Reversible Long Term Contraceptives Utilization among Married Women of Reproductive Age Group in Areka Town, Southern Ethiopia

BACKGROUND፡ In low income countries, bearing many children is the main factor affecting maternal health. This study aimed to estimate the prevalence of reversible long term contraceptives utilization and identify factors associated with it among married women of child bearing age in Areka District in South EthiopiaMETHODS: We conducted a community-based cross-sectional survey involving systematically recruited 346 married women of reproductive age group. Data was collected using a structured interviewer-administered questionnaire on May 2019. We used SPSS version 25 for data entry and analyses. Bivariate logistic regression analysis was used to select exposure variables with crude association. Multivariate analysis was done to control for potential confounders and identify predictors of the outcome. Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI)was reported, and statistical significance was declared at p<0.05.RESULTS: The prevalence of reversible long term contraceptives utilization among married women of reproductive age group was 134(38.7%). Utilization of Reversible Long Term Contraceptives (RLTCs) was positively associated with being protestant Christian religion follower, advanced educational status, history of abortion, and having a better attitude towards reversible long term contraceptives. In other words, being housewife, being daily laborer, having no radio in the household and making fertility decisions alone were negatively associated.CONCLUSION: The prevalence of RLTCs in the study area was high. Women should be empowered educationally through other alternative opportunities to formal school. In addition to electronic media, different community events and community conversations should be used to convey messages on contraceptives particularly RLTCs. Behavioral change communications would benefit women in shaping their attitudestowards RLTCs

Undernutrition and associated factors among school-age children in Wolaita Zone, South Ethiopia: a comparative cross-sectional study

BackgroundNutritional deficiencies in school-age children are a public health concern, especially in resource-limited countries. A school feeding program involves the provision of food on-site or taken home to reduce hunger. It is implemented in several developing nations; however, little is known about the association of school feeding programs with the nutritional status of school-age children in the study area.ObjectivesThe study aimed to determine the magnitudes and associated factors of undernutrition among school-age children with school feeding programs (SFPs) and non-school feeding programs (N-SFPs) in Kindo Didaye woreda, South Ethiopia.MethodsA school-based comparative cross-sectional study was conducted in Kindo Didaye district from May to June 2023. A total of 612 participants were included in the study. The data were collected from each selected student's parents by using a structured interviewer-administered questionnaire. The weight and height of the children were measured, and a household dietary diversity assessment was conducted. The data were analyzed using SPSS version 25. A binary logistic regression analysis was carried out. A p-value of <0.05 and 95% confidence interval (CI) were used to establish a statistically significant association.ResultsThe magnitude of undernutrition among the school-age children was 38.9%: 43.3% in the children from the SFP schools and 34.5% in the children from the N-SFP schools. Stunting was 24.1% among the children in the schools with SFPs and 16% among the children in the N-SFP schools, whereas thinness was 33.8% among the children in the SFP schools and 25.6% among the children in the N-SFP schools. The children who were in the older age group [adjusted odds ratio (AOR) = 4.4, 95%CI; 2.22–8.85], consumed less than three meals per day at home (AOR = 6.03; 95%CI 3.9–9.3), and did not eat breakfast at all before going to school (AOR = 3.5; 95%CI 1.15–10.76) were more likely to become undernourished. The children whose fathers received secondary and above education (AOR = 0.52; 95% CI (0.27–0.971) had lower odds of becoming underweight.ConclusionThe magnitude of undernutrition was high in the current study. Existing interventions that work to improve the nutritional status of school-age children should be strengthened. Children should consume any type of food as breakfast at home before going to school regardless of the presence of school feeding programs and at least three times a day

Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990–2021:a systematic analysis for the Global Burden of Disease Study 2021

