Association of War With Vaccination Dropout Among Children Younger Than 2 Years in the North Wollo Zone, Ethiopia

IMPORTANCE

A civil war that lasted for about 6 months in the North Wollo zone of Ethiopia destroyed numerous health care facilities. However, no studies have been conducted to determine the association of the war with vaccination dropout in the area.

OBJECTIVE

To assess the association of war with vaccination dropout among children younger than 2 years in the North Wollo zone.

DESIGN, SETTING, AND PARTICIPANTS

This population-based cross-sectional study was conducted in the North Wollo zone from April 1 to June 30, 2022. Participants included children younger than 2 years and their mothers. A multistage sampling technique was used to select the participants.

MAIN OUTCOMES AND MEASURES

A vaccination dropout rate (yes or no) was assessed by interviewing mothers.

RESULTS

The study included 449 children younger than 2 years and their mothers, 291 (64.8%) of whom were 20 to 34 years of age. Almost all of the mothers (426 [94.9%]) were married. More than half of the mothers (271 [60.4%]) had a primary level education. Seventy-one children (15.8%) in the area received all basic vaccinations. One hundred ninety-eight children (44.1%) who started vaccination prior to the war dropped out of the immunization program. Additionally, 64 children (14.3%) born during the war did not receive any vaccination. Losing a family member (adjusted odds ratio [AOR], 3.11 [95% CI, 1.63-5.93]; P = .001), not being informed about catch-up vaccination (AOR, 2.18 [95% CI, 1.39-3.43]; P < .001), being a rural resident (AOR, 2.22 [95% CI, 1.37-3.58]; P < .001), home birth (AOR, 1.75 [95% CI, 1.11-2.77]; P = .002), and length of war (AOR for 5 months, 0.51 [95% CI, 0.28-0.93; P = .04]) were associated with the outcome variable.

CONCLUSIONS AND RELEVANCE

The findings of this cross-sectional study suggest that nearly 60% of children in the North Wollo zone remained undervaccinated or unvaccinated. Stakeholders should make coordinated efforts to overcome the humanitarian crisis in the area and optimize the accessibility of health services.

The Effect of Gestational Weight Gain on Low Birth Weight, Case-Control Study in Northeast Amhara Regional State, Ethiopia, 2019

Background: Intrauterine growth and development are one of the most vulnerable periods in the human life cycle that contribute to appropriate fetal development. Therefore, this study aimed to assess the effect of gestational weight on low birth weight (LBW). Methods: A case-control study was conducted from June 30, 2018, to January 1, 2019, in seven governmental hospitals in the northeast Amhara region on 451 participants(150 cases and 301 controls). Results: Inadequate gestational weight gain increases the risk of LBW by four times (AOR: 4.2, 95% CI: 2.4, 6.4). Anemic mothers were 3 times (AOR: 3.2, 95%CI: 2.5, 5.1) more likely to give birth to LBW newborns than non-anemic women. Mothers with a height of less than 150 cm were 2 times more likely to deliver low birth weight babies than their counterparts (AOR:2.1, 95% CI: 1.5,4.4). The odds of LBW delivery were 3.5 times (AOR: 3.5, 95% CI: 2.3, 5.3) higher for mothers with poor dietary diversity than for mothers with good dietary diversity. Conclusion: Inadequate gestational weight gain during pregnancy was found to be a risk factor for LBW. Additionally, anemia, short stature, and poor dietary diversity were also risk factors for LBW. Therefore, selectively targeted interventions such as improving maternal nutrition, anemia prevention, and proper maternal weight monitoring during pregnancy are needed.

Food handling practices and associated factors among food handlers working in public food and drink service establishments in Woldia town, Northeast Ethiopia

INTRODUCTION

foodborne disease (FBD) is a major public health problem globally. Inadequate food workers' knowledge, attitude, and low level of food handling practices (FHPs) may all contribute to the possibility of FBD outbreaks in public food service establishments. This study aimed to assess FHPs and associated factors among food handlers working in public food and drink service establishments in Woldia town, Northeast Ethiopia.

METHODS

an institutional-based cross-sectional study was conducted from 01 to 29, January 2017. A total of 288 food handlers were recruited through a simple random selection method. A structured interviewer-administered questionnaire and observation checklists were used to collect the respondents' socio-demographic characteristics, knowledge status on FHPs, and food handling working practices data. Descriptive statistics, bivariate and multivariate logistic regression analysis were employed using SPSS version 20 software. Those variables with a p< 0.05 were considered statistically significant.

RESULTS

out of 288 participants, 91.7% were female, and 82.3% were single, while 69.8% were literate. One hundred eighty-four (63.9%) of them were under 15-25 years of age, with a median age of 23.3 years. The proportion of good FHP was (n=134, 46.5%) (95% CI: 41.00-52.4%). Advanced age (adjusted odds ratio (AOR) =12.01, 95% CI: 1.96-73.52), education (participants who attend grades 7-12 (AOR=2.33, 95% CI: 1.14-4.79), and above secondary education (AOR=2.29, 95% CI: 1.05-4.61), work experience above six years (AOR=2.43, 95% CI: 2.08-3.17), received formal training (AOR=1.79, 95% CI: 1.68-4.71), and inspection visits by a concerned body (AOR=2.24, 95% CI: 1.05-3.09) were factors positively associated with handling practices.

CONCLUSION

the study revealed that FHP in the study area was low. Age, education, service year, training received and sanitary inspection visits by the regulatory personnel were factors significantly associated with FHPs. This finding highlights the importance of employing regular sanitary inspection visits to public food service establishments by the concerned authority to ensure that all food handlers have the knowledge and the skill to provide safe food.