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Gebreyesus A, Niguse AT, Shishay F, Mamo L, Gebremedhin T, Tsegay K, Gebremariam AG, Kidanu KG, Gidey S, Tesfay F. Prevalence of depression and associated factors among community hosted internally displaced people of Tigray; during war and siege. BMC Psychiatry 2024; 24:3. [PMID: 38166772 PMCID: PMC10763281 DOI: 10.1186/s12888-023-05333-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 10/31/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Displacement is a psychologically stressful event. Since the war began, the people of Tigray were subjected to stressful events such as torture, rape, the killing of a family member, forced displacement, and even ethnic cleansing in their home countries. Especially displaced individuals are faced mental health problems. This study aimed to assess the prevalence of depression and associated factors among community internally displaced people due to the war on Tigray, in 2021. METHODS The community-based cross-sectional study design was applied from August 06 to 30, 2021 in all Weredas of Tigray. A total of 1,990 cIDP were recruited through a two-stage sampling technique. A structured and standardized questionnaire was used to collect data. Both bivariate and multivariable logistic regression was applied to identify associated risk factors and AOR with 95% confidence interval was used to select statistically significant variables. RESULTS The prevalence of depression among internally displaced people was 81.2% (95% CI: 79.4-83%), with more than 60% categorized as moderate and severe depression. The married and divorced marital status, being government employee, having family size > = 4, destruction of household fixed assets, looting of cereals, and having disabled family members due to the war were the significantly associated risk factors of depression. CONCLUSIONS The prevalence of depression among community internally displaced people during the war on Tigray is very high compared to other studies conducted elsewhere. Almost 8 of 10 IDPs are developed depression and this is a very series health issue that needs immediate intervention by local, international organizations and communities around the world.
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Affiliation(s)
- Aregawi Gebreyesus
- Department of Epidemiology, College of Health Science, Mekelle University, Mekelle, Tigray, Ethiopia
| | | | - Fiyori Shishay
- Department of Epidemiology, College of Health Science, Mekelle University, Mekelle, Tigray, Ethiopia
| | - Liya Mamo
- Department of Biostatistics, College of Health Science, Mekelle University, Mekelle, Tigray, Ethiopia
| | - Teklit Gebremedhin
- School of Medicine, College of Health Science, Mekelle University, Mekelle, Tigray, Ethiopia
| | - Kahsu Tsegay
- School of Nursing, College of Health Science, Mekelle University, Mekelle, Tigray, Ethiopia
| | | | - Kokob Gebru Kidanu
- Department of Psychiatry, College of Health Science, Mekelle University, Mekelle, Tigray, Ethiopia
| | - Solomon Gidey
- Department of Psychiatry, College of Health Science, Mekelle University, Mekelle, Tigray, Ethiopia
| | - Fisaha Tesfay
- Deakin University, Geelong, Institute for Health Transformation, Melbourne, Australia.
- College of Medicine and Public Health, Flinders University, Bedford Park, Australia.
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Gebreyesus A, Mulugeta A, Woldemichael A, Asgedom AA, Fisseha G, Tsadik M, Gebrehiwot TG, Mitiku M, Teferi M, Godifay H, Alemayehu Y. Immediate health and economic impact of the Tigray war on internally displaced persons and hosting households. Sci Rep 2023; 13:18071. [PMID: 37872386 PMCID: PMC10593803 DOI: 10.1038/s41598-023-45328-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 10/18/2023] [Indexed: 10/25/2023] Open
Abstract
Globally, war is the major cause of displacement from the usual place of the biological environment. The war of Tigray exposed thousands of people to internal displacement and migration. Evidence has shown that displaced people and migrants shoulder the health and economic burden to ensure survival. However, evidence of the impact of the war on health and the economy related to the displaced people and their hosting communities is not documented. Thus, this study aimed to investigate the health and economic impact of the war on displaced people and the hosting community. A community-based survey was conducted among randomly selected 3572 households of 48 woredas/districts from August 06 to 30/2021 in Tigray. Each district had 4 enumeration sites and there were 20 households (HHs) to be sampled per each enumeration site. Data were collected using a pretested structured questionnaire using face-to-face interviews of displaced and hosting household heads. The entered data is exported to SPSS version 26 statistical packages for data analysis. Summary statistics and geo-spatial analysis was computed. The war had a significant impact on the health and economy of the community of Internally Displaced People (cIDPs) and hosting households. There were 12,691 cIDPs and 3572 hosting HHs. About 12.3% had chronic illness12.3% of (cIDP) who had chronic diseases and follow-up medication was forced to stop their medication. 536 (15%) civilian family members of cIDPs were killed at their homes. During the war, 244 (6.83%) of civilian family members faced physical disability. Consequentially, 43.8% and 58.8% of respondents of cIDPs suffered from severe depression and post-traumatic stress disorder. The war had a significant amount of personal resources such as domestic animals, cereals, cars, machinery, and HH furniture was looted and vandalized by the perpetrator forces from the cIDPs and hosting HHs. The range of family size in the hosting households was 3 to 22. The war had a significant health and economic impact on both cIDPs and hosting HHs. cIDPs suffered from various illnesses and disabilities related to the war with no medical access and follow-up care leading them to stressful situations such as depression and PTSD. There was also a huge economic damage and distraction which threatens the survival of the survivors.
