjuela CA, Castelpietra G, Castro F, Causey K, Cederroth CR, Cercy KM, Cerin E, Chandan JS, Chang KL, Charlson FJ, Chattu VK, Chaturvedi S, Cherbuin N, Chimed-Ochir O, Cho DY, Choi JYJ, Christensen H, Chu DT, Chung MT, Chung SC, Cicuttini FM, Ciobanu LG, Cirillo M, Classen TKD, Cohen AJ, Compton K, Cooper OR, Costa VM, Cousin E, Cowden RG, Cross DH, Cruz JA, Dahlawi SMA, Damasceno AAM, Damiani G, Dandona L, Dandona R, Dangel WJ, Danielsson AK, Dargan PI, Darwesh AM, Daryani A, Das JK, Das Gupta R, das Neves J, Dávila-Cervantes CA, Davitoiu DV, De Leo D, Degenhardt L, DeLang M, Dellavalle RP, Demeke FM, Demoz GT, Demsie DG, Denova-Gutiérrez E, Dervenis N, Dhungana GP, Dianatinasab M, Dias da Silva D, Diaz D, Dibaji Forooshani ZS, Djalalinia S, Do HT, Dokova K, Dorostkar F, Doshmangir L, Driscoll TR, Duncan BB, Duraes AR, Eagan AW, Edvardsson D, El Nahas N, El Sayed I, El Tantawi M, Elbarazi I, Elgendy IY, El-Jaafary SI, Elyazar IRF, Emmons-Bell S, Erskine HE, Eskandarieh S, Esmaeilnejad S, Esteghamati A, Estep K, Etemadi A, Etisso AE, Fanzo J, Farahmand M, Fareed M, Faridnia R, Farioli A, Faro A, Faruque M, Farzadfar F, Fattahi N, Fazlzadeh M, Feigin VL, Feldman R, Fereshtehnejad SM, Fernandes E, Ferrara G, Ferrari AJ, Ferreira ML, Filip I, Fischer F, Fisher JL, Flor LS, Foigt NA, Folayan MO, Fomenkov AA, Force LM, Foroutan M, Franklin RC, Freitas M, Fu W, Fukumoto T, Furtado JM, Gad MM, Gakidou E, Gallus S, Garcia-Basteiro AL, Gardner WM, Geberemariyam BS, Gebreslassie AAAA, Geremew A, Gershberg Hayoon A, Gething PW, Ghadimi M, Ghadiri K, Ghaffarifar F, Ghafourifard M, Ghamari F, Ghashghaee A, Ghiasvand H, Ghith N, Gholamian A, Ghosh R, Gill PS, Ginindza TGG, Giussani G, Gnedovskaya EV, Goharinezhad S, Gopalani SV, Gorini G, Goudarzi H, Goulart AC, Greaves F, Grivna M, Grosso G, Gubari MIM, Gugnani HC, Guimarães RA, Guled RA, Guo G, Guo Y, Gupta R, Gupta T, Haddock B, Hafezi-Nejad N, Hafiz A, Haj-Mirzaian A, Haj-Mirzaian A, Hall BJ, Halvaei I, Hamadeh RR, Hamidi S, Hammer MS, Hankey GJ, Haririan H, Haro JM, Hasaballah AI, Hasan MM, Hasanpoor E, Hashi A, Hassanipour S, Hassankhani H, Havmoeller RJ, Hay SI, Hayat K, Heidari G, Heidari-Soureshjani R, Henrikson HJ, Herbert ME, Herteliu C, Heydarpour F, Hird TR, Hoek HW, Holla R, Hoogar P, Hosgood HD, Hossain N, Hosseini M, Hosseinzadeh M, Hostiuc M, Hostiuc S, Househ M, Hsairi M, Hsieh VCR, Hu G, Hu K, Huda TM, Humayun A, Huynh CK, Hwang BF, Iannucci VC, Ibitoye SE, Ikeda N, Ikuta KS, Ilesanmi OS, Ilic IM, Ilic MD, Inbaraj LR, Ippolito H, Iqbal U, Irvani SSN, Irvine CMS, Islam MM, Islam SMS, Iso H, Ivers RQ, Iwu CCD, Iwu CJ, Iyamu IO, Jaafari J, Jacobsen KH, Jafari H, Jafarinia M, Jahani MA, Jakovljevic M, Jalilian F, James SL, Janjani H, Javaheri T, Javidnia J, Jeemon P, Jenabi E, Jha RP, Jha V, Ji JS, Johansson L, John O, John-Akinola YO, Johnson CO, Jonas JB, Joukar F, Jozwiak JJ, Jürisson M, Kabir A, Kabir Z, Kalani H, Kalani R, Kalankesh LR, Kalhor R, Kanchan T, Kapoor N, Karami Matin B, Karch A, Karim MA, Kassa GM, Katikireddi SV, Kayode GA, Kazemi Karyani A, Keiyoro PN, Keller C, Kemmer L, Kendrick PJ, Khalid N, Khammarnia M, Khan EA, Khan M, Khatab K, Khater MM, Khatib MN, Khayamzadeh M, Khazaei S, Kieling C, Kim YJ, Kimokoti RW, Kisa A, Kisa S, Kivimäki M, Knibbs LD, Knudsen AKS, Kocarnik JM, Kochhar S, Kopec JA, Korshunov VA, Koul PA, Koyanagi A, Kraemer MUG, Krishan K, Krohn KJ, Kromhout H, Kuate Defo B, Kumar GA, Kumar V, Kurmi OP, Kusuma D, La Vecchia C, Lacey B, Lal DK, Lalloo R, Lallukka T, Lami FH, Landires I, Lang JJ, Langan SM, Larsson AO, Lasrado S, Lauriola P, Lazarus JV, Lee PH, Lee SWH, LeGrand KE, Leigh J, Leonardi M, Lescinsky H, Leung J, Levi M, Li S, Lim LL, Linn S, Liu S, Liu S, Liu Y, Lo J, Lopez AD, Lopez JCF, Lopukhov PD, Lorkowski S, Lotufo PA, Lu A, Lugo A, Maddison ER, Mahasha PW, Mahdavi MM, Mahmoudi M, Majeed A, Maleki A, Maleki S, Malekzadeh R, Malta DC, Mamun AA, Manda AL, Manguerra H, Mansour-Ghanaei F, Mansouri B, Mansournia MA, Mantilla Herrera AM, Maravilla JC, Marks A, Martin RV, Martini S, Martins-Melo FR, Masaka A, Masoumi SZ, Mathur MR, Matsushita K, Maulik PK, McAlinden C, McGrath JJ, McKee M, Mehndiratta MM, Mehri F, Mehta KM, Memish ZA, Mendoza W, Menezes RG, Mengesha EW, Mereke A, Mereta ST, Meretoja A, Meretoja TJ, Mestrovic T, Miazgowski B, Miazgowski T, Michalek IM, Miller TR, Mills EJ, Mini GK, Miri M, Mirica A, Mirrakhimov EM, Mirzaei H, Mirzaei M, Mirzaei R, Mirzaei-Alavijeh M, Misganaw AT, Mithra P, Moazen B, Mohammad DK, Mohammad Y, Mohammad Gholi Mezerji N, Mohammadian-Hafshejani A, Mohammadifard N, Mohammadpourhodki R, Mohammed AS, Mohammed H, Mohammed JA, Mohammed S, Mokdad AH, Molokhia