BackgroundUnderstanding the health consequences associated with exposure to risk factors is necessary to inform public health policy and practice. To systematically quantify the contributions of risk factor exposures to specific health outcomes, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 aims to provide comprehensive estimates of exposure levels, relative health risks, and attributable burden of disease for 88 risk factors in 204 countries and territories and 811 subnational locations, from 1990 to 2021.MethodsThe GBD 2021 risk factor analysis used data from 54 561 total distinct sources to produce epidemiological estimates for 88 risk factors and their associated health outcomes for a total of 631 risk–outcome pairs. Pairs were included on the basis of data-driven determination of a risk–outcome association. Age-sex-location-year-specific estimates were generated at global, regional, and national levels. Our approach followed the comparative risk assessment framework predicated on a causal web of hierarchically organised, potentially combinative, modifiable risks. Relative risks (RRs) of a given outcome occurring as a function of risk factor exposure were estimated separately for each risk–outcome pair, and summary exposure values (SEVs), representing risk-weighted exposure prevalence, and theoretical minimum risk exposure levels (TMRELs) were estimated for each risk factor. These estimates were used to calculate the population attributable fraction (PAF; ie, the proportional change in health risk that would occur if exposure to a risk factor were reduced to the TMREL). The product of PAFs and disease burden associated with a given outcome, measured in disability-adjusted life-years (DALYs), yielded measures of attributable burden (ie, the proportion of total disease burden attributable to a particular risk factor or combination of risk factors). Adjustments for mediation were applied to account for relationships involving risk factors that act indirectly on outcomes via intermediate risks. Attributable burden estimates were stratified by Socio-demographic Index (SDI) quintile and presented as counts, age-standardised rates, and rankings. To complement estimates of RR and attributable burden, newly developed burden of proof risk function (BPRF) methods were applied to yield supplementary, conservative interpretations of risk–outcome associations based on the consistency of underlying evidence, accounting for unexplained heterogeneity between input data from different studies. Estimates reported represent the mean value across 500 draws from the estimate's distribution, with 95% uncertainty intervals (UIs) calculated as the 2·5th and 97·5th percentile values across the draws.FindingsAmong the specific risk factors analysed for this study, particulate matter air pollution was the leading contributor to the global disease burden in 2021, contributing 8·0% (95% UI 6·7–9·4) of total DALYs, followed by high systolic blood pressure (SBP; 7·8% [6·4–9·2]), smoking (5·7% [4·7–6·8]), low birthweight and short gestation (5·6% [4·8–6·3]), and high fasting plasma glucose (FPG; 5·4% [4·8–6·0]). For younger demographics (ie, those aged 0–4 years and 5–14 years), risks such as low birthweight and short gestation and unsafe water, sanitation, and handwashing (WaSH) were among the leading risk factors, while for older age groups, metabolic risks such as high SBP, high body-mass index (BMI), high FPG, and high LDL cholesterol had a greater impact. From 2000 to 2021, there was an observable shift in global health challenges, marked by a decline in the number of all-age DALYs broadly attributable to behavioural risks (decrease of 20·7% [13·9–27·7]) and environmental and occupational risks (decrease of 22·0% [15·5–28·8]), coupled with a 49·4% (42·3–56·9) increase in DALYs attributable to metabolic risks, all reflecting ageing populations and changing lifestyles on a global scale. Age-standardised global DALY rates attributable to high BMI and high FPG rose considerably (15·7% [9·9–21·7] for high BMI and 7·9% [3·3–12·9] for high FPG) over this period, with exposure to these risks increasing annually at rates of 1·8% (1·6–1·9) for high BMI and 1·3% (1·1–1·5) for high FPG. By contrast, the global risk-attributable burden and exposure to many other risk factors declined, notably for risks such as child growth failure and unsafe water source, with age-standardised attributable DALYs decreasing by 71·5% (64·4–78·8) for child growth failure and 66·3% (60·2–72·0) for unsafe water source. We separated risk factors into three groups according to trajectory over time: those with a decreasing attributable burden, due largely to declining risk exposure (eg, diet high in trans-fat and household air pollution) but also to proportionally smaller child and youth populations (eg, child and maternal malnutrition); those for which the burden increased moderately in spite of declining risk exposure, due largely to population ageing (eg, smoking); and those for which the burden increased considerably due to both increasing risk exposure and population ageing (eg, ambient particulate matter air pollution, high BMI, high FPG, and high SBP).InterpretationSubstantial progress has been made in reducing the global disease burden attributable to a range of risk factors, particularly those related to maternal and child health, WaSH, and household air pollution. Maintaining efforts to minimise the impact of these risk factors, especially in low SDI locations, is necessary to sustain progress. Successes in moderating the smoking-related burden by reducing risk exposure highlight the need to advance policies that reduce exposure to other leading risk factors such as ambient particulate matter air pollution and high SBP. Troubling increases in high FPG, high BMI, and other risk factors related to obesity and metabolic syndrome indicate an urgent need to identify and implement interventions.FundingBill &amp; Melinda Gates Foundation.<br/

Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

Background: Understanding the health consequences associated with exposure to risk factors is necessary to inform public health policy and practice. To systematically quantify the contributions of risk factor exposures to specific health outcomes, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 aims to provide comprehensive estimates of exposure levels, relative health risks, and attributable burden of disease for 88 risk factors in 204 countries and territories and 811 subnational locations, from 1990 to 2021. Methods: The GBD 2021 risk factor analysis used data from 54 561 total distinct sources to produce epidemiological estimates for 88 risk factors and their associated health outcomes for a total of 631 risk–outcome pairs. Pairs were included on the basis of data-driven determination of a risk–outcome association. Age-sex-location-year-specific estimates were generated at global, regional, and national levels. Our approach followed the comparative risk assessment framework predicated on a causal web of hierarchically organised, potentially combinative, modifiable risks. Relative risks (RRs) of a given outcome occurring as a function of risk factor exposure were estimated separately for each risk–outcome pair, and summary exposure values (SEVs), representing risk-weighted exposure prevalence, and theoretical minimum risk exposure levels (TMRELs) were estimated for each risk factor. These estimates were used to calculate the population attributable fraction (PAF; ie, the proportional change in health risk that would occur if exposure to a risk factor were reduced to the TMREL). The product of PAFs and disease burden associated with a given outcome, measured in disability-adjusted life-years (DALYs), yielded measures of attributable burden (ie, the proportion of total disease burden attributable to a particular risk factor or combination of risk factors). Adjustments for mediation were applied to account for relationships involving risk factors that act indirectly on outcomes via intermediate risks. Attributable burden estimates were stratified by Socio-demographic Index (SDI) quintile and presented as counts, age-standardised rates, and rankings. To complement estimates of RR and attributable burden, newly developed burden of proof risk function (BPRF) methods were applied to yield supplementary, conservative interpretations of risk–outcome associations based on the consistency of underlying evidence, accounting for unexplained heterogeneity between input data from different studies. Estimates reported represent the mean value across 500 draws from the estimate's distribution, with 95% uncertainty intervals (UIs) calculated as the 2·5th and 97·5th percentile values across the draws. Findings: Among the specific risk factors analysed for this study, particulate matter air pollution was the leading contributor to the global disease burden in 2021, contributing 8·0% (95% UI 6·7–9·4) of total DALYs, followed by high systolic blood pressure (SBP; 7·8% [6·4–9·2]), smoking (5·7% [4·7–6·8]), low birthweight and short gestation (5·6% [4·8–6·3]), and high fasting plasma glucose (FPG; 5·4% [4·8–6·0]). For younger demographics (ie, those aged 0–4 years and 5–14 years), risks such as low birthweight and short gestation and unsafe water, sanitation, and handwashing (WaSH) were among the leading risk factors, while for older age groups, metabolic risks such as high SBP, high body-mass index (BMI), high FPG, and high LDL cholesterol had a greater impact. From 2000 to 2021, there was an observable shift in global health challenges, marked by a decline in the number of all-age DALYs broadly attributable to behavioural risks (decrease of 20·7% [13·9–27·7]) and environmental and occupational risks (decrease of 22·0% [15·5–28·8]), coupled with a 49·4% (42·3–56·9) increase in DALYs attributable to metabolic risks, all reflecting ageing populations and changing lifestyles on a global scale. Age-standardised global DALY rates attributable to high BMI and high FPG rose considerably (15·7% [9·9–21·7] for high BMI and 7·9% [3·3–12·9] for high FPG) over this period, with exposure to these risks increasing annually at rates of 1·8% (1·6–1·9) for high BMI and 1·3% (1·1–1·5) for high FPG. By contrast, the global risk-attributable burden and exposure to many other risk factors declined, notably for risks such as child growth failure and unsafe water source, with age-standardised attributable DALYs decreasing by 71·5% (64·4–78·8) for child growth failure and 66·3% (60·2–72·0) for unsafe water source. We separated risk factors into three groups according to trajectory over time: those with a decreasing attributable burden, due largely to declining risk exposure (eg, diet high in trans-fat and household air pollution) but also to proportionally smaller child and youth populations (eg, child and maternal malnutrition); those for which the burden increased moderately in spite of declining risk exposure, due largely to population ageing (eg, smoking); and those for which the burden increased considerably due to both increasing risk exposure and population ageing (eg, ambient particulate matter air pollution, high BMI, high FPG, and high SBP). Interpretation: Substantial progress has been made in reducing the global disease burden attributable to a range of risk factors, particularly those related to maternal and child health, WaSH, and household air pollution. Maintaining efforts to minimise the impact of these risk factors, especially in low SDI locations, is necessary to sustain progress. Successes in moderating the smoking-related burden by reducing risk exposure highlight the need to advance policies that reduce exposure to other leading risk factors such as ambient particulate matter air pollution and high SBP. Troubling increases in high FPG, high BMI, and other risk factors related to obesity and metabolic syndrome indicate an urgent need to identify and implement interventions

