Determinants of iodine deficiency in school children in different regions of Ethiopia

Objective: To determine the magnitude of goitre in school children and measure indicators of iodine deficiency including the most commonly consumed staple foods.Design: A cross-sectional study.Setting: Ten villages from four administrative regions of Ethiopia.Subjects: A total of 2485 randomly selected elementary school children were examined for clinical signs of goitre. Indicators of iodine deficiency disorders (IDD) assessed were urinary iodine excretion (UIE) rate, iodine concentration in water, the commonly consumed individual foods of plant origin and milk, and bacterial contamination of drinking water.Results: The gross prevalence (mean of male and female values) among school children was 53.3%. The prevalence was higher in females (56.1%) than in males (50.8%). The highest prevalence (82 and 91%, respectively) were observed in the villages of Lotte and Kodowono and the lowest (31%) in the village of Abossara. Of the urinary measurements, 70% of the samples showed moderate and 30% mild iodine deficiency. Levels of iodine in water and individual food samples were low in general. Breast milk iodine content was similarly low and related to the maternal daily iodine intake which may affect the nutritional status of the nursing infant. The study also provides further evidence that coliforms and E. coli isolated from drinking water contribute to the high incidence of endemic goitre other than iodinedeficiency.Conclusion: It is difficult to obtain a sufficient iodine intake in the survey villages as the individual foods are very low in the element. However, IDD can be prevented by ensuring normal iodine nutrition through instituting ways that avail iodinated salt to the surveypopulation

The goitre rate, its association with reproductive failure, and the knowledge of iodine deficiency disorders (IDD) among women in Ethiopia: Cross-section community based study

<p>Abstract</p> <p>Background</p> <p>Iodine deficiency is severe public health problem in Ethiopia. Although urinary iodine excretion level (UIE) is a better indicator for IDD the goitre rate is commonly used to mark the public health significance. The range of ill effect of IDD is however beyond goitre in Ethiopia. In this study the prevalence of goitre and its association with reproductive failure, and the knowledge of women on Iodine Deficiency were investigated.</p> <p>Methods</p> <p>A cross-section community based study was conducted during February to May 2005 in 10998 women in child bearing age of 15 to 49 years. To assess the state of iodine deficiency in Ethiopia, a multistage "Proportional to Population Size" (PPS) sampling methods was used, and WHO/UNICEF/ICCIDD recommended method for goitre classification.</p> <p>Results</p> <p>Total goitre prevalence (weighted) was 35.8% (95% CI 34.5–37.1), 24.3% palpable and 11.5% visible goitre. This demonstrates that more than 6 million women were affected by goitre.</p> <p>Goitre prevalence in four regional states namely Southern Nation Nationalities and People (SNNP), Oromia, Bebshandul-Gumuz and Tigray was greater than 30%, an indication of severe iodine deficiency. In the rest of the regions except Gambella, the IDD situation was mild to moderate. According to WHO/UNICEF/ICCIDD this is a lucid indication that IDD is a major public health problem in Ethiopia. Women with goitre experience more pregnancy failure (X²= 16.5, p < 0.001; OR = 1.26, 1.12 < OR < 1.41) than non goitrous women. Similarly reproductive failure in high goitre endemic areas was significantly higher (X²= 67.52; p < 0.001) than in low. More than 90% of child bearing age women didn't know the cause of iodine deficiency and the importance of iodated salt.</p> <p>Conclusion</p> <p>Ethiopia is at risk of iodine deficiency disorders. The findings presented in this report emphasis on a sustainable iodine intervention program targeted at population particularly reproductive age women. Nutrition education along with Universal Salt Iodization program and iodized oil capsule distribution in some peripheries where iodine deficiency is severe is urgently required.</p

Impact of Education on Knowledge and Practice of Kala Azar Preventive Measures among Seasonal and Migrant Agricultural Workers in Northwest Ethiopia.

Kala azar occurs among seasonal and migrant agricultural workers in northwest Ethiopia and accounts for almost 60% of the disease burden in the country. We conducted a quantitative study on the level of knowledge and practice of this vulnerable group in relation to kala azar transmission and acceptability of its vector control tools. A total of 403 workers were randomly selected from eight farms using a purposive sampling technique. Knowledge and practice scores were calculated based on 12 and 9 core questions, respectively. Binary logistic regression was used to identify factors associated with knowledge and practice. A large gap in knowledge of the disease and the vector was evident with 61.8%, 24.6%, and 13.6% of the workers having poor, moderate, and good levels of knowledge scores, respectively. Similarly, 95% of the seasonal workers reported poor level of use of protective measures against the bite of the sand fly vector. Good level of knowledge about kala azar and its sand fly vector was statistically associated with formal education (adjusted odds ratio [AOR] = 2.11; 95% CI = 1.17, 3.80; P < 0.05) and previous exposure to health education (AOR = 4.72; 95% CI = 1.99, 11.16; P < 0.001). Despite poor current knowledge and practice, a large proportion of the study participants showed interest in using vector control tools if made available, with 78% of the seasonal and migrant workers expressing some willingness to pay for different measures that can protect against sand fly bites. Therefore, we strongly recommend that comprehensive health education and vector control programs should be provided to these workers

Routine health management information system data in Ethiopia: consistency, trends, and challenges.