M, Monasta L, Mooney MD, Moradi G, Moradi M, Moradi-Lakeh M, Moradzadeh R, Moraga P, Morawska L, Morgado-da-Costa J, Morrison SD, Mosapour A, Mosser JF, Mouodi S, Mousavi SM, Mousavi Khaneghah A, Mueller UO, Mukhopadhyay S, Mullany EC, Musa KI, Muthupandian S, Nabhan AF, Naderi M, Nagarajan AJ, Nagel G, Naghavi M, Naghshtabrizi B, Naimzada MD, Najafi F, Nangia V, Nansseu JR, Naserbakht M, Nayak VC, Negoi I, Ngunjiri JW, Nguyen CT, Nguyen HLT, Nguyen M, Nigatu YT, Nikbakhsh R, Nixon MR, Nnaji CA, Nomura S, Norrving B, Noubiap JJ, Nowak C, Nunez-Samudio V, Oţoiu A, Oancea B, Odell CM, Ogbo FA, Oh IH, Okunga EW, Oladnabi M, Olagunju AT, Olusanya BO, Olusanya JO, Omer MO, Ong KL, Onwujekwe OE, Orpana HM, Ortiz A, Osarenotor O, Osei FB, Ostroff SM, Otstavnov N, Otstavnov SS, Øverland S, Owolabi MO, P A M, Padubidri JR, Palladino R, Panda-Jonas S, Pandey A, Parry CDH, Pasovic M, Pasupula DK, Patel SK, Pathak M, Patten SB, Patton GC, Pazoki Toroudi H, Peden AE, Pennini A, Pepito VCF, Peprah EK, Pereira DM, Pesudovs K, Pham HQ, Phillips MR, Piccinelli C, Pilz TM, Piradov MA, Pirsaheb M, Plass D, Polinder S, Polkinghorne KR, Pond CD, Postma MJ, Pourjafar H, Pourmalek F, Poznańska A, Prada SI, Prakash V, Pribadi DRA, Pupillo E, Quazi Syed Z, Rabiee M, Rabiee N, Radfar A, Rafiee A, Raggi A, Rahman MA, Rajabpour-Sanati A, Rajati F, Rakovac I, Ram P, Ramezanzadeh K, Ranabhat CL, Rao PC, Rao SJ, Rashedi V, Rathi P, Rawaf DL, Rawaf S, Rawal L, Rawassizadeh R, Rawat R, Razo C, Redford SB, Reiner RC, Reitsma MB, Remuzzi G, Renjith V, Renzaho AMN, Resnikoff S, Rezaei N, Rezaei N, Rezapour A, Rhinehart PA, Riahi SM, Ribeiro DC, Ribeiro D, Rickard J, Rivera JA, Roberts NLS, Rodríguez-Ramírez S, Roever L, Ronfani L, Room R, Roshandel G, Roth GA, Rothenbacher D, Rubagotti E, Rwegerera GM, Sabour S, Sachdev PS, Saddik B, Sadeghi E, Sadeghi M, Saeedi R, Saeedi Moghaddam S, Safari Y, Safi S, Safiri S, Sagar R, Sahebkar A, Sajadi SM, Salam N, Salamati P, Salem H, Salem MRR, Salimzadeh H, Salman OM, Salomon JA, Samad Z, Samadi Kafil H, Sambala EZ, Samy AM, Sanabria J, Sánchez-Pimienta TG, Santomauro DF, Santos IS, Santos JV, Santric-Milicevic MM, Saraswathy SYI, Sarmiento-Suárez R, Sarrafzadegan N, Sartorius B, Sarveazad A, Sathian B, Sathish T, Sattin D, Saxena S, Schaeffer LE, Schiavolin S, Schlaich MP, Schmidt MI, Schutte AE, Schwebel DC, Schwendicke F, Senbeta AM, Senthilkumaran S, Sepanlou SG, Serdar B, Serre ML, Shadid J, Shafaat O, Shahabi S, Shaheen AA, Shaikh MA, Shalash AS, Shams-Beyranvand M, Shamsizadeh M, Sharafi K, Sheikh A, Sheikhtaheri A, Shibuya K, Shield KD, Shigematsu M, Shin JI, Shin MJ, Shiri R, Shirkoohi R, Shuval K, Siabani S, Sierpinski R, Sigfusdottir ID, Sigurvinsdottir R, Silva JP, Simpson KE, Singh JA, Singh P, Skiadaresi E, Skou ST, Skryabin VY, Smith EUR, Soheili A, Soltani S, Soofi M, Sorensen RJD, Soriano JB, Sorrie MB, Soshnikov S, Soyiri IN, Spencer CN, Spotin A, Sreeramareddy CT, Srinivasan V, Stanaway JD, Stein C, Stein DJ, Steiner C, Stockfelt L, Stokes MA, Straif K, Stubbs JL, Sufiyan MB, Suleria HAR, Suliankatchi Abdulkader R, Sulo G, Sultan I, Szumowski Ł, Tabarés-Seisdedos R, Tabb KM, Tabuchi T, Taherkhani A, Tajdini M, Takahashi K, Takala JS, Tamiru AT, Taveira N, Tehrani-Banihashemi A, Temsah MH, Tesema GA, Tessema ZT, Thurston GD, Titova MV, Tohidinik HR, Tonelli M, Topor-Madry R, Topouzis F, Torre AE, Touvier M, Tovani-Palone MRR, Tran BX, Travillian R, Tsatsakis A, Tudor Car L, Tyrovolas S, Uddin R, Umeokonkwo CD, Unnikrishnan B, Upadhyay E, Vacante M, Valdez PR, van Donkelaar A, Vasankari TJ, Vasseghian Y, Veisani Y, Venketasubramanian N, Violante FS, Vlassov V, Vollset SE, Vos T, Vukovic R, Waheed Y, Wallin MT, Wang Y, Wang YP, Watson A, Wei J, Wei MYW, Weintraub RG, Weiss J, Werdecker A, West JJ, Westerman R, Whisnant JL, Whiteford HA, Wiens KE, Wolfe CDA, Wozniak SS, Wu AM, Wu J, Wulf Hanson S, Xu G, Xu R, Yadgir S, Yahyazadeh Jabbari SH, Yamagishi K, Yaminfirooz M, Yano Y, Yaya S, Yazdi-Feyzabadi V, Yeheyis TY, Yilgwan CS, Yilma MT, Yip P, Yonemoto N, Younis MZ, Younker TP, Yousefi B, Yousefi Z, Yousefinezhadi T, Yousuf AY, Yu C, Yusefzadeh H, Zahirian Moghadam T, Zamani M, Zamanian M, Zandian H, Zastrozhin MS, Zhang Y, Zhang ZJ, Zhao JT, Zhao XJG, Zhao Y, Zhou M, Ziapour A, Zimsen SRM, Brauer M, Afshin A, Lim SS. Global burden of 87 risk factors in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 2020; 396:1223-1249. [PMID: 33069327 PMCID: PMC7566194 DOI: 10.1016/s0140-6736(20)30752-2] [Citation(s) in RCA: 3234] [Impact Index Per Article: 808.