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Affiliation(s)
- Aregawi Gebreyesus
- School of Public Health, College of Health Science, Mekelle University, P.O. Box 1871, Mekelle, Tigray, Ethiopia.
| | - Afework Mulugeta
- School of Public Health, College of Health Science, Mekelle University, P.O. Box 1871, Mekelle, Tigray, Ethiopia
| | - Abraha Woldemichael
- School of Public Health, College of Health Science, Mekelle University, P.O. Box 1871, Mekelle, Tigray, Ethiopia
| | - Akeza Awealom Asgedom
- School of Public Health, College of Health Science, Mekelle University, P.O. Box 1871, Mekelle, Tigray, Ethiopia
| | - Girmatsion Fisseha
- School of Public Health, College of Health Science, Mekelle University, P.O. Box 1871, Mekelle, Tigray, Ethiopia
| | - Mache Tsadik
- School of Public Health, College of Health Science, Mekelle University, P.O. Box 1871, Mekelle, Tigray, Ethiopia
| | | | - Mengistu Mitiku
- School of Public Health, College of Health Science, Mekelle University, P.O. Box 1871, Mekelle, Tigray, Ethiopia
| | - Molla Teferi
- School of Public Health, College of Health Science, Mekelle University, P.O. Box 1871, Mekelle, Tigray, Ethiopia
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Tsadik M, Gebretnsae H, Ayalew A, Asgedom AA, Gebreyesus A, Hagos T, Abrha M, Weldegerima K, Abrha B, Gebre G, Hagos M, Esayas R, Gebregeorgis M, Gesesew HA, Mulugeta A. Child health services and armed conflict in Tigray, North Ethiopia: a community-based study. Confl Health 2023; 17:47. [PMID: 37798759 PMCID: PMC10557173 DOI: 10.1186/s13031-023-00545-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 09/26/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND Access to basic health services, notably child health services, is severely hampered by the armed conflict in Tigray, North Ethiopia. Little is known regarding the impacts of the armed conflict during the war in Tigray on access to child health services. The current study investigates the impact of the armed conflict on the utilization of child health services in Tigray. METHODS 4,381 caregivers from randomly recruited households (HHs) with at least one child younger than 1 year old participated in a community-based cross-sectional survey. We collected data on childhood immunizations and illness-related treatment seeking from August 4 to 20, 2021. We describe data using frequency and percentage and carry out an internal comparison among the study participants using chi-square tests. RESULTS 4,381 children under the age of one included in the study. In total, 39% of infants received no basic vaccines, 61.3% of the children under the age of one received at least one vaccine, and 20% received all the vaccinations recommended for their age. About 61% of children were affected by at least one childhood ailments where majority of them were from rural areas. Mothers who did not seek postnatal care (PNC) were responsible for more than 75% of reported childhood illnesses. CONCLUSIONS A sizable portion of children were unvaccinated and had at least one childhood sickness while the war was in progress. Particularly, people who live in rural areas reported a higher percentage of children's illnesses but a lower use of child health services. To lower childhood morbidity and mortality in the besieged area, such as Tigray, local to global actors need to get coordinated and warrying parties should stop weaponization of vaccination healthcare services.
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Affiliation(s)
- Mache Tsadik
- School of Public Health, College of Health Sciences, Mekelle University, Tigray, 231, Ethiopia
| | | | - Asefa Ayalew
- School of Public Health, College of Health Sciences, Mekelle University, Tigray, 231, Ethiopia
| | - Akeza Awealom Asgedom
- School of Public Health, College of Health Sciences, Mekelle University, Tigray, 231, Ethiopia
| | - Aregawi Gebreyesus
- School of Public Health, College of Health Sciences, Mekelle University, Tigray, 231, Ethiopia
| | - Tigist Hagos
- School of Public Health, College of Health Sciences, Mekelle University, Tigray, 231, Ethiopia
| | - Marta Abrha
- School of Medicine, College of Health Sciences, Mekelle University, Tigray, 231, Ethiopia
| | - Kiros Weldegerima
- School of Medicine, College of Health Sciences, Mekelle University, Tigray, 231, Ethiopia
| | - Birikti Abrha
- School of Midwifery, College of Health Sciences, Mekelle University, Tigray, 231, Ethiopia
| | - Gelawdiwos Gebre
- School of Midwifery, College of Health Sciences, Mekelle University, Tigray, 231, Ethiopia
| | - Mulubrhan Hagos
- School of Midwifery, College of Health Sciences, Mekelle University, Tigray, 231, Ethiopia
| | - Rie Esayas
- Tigray Regional Health Bureau, Tigray, 07, Ethiopia
| | | | - Hailay Abrha Gesesew
- School of Public Health, College of Health Sciences, Mekelle University, Tigray, 231, Ethiopia.
