Proximate determinants of fertility and contraceptive use among currently married women in Ethiopia

Philosophiae Doctor - PhD (Statistics and Population Studies)Fertility is one of the elements in population dynamics that has significant contribution towards changing population size and structure over time. In Ethiopia, fertility dropped only slightly between 2000 and 2005, from 5.5 children per woman to 5.4, and then decreased further to 4.8 children in 2011(CSA, 2012). Although a slight decreasing trend has shown from year to year, it is still high as compared to developed nations (Tewodros,2011). The age at which childbearing begins is an important factor in the overall level of fertility as well as of the health and well-being of the mother and the child (CSA, 2012).In 2008, of the 1.4 billion women in the developing world of reproductive age (15-49 years), more than 570 women die per 100,000 live births, and 70 percent of them die due to totally avoidable reasons (World Bank,2010). These women live in countries where their status is poor to extremely poor, and these conditions threaten their health in many ways. Sedgh, Hussain, Bankole, and Singh (2007) found that wherever fertility is high, maternal and infant and child mortality rates are high. In addition to these, high fertility and shorter birth intervals affect the survival chance of children and the health status of mothers. Demographic and Health Surveys (DHS) data from 18 developing countries in Asia, Latin America, Africa, and the Middle East showed that a birth interval of threeyears increases the survival status of under-five children (Rutstein, 2003). Moreover, a similar survey of 52 developing countries found that markedly short birth intervals have a negative effect on pregnancy outcomes, increased morbidity in pregnancy, and increased infant and child mortality (Rutstein,2005). Setty-Venugopal and Upadhyay (2002) have documented that, in Sub-Saharan Africa, about 60% of women deliver the next child before the index child celebrates his/her third birthday, and almost a quarter before the second birth day

Improving maternal and reproductive health in Ethiopia

This study aimed to examine the relationship between maternal health and good quality of life in an attempt to understand the years between 2005 and 2011. Data from the Ethiopia Demographic and Health Surveys 2005 and 2011 were used. Bivariate, Camer-V, chi-square and logistic regression analyses were used to determine the relative contribution of the predictor variables. The hypotheses tested in this study were that gender, wealth quintile, type of place of residence and region are highly significant with women’s education and work status. Females’ expected age (adjusted odds ratio = AOR) for some school training has dropped in 2011 from 0.678 to 0.255 for the age group 25–34, but male expected age (AOR) for some school has increased in 2011 from 0.784 to 2.274. The age of the respondent, age at first cohabitation and socio-economic variables were positively associated with having visited health facilities in the last 12 months and being visited by a family planning worker.IS

Detection and identification of antimicrobial-resistant Salmonella in raw beef at Wolaita Sodo municipal abattoir, Southern Ethiopia

Background: The consumption of multidrug resistant Salmonella isolates along with a raw meat dish is directly relevant to the global public health crisis of antimicrobial resistance. All countries around the globe are suffering from food-borne diseases. In developing countries, more than one billion individuals suffering from gastroenteritis and around five million infected individuals die annually. Methods: A cross-sectional study was carried out from December 2015 to May 2016 to show the risk of Salmonella associated with consuming traditional raw meat dishes and to characterize the antimicrobial resistance profile at Wolaita Sodo municipal abattoir. Animals were being processed as part of the normal work of the abattoir, and 448 carcass samples were taken after getting a written consent from the municipality. Samples were transported to Wolaita Sodo University Microbiology Laboratory in an ice box within an hour of collection. Swab samples were pre-enriched in tetrathionate broth and Rappaport-Vassiliadis R10 broth. Broth culture was sub-cultured on xylose lysine deoxycholate and brilliant green agar and incubated at a temperature of 37 \ub0C for overnight. Antimicrobial susceptibility test was done by disk diffusion method. Microbiological and observational data entry and analysis were done using Microsoft Excel 2007. Results: From the total 448 sampled carcasses, Salmonella growth was observed in 56 (12.5%) samples. The isolates had various resistance profiles, with resistance to 1 to 12 antimicrobial drugs. Tetracycline- and nitrofurantion-resistant isolates were frequent, 83.93 and 73.21% respectively, and followed by streptomycin-resistant isolates (66%). Ciprofloxacin-resistant isolates were rare (7%). Conclusion: Salmonella species contamination frequency was high in raw beef, and most of the isolates exhibited resistance to commonly used antibiotics. People living in the town and consuming the raw meat are at risk for developing diseases, and attention should be given to select antimicrobials in treating Salmonella infections in both animals and human being based on antimicrobial susceptibility test. Moreover, intersectoral working and developing one health approach is essential. Health information should be given to individuals who have the habit of eating raw meat. Training on sanitary and hygiene practice should be given to the abattoir workers