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 03/21/2020] [Accepted: 03/23/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Rigorous analysis of levels and trends in exposure to leading risk factors and quantification of their effect on human health are important to identify where public health is making progress and in which cases current efforts are inadequate. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 provides a standardised and comprehensive assessment of the magnitude of risk factor exposure, relative risk, and attributable burden of disease. METHODS GBD 2019 estimated attributable mortality, years of life lost (YLLs), years of life lived with disability (YLDs), and disability-adjusted life-years (DALYs) for 87 risk factors and combinations of risk factors, at the global level, regionally, and for 204 countries and territories. GBD uses a hierarchical list of risk factors so that specific risk factors (eg, sodium intake), and related aggregates (eg, diet quality), are both evaluated. This method has six analytical steps. (1) We included 560 risk-outcome pairs that met criteria for convincing or probable evidence on the basis of research studies. 12 risk-outcome pairs included in GBD 2017 no longer met inclusion criteria and 47 risk-outcome pairs for risks already included in GBD 2017 were added based on new evidence. (2) Relative risks were estimated as a function of exposure based on published systematic reviews, 81 systematic reviews done for GBD 2019, and meta-regression. (3) Levels of exposure in each age-sex-location-year included in the study were estimated based on all available data sources using spatiotemporal Gaussian process regression, DisMod-MR 2.1, a Bayesian meta-regression method, or alternative methods. (4) We determined, from published trials or cohort studies, the level of exposure associated with minimum risk, called the theoretical minimum risk exposure level. (5) Attributable deaths, YLLs, YLDs, and DALYs were computed by multiplying population attributable fractions (PAFs) by the relevant outcome quantity for each age-sex-location-year. (6) PAFs and attributable burden for combinations of risk factors were estimated taking into account mediation of different risk factors through other risk factors. Across all six analytical steps, 30 652 distinct data sources were used in the analysis. Uncertainty in each step of the analysis was propagated into the final estimates of attributable burden. Exposure levels for dichotomous, polytomous, and continuous risk factors were summarised with use of the summary exposure value to facilitate comparisons over time, across location, and across risks. Because the entire time series from 1990 to 2019 has been re-estimated with use of consistent data and methods, these results supersede previously published GBD estimates of attributable burden. FINDINGS The largest declines in risk exposure from 2010 to 2019 were among a set of risks that are strongly linked to social and economic development, including household air pollution; unsafe water, sanitation, and handwashing; and child growth failure. Global declines also occurred for tobacco smoking and lead exposure. The largest increases in risk exposure were for ambient particulate matter pollution, drug use, high fasting plasma glucose, and high body-mass index. In 2019, the leading Level 2 risk factor globally for attributable deaths was high systolic blood pressure, which accounted for 10·8 million (95% uncertainty interval [UI] 9·51-12·1) deaths (19·2% [16·9-21·3] of all deaths in 2019), followed by tobacco (smoked, second-hand, and chewing), which accounted for 8·71 million (8·12-9·31) deaths (15·4% [14·6-16·2] of all deaths in 2019). The leading Level 2 risk factor for attributable DALYs globally in 2019 was child and maternal malnutrition, which largely affects health in the youngest age groups and accounted for 295 million (253-350) DALYs (11·6% [10·3-13·1] of all global DALYs that year). The risk factor burden varied considerably in 2019 between age groups and locations. Among children aged 0-9 years, the three leading detailed risk factors for attributable DALYs were all related to malnutrition. Iron deficiency was the leading risk factor for those aged 10-24 years, alcohol use for those aged 25-49 years, and high systolic blood pressure for those aged 50-74 years and 75 years and older. INTERPRETATION Overall, the record for reducing exposure to harmful risks over the past three decades is poor. Success with reducing smoking and lead exposure through regulatory policy might point the way for a stronger role for public policy on other risks in addition to continued efforts to provide information on risk factor harm to the general public. FUNDING Bill & Melinda Gates Foundation.