Antimicrobial Resistance Profile of Clinically Isolated Bacteria at Wolaita Sodo University Teaching Referral Hospital

Abstract Background: Antibiotic resistance is a serious threat to the human populations everywhere. However, less attention is given to its concern in sub-Saharan Africa including Ethiopia. There is information gap for the prescribers regarding antibiotic resistance and its pattern. The aim of this study was to review the antimicrobial resistance pattern of bacteria in Wolaita Sodo University Teaching Referral Hospital. Methods: Three years retrospective data of cultures and records of 330 patients were used to analyze the antibiotic sensitivity pattern. The statistical softwares including Epidata 3.5.1 and SPSS version 21 were used. Laboratory records lacking age, sex, culture isolation or drug susceptibility test data were excluded. Results: Out of 330 samples extracted from the microbiology laboratory, 150 samples were culture positive for bacteria isolates. From positive culture growth, 73.3% were gram positive bacteria whereas 26.7% were gram negative. Staphylococcus aureus was the most prevalent isolate among gram-positive isolates as Escherichia coli was for gram negative isolates. Overall antimicrobial resistance of gram positive isolates was 54.2% where as that of gram negative bacteria was 60.0%.Conclusion: As per this study, S. aureus and E. coli were the pathogenic isolates of highest prevalence among gram positive and gram-negative bacteria, respectively, in the study population. Most of the isolated pathogens showed high resistance towards the commonly prescribed antimicrobial agents.</jats:p

Reversible Long Term Contraceptives Utilization among Married Women of Reproductive Age Group in Areka Town, Southern Ethiopia

BACKGROUND፡ In low income countries, bearing many children is the main factor affecting maternal health. This study aimed to estimate the prevalence of reversible long term contraceptives utilization and identify factors associated with it among married women of child bearing age in Areka District in South EthiopiaMETHODS: We conducted a community-based cross-sectional survey involving systematically recruited 346 married women of reproductive age group. Data was collected using a structured interviewer-administered questionnaire on May 2019. We used SPSS version 25 for data entry and analyses. Bivariate logistic regression analysis was used to select exposure variables with crude association. Multivariate analysis was done to control for potential confounders and identify predictors of the outcome. Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI)was reported, and statistical significance was declared at p&lt;0.05.RESULTS: The prevalence of reversible long term contraceptives utilization among married women of reproductive age group was 134(38.7%). Utilization of Reversible Long Term Contraceptives (RLTCs) was positively associated with being protestant Christian religion follower, advanced educational status, history of abortion, and having a better attitude towards reversible long term contraceptives. In other words, being housewife, being daily laborer, having no radio in the household and making fertility decisions alone were negatively associated.CONCLUSION: The prevalence of RLTCs in the study area was high. Women should be empowered educationally through other alternative opportunities to formal school. In addition to electronic media, different community events and community conversations should be used to convey messages on contraceptives particularly RLTCs. Behavioral change communications would benefit women in shaping their attitudestowards RLTCs.</jats:p