Correlates of gender characteristics, health and empowerment of women in Ethiopia

The low status of women prevents them from recognizing and voicing their concerns about health needs. This study aimed to examine the relationship between gender characteristics, health and empowerment of women in an attempt to understand between 2005 and 2011. Data from the Ethiopia Demographic and Health Survey (EDHS) 2005 and 2011 were used. Bivariate and multivariate analyses were used to determine the relative contribution of the predictor variables. The hypotheses tested in this study were that gender (men and women), health and empowerment of women in region are highly significant with women’s education and work status. Study findings showed that the low status of women and their disempowerment are highly associated with poor health outcomes. In both 2005 and 2011 men school ages were positively associated with their attainment in primary education, whereas for women it was negatively related with their attainment in some education. In both 2005 and 2011 women in the richest wealth quintile had the highest odds ratio of relating to some education

Correlates of gender characteristics, health and empowerment of women in Ethiopia

The low status of women prevents them from recognizing and voicing their concerns about health needs. This study aimed to examine the relationship between gender characteristics, health and empowerment of women in an attempt to understand between 2005 and 2011. Data from the Ethiopia Demographic and Health Survey (EDHS) 2005 and 2011 were used. Bivariate and multivariate analyses were used to determine the relative contribution of the predictor variables. The hypotheses tested in this study were that gender (men and women), health and empowerment of women in region are highly significant with women’s education and work status. Study findings showed that the low status of women and their disempowerment are highly associated with poor health outcomes. In both 2005 and 2011 men school ages were positively associated with their attainment in primary education, whereas for women it was negatively related with their attainment in some education. In both 2005 and 2011 women in the richest wealth quintile had the highest odds ratio of relating to some education

Proximate determinants of fertility in Ethiopia: comparative analysis of the 2005 and 2011 DHS

Fertility is one of the elements in population dynamics that makes a significant contribution towards changing population size and structure over time. In Ethiopia, for the last 10 years the total fertility rate (TFR) has declined slightly from 5.5 to 4.8 children in 2011. But, the TFR in urban areas has increased from 2.4 to 2.6 per 1000 live births. The Bongaarts model was applied to estimate the indices of the four main proximate determinants of fertility. Bongaarts defines the TFR of a population as a function of the total fecundity rate (TF), index of marriage (Cm), index of contraception (Cc), index of postpartum infecundability (Ci), and index of abortion (Ca); this can be written as TFR = Cm × Cc × Ci × Ca × TF. In 2005, the index of married women in urban areas was lower than rural, but it was unfortunately the same in urban and rural areas in 2011. For the last decade, the index of postpartum infecundability had a great fertility reduction effect compared with the contraception index and marriage index in rural Ethiopia. The lower the four indices of proximate determinants, the more fertility will be reduced. As such, the Ethiopian government, international non-governmental organizations and policy-makers must pay attention to increase the prevalence of contraceptive use and educate society to fight against child marriage. Permanent contraceptive use, such as female sterilization, should be promoted; moreover, legal organizations and the community must work together to raise the legal age of marriage to 18 years.IS

Ten golden rules for optimal antibiotic use in hospital settings: the WARNING call to action

Antibiotics are recognized widely for their benefits when used appropriately. However, they are often used inappropriately despite the importance of responsible use within good clinical practice. Effective antibiotic treatment is an essential component of universal healthcare, and it is a global responsibility to ensure appropriate use. Currently, pharmaceutical companies have little incentive to develop new antibiotics due to scientific, regulatory, and financial barriers, further emphasizing the importance of appropriate antibiotic use. To address this issue, the Global Alliance for Infections in Surgery established an international multidisciplinary task force of 295 experts from 115 countries with different backgrounds. The task force developed a position statement called WARNING (Worldwide Antimicrobial Resistance National/International Network Group) aimed at raising awareness of antimicrobial resistance and improving antibiotic prescribing practices worldwide. The statement outlined is 10 axioms, or “golden rules,” for the appropriate use of antibiotics that all healthcare workers should consistently adhere in clinical practice

Detection and identification of antimicrobial-resistant Salmonella in raw beef at Wolaita Sodo municipal abattoir, Southern Ethiopia