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Baraki AG, Tessema GM, Demeke EA. High burden of depression among cancer patients on chemotherapy in University of Gondar comprehensive hospital and Felege Hiwot referral hospital, Northwest Ethiopia. PLoS One 2020; 15:e0237837. [PMID: 32822434 PMCID: PMC7446783 DOI: 10.1371/journal.pone.0237837] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 08/04/2020] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION Cancer, the most stressful event a person may experience often triggers depression. Depression among these groups of people, in turn, affects chemotherapy adherence, length of hospitalization, quality of life and cancer treatment outcome. Even though the problem is enormous studies that address it are limited. Therefore this study was conducted to determine the prevalence of depression and associated factors among cancer patients on chemotherapy in Felege-Hiwot referral hospital and University of Gondar referral hospital, Northwest Ethiopia. METHODS An institution-based cross-sectional study was conducted from April to May 2019. A total of 302 cancer patients on chemotherapy were included. Depression was assessed using the patient health questionnaire (PHQ-9). Binary logistic regression was used to select variables and determine Crude Odds Ratio (COR). Variables with P value < 0.2 were entered into multivariable logistic regression. Adjusted Odds Ratio (AOR) with 95% confidence intervals for variables with P-value < 0.05 was estimated to show factors affecting depression among cancer patients. The fitness of the model was checked by using the Hosmer-Lemeshow goodness-of-fit test. RESULTS The prevalence of depression among cancer patients on chemotherapy was 70.86% (95% CI: 65.38, 75.92). Educational status of college and above (AOR = 0.1, 95% CI: 0.02, 0.43), Jobless (AOR = 0.15, 95% CI: 0.04, 0.58), Underweight(AOR = 2.39, 95% CI: 1.10, 5.19)chemotherapy duration ≥ 6 months or more (AOR = 2.36, 95% CI: 1.16, 4.79) were notably associated with depression. CONCLUSION The burden of depression among cancer patients in this study was high. We recommend concerned bodies working to curve the problem to intervene based on the identified risk factors. Improving educational status, reducing work stress and maintaining normal weight would reduce depression.
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Affiliation(s)
- Adhanom Gebreegziabher Baraki
- Department of Epidemiology and Biostatistics, College of Medicine and Health Sciences, Institute of Public Health, University of Gondar, Gondar, Ethiopia
- * E-mail:
| | - Getahun Mengistu Tessema
- Department of Internal Medicine, College of Medicine and Health Sciences, School of Medicine, University of Gondar, Gondar, Ethiopia
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Gontie GB, Wolde HF, Baraki AG. Prevalence and associated factors of malaria among pregnant women in Sherkole district, Benishangul Gumuz regional state, West Ethiopia. BMC Infect Dis 2020; 20:573. [PMID: 32758164 PMCID: PMC7405459 DOI: 10.1186/s12879-020-05289-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 07/26/2020] [Indexed: 12/02/2022] Open
Abstract
Background Malaria during pregnancy leads to serious adverse effects on mothers and the fetus. Approximately 25 million pregnant women in sub-Saharan Africa live at risk of malaria. This study would help to achieve Sustainable Development Goals (SDGs) by improving programs that deal with the prevention of malaria. Therefore, this study aimed to assess the prevalence and associated factors of malaria among pregnant women. Methods A community-based cross-sectional study was conducted from July to August 2018 in Sherkole district, West Ethiopia. A multi-stage sampling technique was used to select 504 pregnant women. The interviewer-administered semi-structured questionnaire was used for data collection. Malaria was also diagnosed using a rapid diagnostic test. The data was entered using EPI info version 7.2.2.2 and transferred to SPSS version 20 for analysis. Descriptive statistics were done using frequency and percentages. Both bivariable and multivariable logistic regression models were employed. Variables having p-value < 0.2 were included in the final multivariable model. Variables having p-values < 0.05 from the multivariable model were considered to be significantly associated with the dependent variable. The adjusted odds ratio with its 95% confidence interval (CI) was used as a measure of association. Results Of the total 498 pregnant women who participated in this study, 51(10.2, 95% CI: 7.72–13.24) were found to have malaria. Of these, 46 (90.2%) and 5 (9.8%) were caused by Plasmodium falciparum and Plasmodium vivax, respectively. Decreasing Age (Adjusted Odds Ratio (AOR) 0.78; 95% CI 0.67–0.911), not using insecticide-treated bed net (ITN) (AOR 12.5; 95% CI 4.86–32.21), lack of consultation and health education about malaria prevention (AOR 7.18; 95% CI 2.74–18.81), being on second-trimester pregnancy (AOR 7.58; 95% CI 2.84–20.2), gravidae II (AOR 5.99; 95% CI 1.68–21.44) were found to be significantly associated with malaria during pregnancy. Conclusion Malaria is still a public health problem among pregnant women in the Sherkole district. Age, ITN use, gravidity, gestational age, and health education had a significant association with malaria. Screening pregnant women for asymptomatic malaria infection and educating and consulting on the appropriate malaria preventive methods shall be provided.
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Affiliation(s)
| | - Haileab Fekadu Wolde
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Adhanom Gebreegziabher Baraki
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Baraki AG, Akalu TY, Wolde HF, Lakew AM, Gonete KA. Factors affecting infant mortality in the general population: evidence from the 2016 Ethiopian demographic and health survey (EDHS); a multilevel analysis. BMC Pregnancy Childbirth 2020; 20:299. [PMID: 32414348 PMCID: PMC7229626 DOI: 10.1186/s12884-020-03002-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 05/08/2020] [Indexed: 11/28/2022] Open
Abstract
Background Infant mortality is one of the leading public health problems globally; the problem is even more staggering in low-income countries. In Ethiopia seven in ten child deaths occurred during infancy in 2016. Even though the problem is devastating, updated information about the major determinants of infant mortality which is done on a countrywide representative sample is lacking. Therefore, this study was aimed to identify factors affecting infant mortality among the general population of Ethiopia, 2016. Methods A Community-based cross-sectional study was conducted in all regions of Ethiopia from January 18 to June 27, 2016. A total of 10,641 live births were included in the analysis. Data were analyzed and reported with both descriptive and analytic statistics. Bivariable and multivariable multilevel logistic regression models were fitted by accounting correlation of individuals within a cluster. Adjusted odds ratio (AOR) with 95% confidence interval was reported to show the strength of the association and its significance. Results A total of 10,641 live-births from the Ethiopian demographic and health survey (EDHS) data were included in the analysis. Being male infant (AOR = 1.51; 1.25, 1.82), Multiple birth (AOR = 5.49; 95% CI, 3.88–7.78), Preterm (AOR = 8.47; 95% CI 5.71, 12.57), rural residents (AOR = 1.76; 95% CI; 1.16, 2.67), from Somali region (AOR = 2.07; 1.29, 3.33), Harari (AOR = 2.14; 1.22, 3.75) and Diredawa (AOR = 1.91; 1.04, 3.51) were found to be statistically significantly associated with infant mortality. Conclusion The study has assessed the determinants of infant mortality based on EDHS data. Sex of the child, multiple births, prematurity, and residence were notably associated with infant mortality. The risk of infant mortality has also shown differences across different regions. Since infant mortality is still major public health problem interventions shall be done giving more attention to infants who were delivered multiple and who are preterm.