Breast self-examination and associated factors among women in Wolaita sodo city, Ethiopia: Community based cross sectional study

Abstract Background: Early detection of breast cancer plays an important role in decreasing morbidity and mortality associated with breast cancer. Breast self-examination (BSE) is one of the screening methods for early detection of breast cancer. BSE involves the woman herself looking at and feeling each breast for possible lumps, distortions or swelling. BSE is a simple exercise which can potentially save the life of a woman but it is not well focused yet. So, this study was aimed to assess breast Self-Examination and associated factors among women in Wolaita Sodo city, Ethiopia. Methods: Community based cross-sectional study design was employed. Systematic random sampling technique was used to select 626 women aged 20-65 years old. The data were collected using pre-tested and structured questionnaire. The data was entered using Epi data version 3.5.1 and exported to SPSS version 21 software for statistical analysis. Bivariable and multiple logistic regression analysis were done.Variables with P-value less than 0.05 were considered as statically significant. Results: A total of 629 women were included in the study. More than half (60.9%) of the participants were in the age range of 20-29 years. Women who had mentioned BSE as method for early detection of breast problem were 6.36 times (AOR: 6.36, 95% CI :( 3.72, 10.71) more likely to perform BSE than those who say that they don’t know any method. Women breast feed 13-24 months were 2.43 times AOR: 2.43, 95% CI :( 1.28, 4.59) more likely to examine their breast than those who breast feed different duration. Employed women were 3.13 times more likely AOR: 3.13 95% CI :( 1.14, 8.58) to practice BSE than women not employed. Likewise being student was 3.73 times AOR: 3.73, 95% CI (1.19, 11.73) more likely to perform BSE than others. Conclusion: The finding of this study showed that women’s practice of breast self-examination is relatively low. Knowledge of BSE, breast feeding 13-24 months, being employed and being student were factors affecting performing breast self-examination. Therefore, educating girls and increasing awareness on electronics media is important.</jats:p

Sexual quality of life and associated factors among podoconiosis patients in Wolaita zone, South Ethiopia

Abstract Background Sexual health is a crucial aspect of overall well-being, yet individuals with podoconiosis often face stigma and exclusion from healthcare services which promote sexual health. In Ethiopia, particularly in the study area, the Sexual quality of life (SQOL) of podoconiosis patients remains unexplored. This study aimed to assess the SQOL and associated factors among podoconiosis patients in Wolaita Zone, South Ethiopia. Methods A community-based cross-sectional study was conducted among 639 podoconiosis patients using a multistage sampling technique. SQOL-F and SQOL-M questionnaires (validated tools) were used to collect data via Kobocollect software. Generalized Linear Models (GLM) with a log link and gamma variance were employed to examine associations between SQOL and independent variables. Data analysis was performed using STATA version 14, with statistical significance set at p-value < 0.05. Results The total of 639 respondents were included in this study. The median SQOL-F and SQOL-M scores were 50 and 22, respectively, with 60.5% of females and 84.2% of males having low SQOL score. Factors positively influencing SQOL-F score included having an educated partner, having family and government support, healthcare accessibility, ability to move from place to place, positive sexual health attitudes, and middle-income status. SQOL-M scorewas negatively affected by having a partner in government or private work, additional chronic illnesses, shorter disease duration, and poor healthcare experiences, while family and government support improved SQOL-M score. Conclusions Podoconiosis significantly lowers SQOL score for both men and women. Strengthening family and community support, improving healthcare access, and integrating sexual health interventions are essential for improving SQOL score among affected individuals