- Research Centre for Public Health, Equity and Human Flourishing, Torrens University Australia, Adelaide, SA, 5000, Australia.
| | - Afework Mulugeta
- School of Public Health, College of Health Sciences, Mekelle University, Tigray, 231, Ethiopia
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Gebrehiwet TG, Abebe HT, Woldemichael A, Gebresilassie K, Tsadik M, Asgedom AA, Fisseha G, Berhane K, Gebreyesus A, Alemayoh Y, Gebresilassie M, Godefay H, Gesesew HA, Tesfaye S, Siraj ES, Aregawi MW, Mulugeta A. War and Health Care Services Utilization for Chronic Diseases in Rural and Semiurban Areas of Tigray, Ethiopia. JAMA Netw Open 2023; 6:e2331745. [PMID: 37651138 PMCID: PMC10472195 DOI: 10.1001/jamanetworkopen.2023.31745] [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: 03/17/2023] [Accepted: 07/15/2023] [Indexed: 09/01/2023] Open
Abstract
Importance The war in Tigray, Ethiopia, has disrupted the health care system of the region. However, its association with health care services disruption for chronic diseases has not been well documented. Objective To assess the association of the war with the utilization of health care services for patients with chronic diseases. Design, Setting, and Participants Of 135 primary health care facilities, a registry-based cross-sectional study was conducted on 44 rural and semiurban facilities of Tigray. Data on health services utilization were extracted for patients with tuberculosis, HIV, diabetes, hypertension, and psychiatric disorders in the prewar period (September 1, to October 31, 2020) and during the first phase of the war period (November 4, 2020, to June 30, 2021). Main Outcomes and Measures Records on the number of follow-up, laboratory tests, and patients undergoing treatment of the aforementioned chronic diseases were counted during the prewar and war periods. Results Of 4645 records of patients with chronic diseases undergoing treatment during the prewar period, 998 records (21%) indicated having treatment during the war period. Compared with the prewar period, 59 of 180 individuals (33%; 95% CI, 26%-40%) had tuberculosis, 522 of 2211 (24%; 95% CI, 22%-26%) had HIV, 228 of 1195 (19%; 95% CI, 17%-21%) had hypertension, 123 of 632 (20%; 95% CI, 16%-22%) had psychiatric disorders, and 66 of 427 (15%; 95% CI, 12%-18%) had type 2 diabetes records, which revealed continued treatment during the war period. Of 174 records of patients with type 1 diabetes in the prewar period, at 2 to 3 months into the war, the numbers dropped to 10 with 94% decline compared with prewar observations. Conclusions and Relevance This study found that the war in Tigray has resulted in critical health care service disruption and high loss to follow-up for patients with chronic disease, likely leading to increased morbidity and mortality. Local, national, and global policymakers must understand the extent and impact of the service disruption and urge their efforts toward restoration of those services.
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Affiliation(s)
| | - Haftom Temesgen Abebe
- School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Tigray, Ethiopia
| | - Abraha Woldemichael
- School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Tigray, Ethiopia
| | - Kibrom Gebresilassie
- School of Medicine, College of Health Sciences, Mekelle University, Mekelle, Tigray, Ethiopia
| | - Mache Tsadik
- School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Tigray, Ethiopia
| | - Akeza Awealom Asgedom
- School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Tigray, Ethiopia
| | - Girmatsion Fisseha
- School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Tigray, Ethiopia
| | - Kiros Berhane
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, New York
| | - Aregawi Gebreyesus
- School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Tigray, Ethiopia
| | | | - Measho Gebresilassie
- School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Tigray, Ethiopia
| | - Hagos Godefay
- Tigray Regional Health Bureau, Mekelle, Tigray, Ethiopia
| | - Hailay Abrha Gesesew
- Research Centre for Public Health, Equity and Human Flourishing, Torrens University Australia, Adelaide, South Australia, Australia
| | - Solomon Tesfaye
- Diabetes Research Unit, Sheffield Teaching Hospitals and the University of Sheffield, Sheffield, United Kingdom
| | - Elias S. Siraj
- Division of Endocrinology & Strelitz Diabetes Center, Eastern Virginia Medical School, Norfolk
| | - Maru W. Aregawi
- Global Malaria Program, World Health Organization, Geneva, Switzerland
| | - Afework Mulugeta
- School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Tigray, Ethiopia
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Fisseha G, Gebrehiwot TG, Gebremichael MW, Wahdey S, Meles GG, Gezae KE, Legesse AY, Asgedom AA, Tsadik M, Woldemichael A, Gebreyesus A, Abebe HT, Haile YA, Gezahegn S, Aregawi M, Berhane KT, Godefay H, Mulugeta A. War-related sexual and gender-based violence in Tigray, Northern Ethiopia: a community-based study. BMJ Glob Health 2023; 8:e010270. [PMID: 37479499 PMCID: PMC10364179 DOI: 10.1136/bmjgh-2022-010270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Accepted: 07/01/2023] [Indexed: 07/23/2023] Open