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Affiliation(s)
- Adhanom Gebreegziabher Baraki
- Department of Epidemiology and Biostatistics, University of Gondar, College of Medicine and Health Sciences, Institute of Public Health, Gondar, Ethiopia.
| | - Temesgen Yihunie Akalu
- Department of Epidemiology and Biostatistics, University of Gondar, College of Medicine and Health Sciences, Institute of Public Health, Gondar, Ethiopia
| | - Haileab Fekadu Wolde
- Department of Epidemiology and Biostatistics, University of Gondar, College of Medicine and Health Sciences, Institute of Public Health, Gondar, Ethiopia
| | - Ayenew Molla Lakew
- Department of Epidemiology and Biostatistics, University of Gondar, College of Medicine and Health Sciences, Institute of Public Health, Gondar, Ethiopia
| | - Kedir Abdela Gonete
- Department of Human Nutrition, University of Gondar, College of Medicine and Health Sciences, Institute of Public Health, Gondar, Ethiopia
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Dadi AF, Akalu TY, Baraki AG, Wolde HF. Epidemiology of postnatal depression and its associated factors in Africa: A systematic review and meta-analysis. PLoS One 2020; 15:e0231940. [PMID: 32343736 PMCID: PMC7188237 DOI: 10.1371/journal.pone.0231940] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 04/05/2020] [Indexed: 11/19/2022] Open
Abstract
Introduction Postnatal depression (PND) is a major cause of negative health-related behaviors and outcomes during infancy, childhood and adolescent period. In Africa, the burden of postnatal depression is high. However, it is under-investigated hence under-treated. To fill this information gap and to advise further interventions, we aimed at analyzing its epidemiology in Africa. Methods We searched observational studies conducted in Africa and published in between 01/01/2007 and 30/06/2018 in CINHAL, MEDLINE, PsycINFO, Psychiatry online, PubMed, SCOPES, and Emcare databases. We assessed the quality of the studies using the Newcastle Ottawa Scale (NOS) and included studies with good quality. We evaluated the heterogeneity using the Higgins I2 statistics. We used a random-effects model to pool estimates. We assessed publication bias using the funnel plot and Egger's test statistics and adjusted using Tweedie’s and Duval Trim and Fill analysis. The protocol has been registered in the PROSPERO (Protocol No. CRD42018100461). Results Nineteen studies involving 40,953 postnatal mothers were part of this systematic review and meta-analysis. The overall pooled prevalence of PND was 16.84% (95% CI: 14.49% –19.19%). The odds of having PND was higher among women with a poor obstetric condition (POR = 2.11; 95% CI: 1.11–4.01) and history of adverse birth and infant health outcomes (POR = 2.85; 95% CI: 1.29–6.25). Having a history of common mental health disorders (POR = 2.47; 95% CI: 1.51–4.04), poor social support (POR = 2.06; 95% CI: 1.05–4.05), lower economic status (POR = 2.38; 95% CI: 1.75–3.23), and those who had exposure to a different form of intimate partner violence (POR = 2.87; 95% CI: 1.60–5.16) had higher odds of PND. Conclusion While robust prevalence studies are scarce, our review indicated a high prevalence rate of postnatal depression. The analysis also identified postpartum women at increased risk of PND. Therefore, there is a need to design and escalate comprehensive strategies to decrease its burden, focusing on those women at risk of PND.
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Affiliation(s)
- Abel Fekadu Dadi
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine & Health Sciences, University of Gondar, Gondar, Ethiopia
- College of Medicine and Public Health, Discipline of Public Health, Flinders University, Adelaide, Australia
| | - Temesgen Yihunie Akalu
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine & Health Sciences, University of Gondar, Gondar, Ethiopia
- * E-mail:
| | - Adhanom Gebreegziabher Baraki
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine & Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Haileab Fekadu Wolde
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine & Health Sciences, University of Gondar, Gondar, Ethiopia
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Dadi AF, Wolde HF, Baraki AG, Akalu TY. Epidemiology of antenatal depression in Africa: a systematic review and meta-analysis. BMC Pregnancy Childbirth 2020; 20:251. [PMID: 32345263 PMCID: PMC7189721 DOI: 10.1186/s12884-020-02929-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 04/07/2020] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Antenatal depression is a serious problem worldwide that has devastating consequences not only for the mother but also for the child and family. The pooled evidence regarding the prevalence and associated factors of antenatal depression is rare in Africa. Hence this review aimed to investigate the prevalence and associated factors of antenatal depression in Africa. METHODS We searched CINHAL, MEDLINE, PsycINFO, Psychiatry online, PubMed, SCOPES, and Emcare databases for English written observational studies conducted in Africa from 2007 to 2018.Quality of studies was assessed using the Newcastle Ottawa Scale (NOS), and studies with good quality were included in the final review. Heterogeneity across studies was assessed using the I2 and Higgins test. Publication bias was checked using Funnel plot symmetry, and Egger's regression test and adjustment was made by using Duval and Tweedie's Trim and Fill analysis. A random effect Meta-analysis was employed to determine the pooled estimates with 95% confidence interval (CI). Stata 14 was used for analysis. The review protocol has been registered in PROSPERO number CRD42018106717. RESULT Of the 175 studies identified, 28 studies with an overall sample size of 17,938 were included. According to the random effect model following trim and fill analysis, the pooled prevalence of antenatal depression in Africa was 26.3% (95%CI: 22.2, 30.4%). Economic difficulties [POR = 1.87;95%CI:1.25,2.78,I2 = 88.1%], unfavorable marital condition [POR = 4.17;95% CI:1.75, 9.94, I2 = 81.2%], poor support from relatives [POR = 1.36;95% CI:1.18, 1.56, I2 = 78.0%], bad obstetric history [POR = 2.30;95% CI:1.81, 2.92), I2 = 81.7%], and history of mental health problem [POR = 2.97; 95% CI:1.74, 5.06, I2 = 92.0%]were the factors associated with antenatal depression. CONCLUSION The prevalence of antenatal depression is high in Africa, which showed that one in four pregnant women had depression. Pregnant mothers who had economic difficulties, bad obstetric history, poor support from relatives, previous mental health problems, and unfavorable marital conditions were at higher risk of antenatal depression. Therefore these factors should be considered while designing mental health care services for pregnant mothers.