Abstract Background The consumption of multidrug resistant Salmonella isolates along with a raw meat dish is directly relevant to the global public health crisis of antimicrobial resistance. All countries around the globe are suffering from food-borne diseases. In developing countries, more than one billion individuals suffering from gastroenteritis and around five million infected individuals die annually. Methods A cross-sectional study was carried out from December 2015 to May 2016 to show the risk of Salmonella associated with consuming traditional raw meat dishes and to characterize the antimicrobial resistance profile at Wolaita Sodo municipal abattoir. Animals were being processed as part of the normal work of the abattoir, and 448 carcass samples were taken after getting a written consent from the municipality. Samples were transported to Wolaita Sodo University Microbiology Laboratory in an ice box within an hour of collection. Swab samples were pre-enriched in tetrathionate broth and Rappaport-Vassiliadis R10 broth. Broth culture was sub-cultured on xylose lysine deoxycholate and brilliant green agar and incubated at a temperature of 37 °C for overnight. Antimicrobial susceptibility test was done by disk diffusion method. Microbiological and observational data entry and analysis were done using Microsoft Excel 2007. Results From the total 448 sampled carcasses, Salmonella growth was observed in 56 (12.5%) samples. The isolates had various resistance profiles, with resistance to 1 to 12 antimicrobial drugs. Tetracycline- and nitrofurantion-resistant isolates were frequent, 83.93 and 73.21% respectively, and followed by streptomycin-resistant isolates (66%). Ciprofloxacin-resistant isolates were rare (7%). Conclusion Salmonella species contamination frequency was high in raw beef, and most of the isolates exhibited resistance to commonly used antibiotics. People living in the town and consuming the raw meat are at risk for developing diseases, and attention should be given to select antimicrobials in treating Salmonella infections in both animals and human being based on antimicrobial susceptibility test. Moreover, intersectoral working and developing one health approach is essential. Health information should be given to individuals who have the habit of eating raw meat. Training on sanitary and hygiene practice should be given to the abattoir workers

Additional file 1: Table S1. of Detection and identification of antimicrobial-resistant Salmonella in raw beef at Wolaita Sodo municipal abattoir, Southern Ethiopia

Conventional biochemical test results of the samples that yielded growth on agar at Wolaita Sodo municipal abattoir, 2016. Table S2 Antimicrobial susceptibility pattern of 56 isolates of Salmonella spp. at Wolaita Sodo municipal abattoir, 2016. Figure S1 Antimicrobial susceptibility pattern of salmonella isolate at Wolaita Sodo Municipal Abattoir, 2016. (DOCX 37 kb

Antibiotic resistant airborne bacteria and their multidrug resistance pattern at University teaching referral Hospital in South Ethiopia

Abstract Background Hospitals provide a reservoir of microorganisms, many of which are multi-resistant to antibiotics. Emergence of multi-drug resistant strains in a hospital environment, particularly in developing countries is an increasing problem to infection treatment. This study aims at assessing antibiotic resistant airborne bacterial isolates. Methods A cross-sectional study was conducted at Wolaita Sodo university teaching and referral Hospital. Indoor air samples were collected by using passive air sampling method. Sample processing and antimicrobial susceptibility testing were done following standard bacteriological techniques. The data was analyzed using SPSS version 20. Results Medically important bacterial pathogens, Coagulase negative staphylococci (29.6%), Staphylococcus aureus (26.3%), Enterococci species, Enterococcus faecalis and Enterococcus faecium (16.5%), Acinetobacter species (9.5%), Escherichia coli (5.8%) and Pseudomonas aeruginosa (5.3%) were isolated. Antibiotic resistance rate ranging from 7.5 to 87.5% was detected for all isolates. Acinetobacter species showed a high rate of resistance for trimethoprim-sulfamethoxazole, gentamicin (78.2%) and ciprofloxacin (82.6%), 28 (38.9%) of S. aureus isolates were meticillin resistant, and 7.5% Enterococci isolates of were vancomycin resistant. 75.3% of all bacterial pathogen were multi-drug resistant. Among them, 74.6% were gram positive and 84% were gram negative. Multi-drug resistance were observed among 84.6% of P. aeruginosa, of 82.5% Enterococcii, E. coli 78.6%, S. aureus 76.6%, and Coagulase negative staphylococci of 73.6%. Conclusions Indoor environment of the hospital was contaminated with airborne microbiotas, which are common cause of post-surgical site infection in the study area. Bacterial isolates were highly resistant to commonly used antibiotics with high multi-drug resistance percentage. So air quality of hospital environment, in restricted settings deserves attention, and requires long-term surveillance to protect both patients and healthcare workers