Abstract
INTRODUCTION Sexual and gender-based violence (SGBV) during armed conflicts has serious ramifications with women and girls disproportionally affected. The impact of the conflict that erupted in November 2020 in Tigray on SGBV is not well documented. This study is aimed at assessing war-related SGBV in war-affected Tigray, Ethiopia. METHODS A community-based survey was conducted in 52 (out of 84) districts of Tigray, excluding its western zone and some districts bordering Eritrea due to security reasons. Using a two-stage multistage cluster sampling technique, a total of 5171 women of reproductive age (15-49 years) were randomly selected and included in the study. Analysis used weighted descriptive statistics, regression modelling and tests of associations. RESULTS Overall, 43.3% (2241/5171) of women experienced at least one type of gender-based violence. The incidents of sexual, physical and psychological violence, and rape among women of reproductive age were found to be 9.7% (500/5171), 28.6% (1480/5171), 40.4% (2090/5171) and 7.9% (411/5171), respectively. Of the sexual violence survivors, rape accounted for 82.2% (411/500) cases, of which 68.4% (247) reported being gang raped. Young women (aged 15-24 years) were the most affected by sexual violence, 29.2% (146/500). Commonly reported SGBV-related issues were physical trauma, 23.8% (533/2241), sexually transmitted infections, 16.5% (68/411), HIV infection, 2.7% (11/411), unwanted pregnancy, 9.5% (39/411) and depression 19.2% (431/2241). Most survivors (89.7%) did not receive any postviolence medical or psychological support. CONCLUSIONS Systemic war-related SGBV was prevalent in Tigray, with gang-rape as the most common form of sexual violence. Immediate medical and psychological care, and long-term rehabilitation and community support for survivors are urgently needed and recommended.
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Affiliation(s)
- Girmatsion Fisseha
- School of Public Health, Mekelle University College of Health Sciences, Mekelle, Tigray, Ethiopia
| | | | | | - Shishay Wahdey
- School of Public Health, Mekelle University College of Health Sciences, Mekelle, Tigray, Ethiopia
| | | | - Kebede Embaye Gezae
- School of Public Health, Mekelle University College of Health Sciences, Mekelle, Tigray, Ethiopia
| | - Awol Yemane Legesse
- School of Medicine, Mekelle University College of Health Sciences, Mekelle, Tigray, Ethiopia
| | - Akeza Awealom Asgedom
- School of Public Health, Mekelle University College of Health Sciences, Mekelle, Tigray, Ethiopia
| | - Mache Tsadik
- School of Public Health, Mekelle University College of Health Sciences, Mekelle, Tigray, Ethiopia
| | - Abraha Woldemichael
- School of Public Health, Mekelle University College of Health Sciences, Mekelle, Tigray, Ethiopia
| | - Aregawi Gebreyesus
- School of Public Health, Mekelle University College of Health Sciences, Mekelle, Tigray, Ethiopia
| | - Haftom Temesgen Abebe
- School of Public Health, Mekelle University College of Health Sciences, Mekelle, Tigray, Ethiopia
| | | | - Selome Gezahegn
- Hennepin Healthcare, Minneapolis, Minnesota, USA
- University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Maru Aregawi
- Global Malaria Program, World Health Organization, Geneve, Switzerland
| | | | | | - Afework Mulugeta
- School of Public Health, Mekelle University College of Health Sciences, Mekelle, Tigray, Ethiopia
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Asgedom AA, Abirha BT, Tesfay AG, Gebreyowhannes KK, Abraha HB, Hailu GB, Abrha MB, Tsadik M, Gebrehiwet TG, Gebreyesus A, Desalew T, Alemayehu Y, Mulugeta A. Unimproved water and sanitation contributes to childhood diarrhoea during the war in Tigray, Ethiopia: a community based assessment. Sci Rep 2023; 13:7800. [PMID: 37179380 PMCID: PMC10182988 DOI: 10.1038/s41598-023-35026-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 05/11/2023] [Indexed: 05/15/2023] Open
Abstract
Access to water, sanitation, and hygiene (WASH) is a global public health problem. The situation is worst in conflict areas, where people are displaced from their usual homes. Household supply of WASH and the incidence of diarrhoeal disease among children during the war in Tigray are not known or documented. The objective of this study was to investigate the sources of drinking water, sanitation and hygiene practices, and the incidence of diarrhoeal diseases among children during the war in Tigray, Ethiopia. A cross-sectional study was conducted to collect data on selected WASH indicators in six zones of Tigray from August 4-20, 2021. Data were collected from a total of 4381 sample households selected by lottery. Descriptive analysis was performed and the analysed data