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Affiliation(s)
- Abel Fekadu Dadi
- University of Gondar, College of Medicine and Health Sciences, Institute of Public Health, Department of Epidemiology and Biostatistics, Gondar, Ethiopia.,School of Public Health, College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Haileab Fekadu Wolde
- University of Gondar, College of Medicine and Health Sciences, Institute of Public Health, Department of Epidemiology and Biostatistics, Gondar, Ethiopia.
| | - Adhanom Gebreegziabher Baraki
- University of Gondar, College of Medicine and Health Sciences, Institute of Public Health, Department of Epidemiology and Biostatistics, Gondar, Ethiopia
| | - Temesgen Yihunie Akalu
- University of Gondar, College of Medicine and Health Sciences, Institute of Public Health, Department of Epidemiology and Biostatistics, Gondar, Ethiopia
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Baraki AG, Akalu TY, Wolde HF, Takele WW, Mamo WN, Derseh B, Desyibelew HD, Dadi AF. Time to recovery from severe acute malnutrition and its predictors: a multicentre retrospective follow-up study in Amhara region, north-west Ethiopia. BMJ Open 2020; 10:e034583. [PMID: 32060161 PMCID: PMC7045195 DOI: 10.1136/bmjopen-2019-034583] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 01/09/2020] [Accepted: 01/13/2020] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES This study aimed to determine the time to recovery from severe acute malnutrition (SAM) and its predictors in selected public health institutions in Amhara Regional State, Ethiopia. DESIGN An institution-based retrospective follow-up study was conducted using data extracted from 1690 patient cards from September 2012 to November 2016. SETTING Selected government health institutions in the Amhara region, Ethiopia. PARTICIPANTS Children treated in therapeutic feeding units for SAM were included. OUTCOME MEASURES Time to recovery from SAM. RESULTS One thousand and fifty children have recovered from SAM, 62.13% (95% CI 59.8% to 64.5%). The median time to recovery was 16 days (IQR=11-28). Female gender (adjusted HR (AHR)=0.81, 95% CI 0.67 to 0.98), oedematous malnutrition (AHR=0.74 95% CI 0.59 to 0.93), pneumonia (AHR=0.66, 95% CI 0.53 to 0.83), tuberculosis (AHR=0.53, 95% CI 0.36 to 0.77), HIV/AIDS (AHR=0.47, 95% CI 0.28 to 0.79), anaemia (AHR=0.73, 95% CI 0.60 to 0.89) and receiving vitamin A (AHR=1.43, 95% CI 1.12 to 1.82) were notably associated with time to recovery. CONCLUSIONS The time to recovery in this study was acceptable but the proportion of recovery was far below the minimum standard. Special emphasis should be given to the prevention and treatment of comorbidities besides the therapeutic feeding. Supplementing vitamin A would also help to improve the recovery rate.
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Affiliation(s)
- Adhanom Gebreegziabher Baraki
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Temesgen Yihunie Akalu
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Haileab Fekadu Wolde
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Wubet Worku Takele
- Department of Community Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Worku Nigussu Mamo
- Nutrition, Abrhajira Primary Hospital, West Gondar Zone, Gondar, Ethiopia
| | - Behailu Derseh
- Department of Public Health, College of Health Sciences, Debre Berhan University, Gondar, Ethiopia
| | - Hanna Demelash Desyibelew
- Department of Public Health Nutrition, College of Medicine and Health Sciences, Bahirdar University, Bahir Dar, Ethiopia
| | - Abel Fekadu Dadi
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Akalu TY, Baraki AG, Wolde HF, Lakew AM, Gonete KA. Factors affecting current khat chewing among male adults 15-59 years in Ethiopia, 2016: a multi-level analysis from Ethiopian Demographic Health Survey. BMC Psychiatry 2020; 20:21. [PMID: 31937273 PMCID: PMC6961402 DOI: 10.1186/s12888-020-2434-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 01/08/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Regular khat chewing causes gingivitis, tooth loss, gastric disorders, cardiac complications, male impotence, sleeplessness, and several mental health problems. Based on the Ethiopian Demographic and Health Survey (EDHS) 2016, 12% of women and 27% of men have reported having ever chewed khat. Even though khat addiction is a major public health problem, studies that consider both individual level and community level factors are limited. Therefore, this study aimed to determine the prevalence and factors affecting current khat chewing among male adults in Ethiopia. METHODS Data from EDHS, a community-based cross-sectional study conducted from January 18, 2016, to June 27, 2016, was used. A multistage stratified cluster sampling technique was used to select participants. Both descriptive and analytical statistics were done. Bi-variable and multivariable multilevel logistic regression analyses were performed to determine factors affecting current khat chewing. Adjusted Odds ratio (AOR) with 95% Confidence Interval (CI) for variables with P-value < 0.05 was used as a measure of association. RESULT A total of 12,595 male adults were included. The prevalence of current khat chewing was 23.61% (95% CI: 22.87, 24.36). Age 20-24 years; (AOR = 2.68, 95% CI: 2.02, 3.56), being uneducated (AOR = 1.62, 95% CI: 1.10, 2.39), professional/technical/managerial job (AOR = 3.59, 95% CI: 2.18, 5.91), Muslim religion (AOR = 18.30, 95% CI: 13.54, 24.74), poorest wealth index (AOR = 0.67, 95% CI: 0.51, 0.89), being divorced (AOR = 0.38, 95% CI: 0.21, 0.69), history of alcohol drinking in the last 30 days (AOR = 2.15, 95% CI: 1.69, 2.73), and history of cigarette smoking in the last 30 days (AOR = 14.92, 95% CI: 10.88, 20.47), and Amhara region (AOR = 0.07, 95% CI: 0.04, 0.14) were significantly associated with khat chewing. CONCLUSION Khat chewing remains high in Ethiopia with certain regional variations. The uneducated, older age, Alcohol and cigarette users, Muslims, and professional workers were at higher risk of khat chewing whereas the poorest wealth index and being divorced reduced its risk. Policymakers should consider a multi-faceted policy approach that accounts for regional variation and the identified risk factors to alleviate the problem.