Background: Ethiopia is investing in the routine Health Management Information System. Improved routine data are needed for decision-making in the health sector. Objective: To analyse the quality of the routine Health Management Information System data and triangulate with other sources, such as the Demographic and Health Surveys. Methods: We analysed national Health Management Information System data on 19 indicators of maternal health, neonatal survival, immunization, child nutrition, malaria, and tuberculosis over the 2012-2018 time period. The analyses were conducted by 38 analysts from the Ministry of Health, Ethiopia, and two government agencies who participated in the Operational Research and Coaching for Analysts (ORCA) project between June 2018 and June 2020. Using a World Health Organization Data Quality Review toolkit, we assessed indicator definitions, completeness, internal consistency over time and between related indicators, and external consistency compared with other data sources. Results: Several services reported coverage of above 100%. For many indicators, denominators were based on poor-quality population data estimates. Data on individual vaccinations had relatively good internal consistency. In contrast, there was low external consistency for data on fully vaccinated children, with the routine Health Management Information System showing 89% coverage but the Demographic and Health Survey estimate at 39%. Maternal health indicators displayed increasing coverage over time. Indicators on child nutrition, malaria, and tuberculosis were less consistent. Data on neonatal mortality were incomplete and operationalised as mortality on day 0-6. Our comparisons with survey and population projections indicated that one in eight early neonatal deaths were reported in the routine Health Management Information System. Data quality varied between regions. Conclusions: The quality of routine data gathered in the health system needs further attention. We suggest regular triangulation with data from other sources. We recommend addressing the denominator issues, reducing the complexity of indicators, and aligning indicators to international definitions

Unpacking the agroclimatic challenges and determinants of sweetpotato seed conservation and multiplication strategies by smallholder farmers in Southern Ethiopia

Sweetpotato is increasingly important in sub-Saharan Africa due to its yield potential under sub-optimal growing conditions. But lack of planting material (seed) at the onset of the rains is a major constraint. This study examined smallholder strategies for sweetpotato seed conservation and multiplication, their agroclimatic determinants, and farmers’ perceived drought risk at four sites (Dilla, Chuko, Hawassa, Sodo) in Ethiopia using informant interviews, a survey of 278 households, and agroclimatic statistics. Conservation practices were dictated by farming system and agroecological conditions. The long-term mean length of dry period when multipliers must conserve seeds ranged between 103 and 131 days across sites. Seed multipliers faced high uncertainty of rainfall onset that varied from the end of February to mid-May. Estimated probabilities of moderate and severe droughts affecting seed conservation ranged from 36–75%, and 15–58%, respectively. In drier sites, age of multiplier, land-holding size, sweetpotato production experience and access to extension were positively associated with being a vine multiplier. Knowledge of indigenous conservations strategies should inform seed system intervention design

Lesson Learned During a Pandemic: A Phenomenological Study of Pregnant Women&rsquo;s Experience in Resource-Limited Setting

Aneleay Cherinet,1 Abebayehu Zemedkun,2 Aregahegn Wudineh,1 Wondwosen Molla,1 Daniel Sisay,3 Belay Negassa,4 Andualem Mebratu,1 Aschalew Gossaye,5 Getnet Melaku,1 Derebe Madoro6 1Department of Midwifery, College of Health Sciences and Medicine, Dilla University, Dilla, Ethiopia; 2Department of Anesthesiology, College of Health Sciences and Medicine, Dilla University, Dilla, Ethiopia; 3School of Public Health, College of Health Sciences and Medicine, Dilla University, Dilla, Ethiopia; 4Department of Environmental Health, College of Health Sciences and Medicine, Dilla University, Dilla, Ethiopia; 5Departments of Nursing, College of Health Sciences and Medicine, Dilla University, Dilla, Ethiopia; 6Department of Psychiatry, College of Health Sciences and Medicine, Dilla University, Dilla, EthiopiaCorrespondence: Aneleay Cherinet, Department of Midwifery, College of Health Sciences and Medicine, Dilla University, P.O Box: 419, Dilla, Ethiopia, Tel +251938828045, Email [email protected] Abebayehu Zemedkun, Department of Anesthesiology, College of Health Sciences and Medicine, Dilla University, P.O Box: 419, Dilla, Ethiopia, Tel +251900053426, Email [email protected]: Pandemics like COVID-19 has strained healthcare systems globally, particularly in resource-limited settings where pre-existing healthcare gaps and constraints amplify the challenges faced by pregnant women. Having this lesson on pregnant women’s experiences during COVID-19 offers invaluable insights into potential strategies and interventions needed to mitigate the impact of similar outbreaks in the future. Therefore, this phenomenological study aimed to uncover the experiences of pregnant women during the COVID-19 pandemic in Dilla town, Gedeo zone, southern Ethiopia.Method and Materials: A descriptive phenomenological design was employed at Dilla University teaching hospital. A Purposive sampling technique was used and point of data saturation was declared at participant 16th. An in-depth interview was conducted in a private room after they received antenatal care services. The interviews were audiotaped, transcribed, and analysed using the open code software version 4.03. The interviews were transcribed verbatim to provide tick descriptions of data. Thematic analysis was employed using an inductive approach. Direct quotes from participants were included without any grammar editing to preserve their intended meaning.Results: Our study found five predominant themes: mental health consequences of the COVID-19 pandemic, health impact of COVID-19, concerns over the economic impact of the COVID-19 pandemic, COVID-19 influence on social engagements, and challenge on getting reliable information.Conclusion and Recommendation: This study identified that pregnant women experienced various challenges during the pandemic which includes psychological problems, health impact of COVID-19, economic problems, lack of reliable information and limited social support. Hence, implementing a customized approach by integrating psychosocial interventions with prenatal care services and conducting intensive health education sessions and economic empowerment are beneficial as mitigation strategies to better prepare for future pandemics.Keywords: pandemic, COVID-19, pregnant women, lived experience, resource limited, phenomenological study, Dill