are presented in tables, figures and explanatory notes. Binary logistic regression was performed to examine the relationship between independent and dependent variables. A total of 4381 households from 52 woredas participated in the study. Approximately 67.7% of the study participants reported that they relied on an improved source of drinking water during the war. Coverage of sanitation, hand washing, and menstrual hygiene during the war was reported as 43.9%, 14.5%, and 22.1%, respectively. The prevalence of diarrhoeal diseases among children was 25.5% during the war. Water source, latrine type, solid waste disposal and health extension worker visits were the significant predictors of the likelihood of diarrhoea in children (p < 0.05). The results of the study show that a decrease in services from WASH is associated with a higher prevalence of diarrhoeal disease among children during the war in Tigray. To prevent the high prevalence of diarrhoeal disease among children in war-torn Tigray, Ethiopia, improved access to water and sanitation is recommended. In addition, collaborative efforts are needed to engage health extension workers to provide appropriate promotion and prevention services to war-affected communities in Tigray, Ethiopia. Further comprehensive surveys of households with children over one year of age are recommended to assess access to WASH and the burden of WASH associated diseases.
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Affiliation(s)
- Akeza Awealom Asgedom
- Department of Environmental Health and Behavioural Sciences, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia.
| | | | - Askual Girmay Tesfay
- Department of Hygiene and Environmental Health, Tigray Health Bureau, Mekelle, Ethiopia
| | | | | | - Gessessew Bugssa Hailu
- Department of Medical Parasitology and Entomology, School of Medicine, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Mesele Bahre Abrha
- Department of Environmental Health and Behavioural Sciences, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Mache Tsadik
- Department of Reproductive Health, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | | | - Aregawi Gebreyesus
- Department of Epidemiology, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Tilahun Desalew
- OXFAM Emergency Response - Tigray Field Office, Mekelle, Ethiopia
| | | | - Afework Mulugeta
- Department of Nutrition and Dietetics, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
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Ayele E, Tasew H, Mariye T, Gebreayezgi G, Bahrey D, Gereziher K, Engdashet S, Gidey T, Gebreyesus A. Magnitude of kangaroo mother care practice and its associated factors in Tigray region, northern Ethiopia, 2019: cross-sectional study design. Pan Afr Med J 2023; 44:5. [PMID: 36818028 PMCID: PMC9935649 DOI: 10.11604/pamj.2023.44.5.29894] [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: 05/18/2021] [Accepted: 10/18/2022] [Indexed: 01/06/2023] Open
Abstract
Introduction kangaroo mother care is an evidence based approach care of preterm and low birth weight infants carried skin-to-skin with the parents that can decrease morbidity and mortality of infant. Country level adoption and practice of kangaroo mother care has been limited and global coverage remains low and few studies have examined the reasons for low practice. The aim of this study was to assess the magnitude of kangaroo mother care practice and its associated factors in Tigray, northern Ethiopia, 2019. Methods an institutional-based cross-sectional study design was conducted in public general hospitals of Tigray, northern Ethiopia, 2019. Two-stage sampling technique was used and an interviewer-administered questionnaire were used to collect the necessary information. The data were cleaned and entered using epi-Data version 3.1 then exported to stoical package for social science (SPSS) version 22.0 for analysis. Bivariate logistic regression and multivariable analysis were carried out at adjusted odds ratios (AOR) with 95% CI and significance level p-value (<0.05). Results out of the total 844 selected mothers with their infants, 840 were participated in the study yielding to a response rate of 99.5%, of these respondent's kangaroo mother care practice was found to be 70.2%. Being mothers housewife [(AOR=4.12, 95% CI: (1.5, 0.11)], maternal age [(AOR=9.3, 95% CI: (2.5, 33.9 )], currently mode delivery [(AOR=5.39, 95% CI: (2.3, 12.25)], number of children [(AOR=8.38, 95%: (4.6, 15.3)], mother having ≥5 children [(AOR=18.2, 95%CI: (9.4, 35.4)], antenatal care [(AOR=3.299 95%CI: (1.54, 7.07)] were factors at p-value (<0.05) significantly associated with kangaroo mother care practice. Conclusion in this study, maternal age, parity, antenatal care, occupation and mode of delivery were factors that influence kangaroo mother care practice in the study area, so healthcare providers, policymakers and other stakeholders should give special focuses on those influencing factors.