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Affiliation(s)
- Temesgen Yihunie Akalu
- 0000 0000 8539 4635grid.59547.3aDepartment of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Adhanom Gebreegziabher Baraki
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Haileab Fekadu Wolde
- 0000 0000 8539 4635grid.59547.3aDepartment of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Ayenew Molla Lakew
- 0000 0000 8539 4635grid.59547.3aDepartment of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Kedir Abdela Gonete
- 0000 0000 8539 4635grid.59547.3aDepartment of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Baraki AG, Gezie LD, Zeleke EG, Awoke T, Tsegaye AT. Body mass index variation over time and associated factors among HIV-positive adults on second-line ART in north-west Ethiopia: a retrospective follow-up study. BMJ Open 2019; 9:e033393. [PMID: 31551394 PMCID: PMC6773344 DOI: 10.1136/bmjopen-2019-033393] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES This study aimed to assess the evolution of body mass index (BMI) of HIV-positive adults on second-line antiretroviral therapy (ART) over time and factors affecting it in north-west Ethiopia. DESIGN An institution-based retrospective follow-up study was conducted using data extracted from 1016 patient cards from February 2008 to February 2016. SETTING Eight referral hospitals from Amhara region, Ethiopia were included. PARTICIPANTS HIV patients who started second-line ART. OUTCOME MEASURES Change in BMI since starting second-line ART. RESULTS Five hundred and thirty-eight (52.95%) participants were males and the median age of the participants was 33 years (IQR: 28; 39). The median follow-up time was 18 months (IQR: 5.2; 32.2). The average change of BMI showed linear increase over time. The amount of BMI increment or decrement according to each variable was shown as β coefficients. Treatment duration (β=0.013, 95% CI 0.004 to 0.022), isoniazid prophylaxis (β=0.87, 95% CI 0.32 to 1.42), cotrimoxazole prophylaxis (β=0.63, 95% CI 0.08 to 1.19), ambulatory functional status (β=-1.16, 95% CI -1.95 to 1.31), bedridden functional status (β=-1.83, 95% CI -2.47 to 1.21), WHO stage III (β=-0.42, 95% CI -0.65 to 0.20), WHO stage IV (β=-0.62, 95% CI -1.02 to 0.22), CD4 count (β=0.001, 95% CI 0.0008 to 0.0015), and time interaction of variables like tertiary educational status (β=0.02, 95% CI 0.01 to 0.04), ambulatory functional status (β=0.03, 95% CI 0.01 to 0.05) and WHO stages III (β=0.01, 95% CI 0.007 to 0.02) were found to be significant predictors. CONCLUSION The BMI of patients has shown linear increment over the treatment time. Factors affecting it have been identified but its effect on cardiovascular disease needs further study.
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Affiliation(s)
- Adhanom Gebreegziabher Baraki
- Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Lemma Derseh Gezie
- Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Ejigu Gebeye Zeleke
- Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tadesse Awoke
- Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Adino Tesfahun Tsegaye
- Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Wolde HF, Gonete KA, Akalu TY, Baraki AG, Lakew AM. Factors affecting neonatal mortality in the general population: evidence from the 2016 Ethiopian Demographic and Health Survey (EDHS)-multilevel analysis. BMC Res Notes 2019; 12:610. [PMID: 31547855 PMCID: PMC6757386 DOI: 10.1186/s13104-019-4668-3] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 09/19/2019] [Indexed: 12/15/2022] Open
Abstract
Objective This study was aimed to identify factors affecting neonatal mortality in Ethiopia. Results According to the multilevel multivariable logistic regression analysis, the odds of neonatal mortality was significantly associated with husbands with no education (AOR = 2.30, 95% CI 1.10, 4.83), female birth (AOR = 0.57, 95% CI 0.39, 0.83), twin birth (AOR = 13.62, 95% CI 7.14, 25.99), pre-term birth (AOR = 15.07, 95% CI 7.80, 29.12) and mothers with no antenatal care (ANC) visit during pregnancy (AOR = 1.90 95% CI 1.11, 3.25).
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Affiliation(s)
- Haileab Fekadu Wolde
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Kedir Abdela Gonete
- Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Temesgen Yihunie Akalu
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Adhanom Gebreegziabher Baraki
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Ayenew Molla Lakew
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Workie GY, Akalu TY, Baraki AG. Environmental factors affecting childhood diarrheal disease among under-five children in Jamma district, South Wello zone, Northeast Ethiopia. BMC Infect Dis 2019; 19:804. [PMID: 31519160 PMCID: PMC6743097 DOI: 10.1186/s12879-019-4445-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 09/06/2019] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Globally, diarrhea is the leading cause of morbidity and mortality among less than 5 years old children and it contributes to the deaths of approximately one million children every year. In Ethiopia, diarrhea is the second cause of under-five mortality and morbidity. However, in the study area, studies were limited. Therefore, this study has assessed the prevalence of diarrhea and associated factors among < 5 years of age in Jamma district, Northeast Ethiopia. METHODS A community-based cross-sectional study was conducted from August 15 to September 15, 2017, in Jamma district, South Wello zone, northeast Ethiopia. A Systematic random sampling technique was used to select 614 households and a pretested structured questionnaire was used to collect the data. A multivariable logistic regression analysis was used to investigate factors associated with diarrheal disease. Adjusted Odds Ratio (AOR) with the corresponding 95% Confidence Interval (CI) for variables with P-value < 0.05 was used to show statistically significant association. RESULTS In this study, the prevalence of diarrhea among under-five children was 23.1% (95% CI: (19.4, 26.5). Child's age 6 to 23 months [AOR: 2.46, 95% CI: (1.49, 4.05)], Living in rural area [AOR: 2.75, 95% CI: (1.33,5.66)], absence of latrine [AOR: 4.80, 95% CI: (2.39,9.60)], absence of handwashing facility [AOR: 2.45, 95% CI: (1.53,3.93], unprotected drinking water source [AOR:2.68, 95% CI: (1.54,4.68)], and Improper waste disposal practices [AOR:3.86, 95% CI: (2.38,6.26)] were associated with diarrhea disease. CONCLUSION There was a high prevalence of diarrheal disease among children in the study area. Child age, rural residence, availability of latrine and handwashing facility, source of drinking water, and improper waste disposal were notably associated with childhood diarrheal disease. Therefore, improving handwashing practices and pure water supply, proper waste disposal including the availability of latrines would minimize the burden of diarrheal disease.