Understanding the risk perception of visceral leishmaniasis exposure and the acceptability of sandfly protection measures among migrant workers in the lowlands of Northwest Ethiopia: a health belief model perspective.

BACKGROUND: Visceral leishmaniasis (VL) is the leading cause of health concerns among Ethiopian migrant workers. Understanding risk perception and health-protective behavior are significant challenges in the prevention and eradication of the disease. As a result, studies are required to assess these important epidemiological factors, which will provide guidance on how to assist migrant workers in taking preventive measures against VL. METHOD: We conducted qualitative research among migrant workers on seasonal agricultural farms in Northwest Ethiopia between June and November 2019 to assess their perception of the risk of contracting VL and their willingness to use protective measures against the disease. Seventeen focus group discussions and 16 key informant interviews were conducted to study migrant workers' risk perception in relation to sandfly bite exposure and use of sandfly control measures. For analysis, all interviews were recorded, transcribed, and translated. ATLASti was used to perform qualitative content analysis on the data. RESULT: Migrant workers are fearful of VL because of previous exposure and the disease's prevalence in the area. They believe, however, that VL is a minor illness that is easily treated. While Insecticide Treated Nets (ITNs) are widely accepted as a protective measure, there are still reservations about using them due to the seasonality of the transmission, difficulties in hanging them on farm areas, and a preference for alternative traditional practices. Regardless of perceived self-efficacy, the central cues were the message delivered by the health workers and an increase in sandfly bite irritation. Based on the findings, three levels of intervention modalities are suggested: 1) increasing pre-arrival awareness through outdoor media (posters, stickers, billboards), 2) encouraging proper use of protective measures upon arrival at farm camps, and 3) informing departing workers on disease recognition and best practices for health-seeking continuous use of protective measures at home. CONCLUSION: This finding suggests that VL prevention interventions should focus on individuals' perceptions in order to promote consistent use of protective measures. The findings are highly useful in planning effective interventions against VL

Iodine nutritional status and risk factors for goitre among schoolchildren in south Tajikistan

Iodine deficiency affects nearly 1.9 billion people worldwide, but it can be prevented by salt iodization. This cross-sectional survey assessed current iodine status, iodized salt coverage and risk factors for goitre among schoolchildren in South Tajikistan.; Ten primary schools in four districts in South Tajikistan were randomly selected. In schoolchildren aged 7 to 11 years, a spot urine sample was collected for measurement of urinary iodine, dried blood spots were collected for measurement of thyroglobulin, and goitre was assessed by palpation. Iodine content of salt samples and local selling points was determined by coloration using rapid test kits and titration method.; Of 623 schoolchildren enrolled, complete data was obtained from 589. The overall median urinary iodine concentration (UIC) was 51.2 mug/L indicating mild-to-moderate iodine deficiency. Among all children, 46.6% (95% Confidence Interval (CI) = 42.4%-50.6%) of children were found to be goitrous (grade 1 goitre: 30.6%, 95% CI = 26.9%-34.5%; grade 2 goitre: 16.0%, 95% CI = 13.1%-19.2%). The risk factor for goitre remaining significant in the multivariable logistic regression model was 'buying salt once a month' (OR = 2.89, 95% CI = 1.01-8.22) and 'buying salt once every six months' (OR = 2.26, 95% CI = 1.01-5.04) compared to 'buying salt every one or two weeks'. The overall median thyroglobulin concentration was elevated at 13.9 mug/L. Of the salt samples from households and selling points, one third were adequately iodised, one third insufficiently and one third were not iodised.; Iodine deficiency remains a serious health issue among children in southern Tajikistan. There is a persisting high prevalence of goitre, elevated thyroglobulin and low UIC despite interventions implemented by Tajikistan and international partners. Quality control of salt iodine content needs to be improved. Continued efforts to raise awareness of the health effects of iodine deficiency are needed to increase consum demand for iodised salt