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Affiliation(s)
- Ebud Ayele
- Department of Public Health Nutrition, College of Medicine and Health Sciences, Axum University, Axum, Ethiopia,,Corresponding author: Ebud Ayele, Department of Public Health Nutrition, College of Medicine and Health Sciences, Axum University, Axum, Ethiopia.
| | - Hagos Tasew
- Department of Nursing, College of Medicine and Health Science, Axum University, Axum, Ethiopia
| | - Teklewoini Mariye
- Department of Nursing, College of Medicine and Health Science, Axum University, Axum, Ethiopia
| | - Guesh Gebreayezgi
- Department of Public Health Epidemiology, College of Medicine and Health Sciences, Axum University, Axum, Ethiopia
| | - Degena Bahrey
- Department of Nursing, College of Medicine and Health Science, Axum University, Axum, Ethiopia
| | - Kiros Gereziher
- Department of Public Health Nutrition, College of Medicine and Health Sciences, Axum University, Axum, Ethiopia
| | - Shewit Engdashet
- Department of Public Health Nutrition, College of Medicine and Health Sciences, Axum University, Axum, Ethiopia
| | - Tsehaynesh Gidey
- Department of Public Health Economics, College of Medicine and Health Science, Mekelle University, Mekelle, Ethiopia
| | - Aregawi Gebreyesus
- Department of Public Health Epidemiology, College of Medicine and Health Science, Mekelle University, Mekelle, Ethiopia
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Hailu C, Fisseha G, Gebreyesus A. Determinants of measles vaccination dropout among 12 − 23 months aged children in pastoralist community of Afar, Ethiopia. BMC Infect Dis 2022; 22:376. [PMID: 35421952 PMCID: PMC9008940 DOI: 10.1186/s12879-022-07350-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 04/05/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Measles is a viral disease and a leading vaccine-preventable childhood killer. More than 95% of measles deaths occur in countries with low incomes and weak health infrastructures. In response to this, Ethiopia prepared a measles elimination strategic plan to achieve by 2020. However, based on the Mini-Ethiopian demographic health survey 2019 the full coverage of immunization is 43% at the country level and it is lowest (20%) in the Afar region where this study was conducted. Therefore, this study aimed to identify the determinants of the measles vaccine dropout rate in Afar regional state which is one of the pastoralist communities in Ethiopia.
Methods
Community based unmatched case-control study design was used. The study was conducted in Awash district of Afar regional state, Ethiopia from June 1st -30th 2018. Data were collected from a study unit of 12–23 months old children. For this study, a sample of 166 cases and 331controls were selected by simple random sampling methods and the total sample size was 497. Data were collected using a pretested structured questionnaire by health workers using the local language. Data were entered into Epi-info − 7 and analyzed by SPSS version 20 software and logistic regression was used to assess the determinants measles dropout rate.
Results
A total of 487 children participated in this study with a response rate of 97.9%. More than half of the children were female (53.3%) and 113 (35.2%) children mothers’ were not attended formal education. Mother who had antenatal care ≤ 2 visits [AOR:=5.7(3.2–10.14)], being in the birth order of 1 − 3 [AOR = 4.47(1.63–12.29)], long waiting time > 60 min at nearby health facility for vaccine [AOR = 2.37(1.36–4.15)], households visit by health extension workers [AOR = 2.03(1.12–3.66)], pregnant women not participating with women development army [AOR = 3.5(1.94–6.18)], and poor maternal knowledge on vaccination [AOR = 3.30(1.9–5.73)] were significant determinants with measles vaccination dropout rate.
Conclusions
Health facility and mother characteristics were the determinants of the measles vaccine dropout rate. Therefore, tracing and strict follow up by the health extension works using home visits and women development army at the pastoralist community is necessary to reach them.
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Reda G, Yemane D, Gebreyesus A. Prevalence and associated factors of active trachoma among 1-9 years old children in Deguatemben, Tigray, Ethiopia, 2018: community cross-sectional study. BMC Ophthalmol 2020; 20:144. [PMID: 32293359 PMCID: PMC7161230 DOI: 10.1186/s12886-020-01394-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 01/06/2020] [Accepted: 03/16/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Trachoma is a contagious infection of the eye. World Health Organization recommended three rounds of mass drug administration in districts where the prevalence of trachomatous follicular (TF) is ≥10% in children aged 1-9 years. Mass drug distribution was given to residents for three consecutive years with more than 90% coverage. However, the prevalence and associated factors of active trachoma in the study community after the intervention was not yet determined. Thus, this deals with the prevalence and associated factors of active trachoma among children aged 1-9 years. METHODS We conducted a Community based cross-sectional study among 502 children aged 1-9 in March 2018 in Deguatemben. A multi-stage sampling technique was applied. Selected children were examined for trachoma using 2.5x binocular loupe and graded based on the WHO simplified grading system. Mothers were interviewed for factors associated with trachoma using a structured questionnaire. Data was entered on Epi-Info and exported to SPSS for analysis. Both descriptive and inferential analyses were done with 95% confidence intervals (CIs) at a p-value < 0.05 for the final model. RESULTS The prevalence of active trachoma was found 21.5% (95% CI: 17.8-25.1%). Being 1 to 4 years old [AOR (95% CI) = 6.81(2.00-23.11)], not washing face [AOR (95% CI) =9.31(1.13-77.66)], not using soap [AOR (95% CI) =5.84(1.87-18.21)], unclean face [AOR(95% CI) = 18.22(4.93-69.32)] and mother's knowledge [AOR (95% CI) =0.06(0.02-0.19)] were found as independent predictors. CONCLUSION The prevalence declined from the baseline, but it is still a public health problem in the district. Personal-related factors were found to be associated with the disease. Health education of "Facial cleanness" and related factors is recommended to increase knowledge of the mothers on their children's care in addition to the provision of antibiotics.