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Affiliation(s)
- Getachew Yismaw Workie
- South Wello Zonal Health Department Public Health Emergency Early Warning and Preparedness Officer, South Wello, Ethiopia
| | - Temesgen Yihunie Akalu
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Adhanom Gebreegziabher Baraki
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Desyibelew HD, Baraki AG, Dadi AF. Mortality rate and predictors of time to death in children with severe acute malnutrition treated in Felege-Hiwot Referral Hospital Bahir Dar, Northwest Ethiopia. BMC Res Notes 2019; 12:409. [PMID: 31307556 PMCID: PMC6631743 DOI: 10.1186/s13104-019-4467-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 07/11/2019] [Indexed: 11/30/2022] Open
Abstract
Objectives This study aimed to determine mortality rate, time to death and factors affecting the time to death among children with severe acute malnutrition admitted to therapeutic feeding unit of Felege Hiwot Referral Hospital, Bahirdar. Result A total of 401 children with severe acute malnutrition who were admitted to therapeutic feeding units from September 2012 to January 2016 were included in the study. The incidence of death rate was 8.47% (95% CI 6.11%, 11.65%). The median time to death was 3 days (Inter Quartile Range of 4 days). Children’s of age > 24 months (AHR = 0.27; 95% CI 0.1, 0.73), fully vaccinated status (AHR = 0.16; 95% CI 0.07, 0.36), HIV infection (AHR = 3.82; 95% CI 1.3, 11.15) and congestive heart failure (AHR = 6.98; 95% CI 2.42, 20.09) were significant predictors of mortality among children admitted for severe acute malnutrition.
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Affiliation(s)
- Hanna Demelash Desyibelew
- Department of Public Health Nutrition, College of Medicine and Health Sciences, Bahirdar University, Bahir Dar, Ethiopia
| | - Adhanom Gebreegziabher Baraki
- Department of Epidemiology and Biostatistics, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Abel Fekadu Dadi
- Department of Epidemiology and Biostatistics, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.,Flinders University, Health Sciences Building, Sturt Road, Bedford Park, Adelaide, SA, 5001, Australia
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Alemu AS, Baraki AG, Alemayehu M, Yenit MK. The prevalence of intestinal parasite infection and associated factors among food handlers in eating and drinking establishments in Chagni Town, Northwest Ethiopia. BMC Res Notes 2019; 12:302. [PMID: 31138325 PMCID: PMC6540465 DOI: 10.1186/s13104-019-4338-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 05/22/2019] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES This study aimed to determine the prevalence of intestinal parasites and associated factors among food handlers in Changni district, Awi zone Ethiopia. RESULTS A total of 442 food handlers were included in the study with a response rate of 90%. The prevalence of infection with at least one of the intestinal parasites was 14.8% [95% CI (11.5%, 18.0%)]. According to multivariable logistic regression analysis, lack of regular hand washing before meal [AOR = 4.77, 95% CI (2.09, 10.87)], regular hand washing after visiting toilets, [AOR = 3.39, 95% CI (1.52, 7.57)], trimmed fingernails, [AOR = 2.39, 95% CI (1.29, 4.42)], and frequent medical check-ups for intestinal parasites [AOR = 3.54, 95% CI (1.11, 11.31)] were significantly associated with the infection of intestinal parasitosis.
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Affiliation(s)
| | | | - Mekuriaw Alemayehu
- Department of Environmental and Occupational Safety, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Melaku Kindie Yenit
- Department of Epidemiology and Biostatistics, Institute of Public Health, University of Gondar, Gondar, Ethiopia
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Taddese AA, Baraki AG, Gelaye KA. Spatial modeling, prediction and seasonal variation of malaria in northwest Ethiopia. BMC Res Notes 2019; 12:273. [PMID: 31088545 PMCID: PMC6518452 DOI: 10.1186/s13104-019-4305-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 05/04/2019] [Indexed: 02/07/2023] Open
Abstract
Objectives The aim of this study was to determine the spatial modeling, seasonal variation of malaria and making prediction map of malaria in northwest Ethiopia. Results The overall average cumulative annual malaria incidence during the study period was 30 per 100 populations at risk. The highest proportion (29.2%) was observed from June 2015 to October 2016. In temporal analysis of clusters, the epidemic was observed from 2015/7/1 to 2016/12/31 throughout the study period in all districts. Hotspot areas with high clusters (p < 0.001) were observed in Metema district it accounts 18.6% of the total malaria cases. An area of high median predicted incidence proportion (> 50%) was seen in the southwest part of the region. Most of the northern part of the study area was predicted to have a low median incidence proportion (< 10%). Electronic supplementary material The online version of this article (10.1186/s13104-019-4305-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Asefa Adimasu Taddese
- Department of Epidemiology and Biostatistics, Institute of Public Health College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Adhanom Gebreegziabher Baraki
- Department of Epidemiology and Biostatistics, Institute of Public Health College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Kassahun Alemu Gelaye
- Department of Epidemiology and Biostatistics, Institute of Public Health College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Mekonnen N, Abdulkadir M, Shumetie E, Baraki AG, Yenit MK. Incidence and predictors of loss to follow-up among HIV infected adults after initiation of first line anti-retroviral therapy at University of Gondar comprehensive specialized Hospital Northwest Ethiopia, 2018: retrospective follow up study. BMC Res Notes 2019; 12:111. [PMID: 30819236 PMCID: PMC6396485 DOI: 10.1186/s13104-019-4154-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 02/22/2019] [Indexed: 11/10/2022] Open
Abstract
Objectives The aim of this study was to estimate the incidence of lost to follow up from anti-retroviral therapy (ART) care and identify the associated factors among human immunodeficiency virus (HIV) infected patients after first-line ART initiation at University of Gondar comprehensive specialized hospital, Northwest Ethiopia between January 2012 and January 2018. Results The overall incidence rate of lost to follow up was 12.26 per 100 person years (95% CI (10.61–14.18)). Being underweight (< 18.5 kg/m2) (AHR, 1.52, 95% CI 1.01–2.28), jobless (AHR, 2.22, 95% CI 1.2–4.11), substance abuser (AHR, 1.84 95% CI 1.19–2.86), having sub-optimal adherence (fair/poor) (AHR 6.33, 95% CI (3.90–10.26)), not receiving isoniazid prophylaxis (AHR 2.47, 95% CI (1.36–4.48)), ambulatory functional status (AHR 1.94, 95% CI (1.23–3.06)), having opportunistic infections (AHR, 1.74 95% CI 1.11–2.72), having CD4 count 201–349 cells/µL (AHR 0.58, 95% CI (0.38–0.88)) were found to be significant predictors of lost to follow up from ART service.
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Affiliation(s)
- Nebiyu Mekonnen
- School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mohamed Abdulkadir
- School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Eleyias Shumetie
- School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Adhanom Gebreegziabher Baraki
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Melaku Kindie Yenit
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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