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Affiliation(s)
| | - Dejen Yemane
- College of Health Sciences, Mekelle University, P.O.BOX:1871, Mekelle, Tigray, Ethiopia
| | - Aregawi Gebreyesus
- College of Health Sciences, Mekelle University, P.O.BOX:1871, Mekelle, Tigray, Ethiopia.
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10
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Kide F, Baraki N, Oljira L, Gebreyesus A. The Utilization of Health Service Packages Among Mothers of Children Less Than 1 Year of Age in the Somali Region of Ethiopia. J Community Health 2020; 45:846-855. [PMID: 32146640 DOI: 10.1007/s10900-020-00801-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Health Service Package is the package of services that the government is providing or is aspiring to provide to its citizens in an equitable manner. The Ethiopia Family Health Service Package is part of the health extension program consisting of antenatal care, delivery service, postnatal care, immunization, and family planning. This package facilitates the utilization of maternal, neonatal and child health services and contributes to the reduction of maternal and child mortality. However, there is no data on the utilization of this package in pastoralist societies. This study aimed to assess the utilization of the Family Health Service Package and associated factors among mothers of children less than 1-year-old. From February 18-March 6, 2017 we conducted a community-based cross-sectional study with 421 mothers who gave birth in the last year in the Afdem district of the Somali region in Ethiopia. Mothers who gave birth between January 1/2016 to January 1/2017 in the district were selected by systematic random sampling. The study analysis included descriptive and bivariate statistics and multivariate logistic regression model. The overall utilization of the package was 25.1% (95% CI of 21.1-29.5%). Factors associated significantly with family health service utilization were urban place of residence [(AOR 95% CI) = 3.8 (1.5-9.9)], mother visited by health extension workers [(AOR (95% CI) = 3.1 (1.6-6.3)] and mothers participation in health extension program activities [(AOR (95% CI) = 2.8 (1.5-5.4)]. The utilization of the Family Health Service Package was low. Mothers visited by health extension workers and participated in the health extension program were more likely to utilize family health services. It needs to expand services beyond urban areas and involve rural mothers in health extension program activities.
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Affiliation(s)
- Fisseha Kide
- Tigray Statistical Agency, Mekelle, Tigray, Ethiopia
| | - Negga Baraki
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Lemessa Oljira
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Aregawi Gebreyesus
- Department of Epidemiology, School of Public Health, Mekelle University, P.O. BOX: 1871, Mekelle, Ethiopia.
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11
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Gebreyesus A. Determinants of client satisfaction with family planning services in public health facilities of Jigjiga town, Eastern Ethiopia. BMC Health Serv Res 2019; 19:618. [PMID: 31477100 PMCID: PMC6721189 DOI: 10.1186/s12913-019-4475-5] [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: 05/19/2019] [Accepted: 08/28/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Client satisfaction is the best indicator of quality service provision and has been found to correlate with continuity of care perceived by the client. The measurement of client satisfaction helps in understanding willingness and decisions to return for future services. Thus, this study aimed at assessing the level and factors associated with client satisfaction of FP services among family planning users. METHODS An institutional based cross-sectional study was conducted on 492 family planning users in Public health facilities of Jigjiga town, Eastern Ethiopia from February 10 to March 10, 2017. Participants were chosen by systematic random sampling and interviewed immediately after having received family planning service using via a structured and pre-tested questionnaire. The data were entered into Epi Info 7 and then exported to SPSS 20 for analysis. All associations with client satisfaction were tested for statistical significance with alpha set at the 0.05 level. RESULT The findings of this study showed that the overall client satisfaction with FP services among FP users of public health facilities of Jigjiga town was 41.7% with 95% CI of (37 - 46.1%). Knowledge on FP [adjusted odds ratio, AOR (95% CI) = 0.037 (0.019-0.072)], demonstrate how to use the method [AOR (95% CI) = 16.1 (8.4-30.7)], describing side effect of the method [AOR (95% CI) = 2.4 (1.41-4.23)] and distance of FP user's home to health facility [AOR (95% CI) = 0.24 (0.14-0.42)] were found to be significantly associated with the client satisfaction of FP services. CONCLUSIONS The overall client satisfaction with FP services was relatively low. Knowledge of FP, demonstrating how to use the method, describing the side effect of the method and distance of FP user's home to health facilities were found to be factors that influence client satisfaction with family planning services. Thus, efforts should be made to improve on client interaction especially on the information given and knowledge of clients.
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Affiliation(s)
- Aregawi Gebreyesus
- School of Public Health, Department of Epidemiology, Mekelle University, P.O.Box 1871, Mekelle, Ethiopia.
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12
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Kiros YK, Elinav H, Gebreyesus A, Gebremeskel H, Azar J, Chemtob D, Abreha H, Elbirt D, Shahar E, Chowers M, Turner D, Grossman Z, Haile A, Sutton RE, Maayan SL, Wolday D. Identification and characterization of HIV positive Ethiopian elite controllers in both Africa and Israel. HIV Med 2019; 20:33-37. [PMID: 30318718 PMCID: PMC6510948 DOI: 10.1111/hiv.12680] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVES HIV elite controllers (ECs) are a unique subgroup of HIV-positive patients who are long-term virologically suppressed in the absence of antiretroviral treatment (ART). The prevalence of this subgroup is estimated to be < 1%. Various cohorts of ECs have been described in developed countries, most of which have been demographically heterogeneous. The aim of this study was to identify ECs in two large African cohorts and to estimate their prevalence in a relatively genetically homogenous population. METHODS We screened two cohorts of HIV-positive Ethiopian patients. The first cohort resided in Mekelle, Ethiopia. The second was comprised of HIV-positive Ethiopian immigrants in Israel. In the Mekelle cohort, ART-naïve subjects with stable CD4 counts were prospectively screened using two measurements of viral load 6 months apart. Subjects were defined as ECs when both measurements were undetectable. In the Israeli cohort, subjects with consistently undetectable viral loads (mean of 17 viral load measurements/patient) and stable CD4 count > 500 cells/μL were defined as ECs. RESULTS In the Mekelle cohort, 16 of 9515 patients (0.16%) fitted the definition of EC, whereas seven of 1160 (0.6%) in the Israeli cohort were identified as ECs (P = 0.011). CONCLUSIONS This is the first large-scale screening for HIV-positive ECs to be performed in entirely African cohorts. The overall prevalence of ECs is within the range of that previously described in developing countries. The significant difference in prevalence between the two cohorts of similar genetic background is probably a consequence of selection bias but warrants further investigation into possible environmental factors which may underlie the EC state.
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Affiliation(s)
- Y K Kiros
- Mekelle University College of Health Sciences, Mekelle, Tigray, Ethiopia
| | - H Elinav
- Clinical Microbiology and Infectious Diseases Department, Hadassah University Medical Center, Jerusalem, Israel
| | - A Gebreyesus
- Mekelle University College of Health Sciences, Mekelle, Tigray, Ethiopia
| | - H Gebremeskel
- Mekelle University College of Health Sciences, Mekelle, Tigray, Ethiopia
| | - J Azar
- Internal Medicine Division, Hadassah University Medical Center, Jerusalem, Israel
| | - D Chemtob
- Department of Tuberculosis and AIDS, Ministry of Health, Jerusalem, Israel
| | - H Abreha
- Mekelle University College of Health Sciences, Mekelle, Tigray, Ethiopia
| | - D Elbirt
- The Allergy, Clinical Immunology and AIDS Unit, Kaplan Medical Center, Rehovot, Israel
| | - E Shahar
- Institute of Allergy, Immunology and AIDS Rambam Medical Center, Haifa, Israel
| | - M Chowers
- Infectious Diseases Unit, Meir Medical Center, Kfar Saba, Israel
| | - D Turner
- Crusaid Kobler AIDS Center, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - Z Grossman
- Clinical Microbiology and Infectious Diseases Department, Hadassah University Medical Center, Jerusalem, Israel
| | - A Haile
- Mekelle University College of Health Sciences, Mekelle, Tigray, Ethiopia
| | - R E Sutton
- Division of Infectious Diseases, Department of Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - S L Maayan
- Division of Infectious Diseases, Barzilai Medical Center, Ashkelon, Israel
| | - D Wolday
- Mekelle University College of Health Sciences, Mekelle, Tigray, Ethiopia
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Gebremedhin T, Workie Z, Gebreyesus A. Prevalence and Economic Losses of Bovine Fasciolosis at Hawzien Abattoir, Tigray Region, Northern Ethiopia. ACTA ACUST UNITED AC 2015. [DOI: 10.5455/jva.20150409021806] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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