Prevalence, years lived with disability, and trends in anaemia burden by severity and cause, 1990-2021: findings from the Global Burden of Disease Study 2021

Background Anaemia is a major health problem worldwide. Global estimates of anaemia burden are crucial for developing appropriate interventions to meet current international targets for disease mitigation. We describe the prevalence, years lived with disability, and trends of anaemia and its underlying causes in 204 countries and territories. Methods We estimated population-level distributions of haemoglobin concentration by age and sex for each location from 1990 to 2021. We then calculated anaemia burden by severity and associated years lived with disability (YLDs). With data on prevalence of the causes of anaemia and associated cause-specific shifts in haemoglobin concentrations, we modelled the proportion of anaemia attributed to 37 underlying causes for all locations, years, and demographics in the Global Burden of Disease Study 2021. Findings In 2021, the global prevalence of anaemia across all ages was 24·3% (95% uncertainty interval [UI] 23·9–24·7), corresponding to 1·92 billion (1·89–1·95) prevalent cases, compared with a prevalence of 28·2% (27·8–28·5) and 1·50 billion (1·48–1·52) prevalent cases in 1990. Large variations were observed in anaemia burden by age, sex, and geography, with children younger than 5 years, women, and countries in sub-Saharan Africa and south Asia being particularly affected. Anaemia caused 52·0 million (35·1–75·1) YLDs in 2021, and the YLD rate due to anaemia declined with increasing Socio-demographic Index. The most common causes of anaemia YLDs in 2021 were dietary iron deficiency (cause-specific anaemia YLD rate per 100 000 population: 422·4 [95% UI 286·1–612·9]), haemoglobinopathies and haemolytic anaemias (89·0 [58·2–123·7]), and other neglected tropical diseases (36·3 [24·4–52·8]), collectively accounting for 84·7% (84·1–85·2) of anaemia YLDs. Interpretation Anaemia remains a substantial global health challenge, with persistent disparities according to age, sex, and geography. Estimates of cause-specific anaemia burden can be used to design locally relevant health interventions aimed at improving anaemia management and prevention. Funding Bill & Melinda Gates Foundation

Behavioral Responses for Face Cleanliness Message to Prevent Trachoma Among Mothers Having Children Age 1–9 Years Old, in Fogera District, Northwest Ethiopia: An Application of Extended Parallel Process Model

Natnael Muche, Yosef Wasihun, Habtamu Wondiye, Eyob Ketema Bogale, Tadele Fentabil Anagaw Department of Health Promotion and Behavioural science, school of Public Health College of Medicine and Health Science, Bahir Dar University, Bahir Dar, EthiopiaCorrespondence: Tadele Fentabil Anagaw, PO.BOX. 079, Tel +251-927692916, Email [email protected]: Trachoma is an eye disease caused by bacteria called Chlamydia trachomatis. This infection causes papillary and/or follicular inflammation of the tarsal conjunctiva referred to as active trachoma. Active trachoma prevalence among 1 to 9 years old children is 27.2% in Fogera district (study area). Many people still require the implementation of the face cleanliness components of the SAFE strategy. Even if face cleanness is an important component to prevent trachoma, there is limited research done on this area. Therefore, the purpose of this study is to assess behavioral responses to face cleanliness messages to prevent trachoma among mothers having children aged 1 to 9 years old.Methods: A community-based cross-sectional study was conducted with the guidance of an extended parallel process model in Fogera District from December 01 to December 30, 2022. A multi-stage sampling technique was used to select 611 study participants. Interviewer administered questionnaire was used to collect the data. Bivariable and multivariable logistic regression analysis was done to identify predictors of behavioral responses using SPSS V.23 significant variables were declared by AOR at a 95% confidence interval and a p-value < 0.05.Result: Among the total participants, 292 (47.8%) were in danger control. Residence [AOR = 2.91; 95% CI: (1.44– 3.86)], marital status [AOR = 0.79; 95% CI: (0.667– 0.939)], level of education [AOR = 2.74; 95% CI: (1.546– 3.65)], family size [AOR = 0.57; 95% CI: (0.453– 0.867)], round trip to collect water [AOR = 0.79; 95% CI: (0.423– 0.878)], having information about face washing [AOR = 3.79; 95% CI: (2.661– 5.952)], Source of an information health facility [AOR = 2.76; 95% CI: (1.645– 4.965)], school [AOR = 3.68; 95% CI: (1.648– 7.530)], health extension workers [AOR = 3.96; 95% CI: (2.928– 6.752)], Women development army [AOR = 2.809; 95% CI: (1.681– 4.962)], knowledge [AOR = 2.065; 95% CI: (1.325– 4.427)] self-esteem [AOR = 1.013; 95% CI: (1.001– 1.025)], self-control [AOR = 1.132; 95%CI: (1.04– 1.24)], and future orientation [AOR = 2.16; 95% CI: (1.345– 4.524)] were found to be statistically significant predictors of behavioral response.Conclusion: Less than half of the participants were in the danger control response. Residence, marital status, level of education, family size, face-washing information, source of information, knowledge, self-esteem, self-control, and future orientation were independent predictors of face cleanliness. Strategies of face cleanliness messages should give high attention to perceived efficacy with consideration of perceived threat.Keywords: trachoma, face cleanliness, behavioral response, extended parallel process mode

Formula Feeding Practice and Associated Factors Among Mothers Who Visited Health Facilities for Their Infants Aged Below 6 Months in Bahir Dar City, Northwest Ethiopia, 2020

Hamelmal Azene Alemu,1 Hiwot Tesfa,2 Tadele Fentabil Anagaw,3 Hunegnaw Almaw Derseh,4 Netsanet Fentahun Babbel4 1Department of Human Nutrition, Health Science College, Debre Tabor University, Debre Tabor, Ethiopia; 2Department of Public Health, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia; 3Department of Health Promotion and Behavioral Science, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia; 4Department of Public Health Nutrition, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, EthiopiaCorrespondence: Hunegnaw Almaw Derseh, Department of Public Health Nutrition, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, PO Box: 79, Bahir Dar, Ethiopia, Tel +251-912-80-22-59, Email [email protected]: Even though breastfeeding for infants and young children provides the ideal food for healthy growth and development, nowadays the use of infant formula feeding has increased worldwide. In developing countries, 1.3 million to 1.45 million childhood deaths are attributed to suboptimal breastfeeding practices.Objective: This study aimed to assess infant formula feeding practice and associated factors among mothers who visited health facilities for their infants aged less than 6 months in Bahir Dar city in 2020.Methods: An institution-based cross-sectional study was conducted in March–May 2020. Data were collected from 593 randomly selected mothers with infants less than 6 months of age. A multivariable logistic regression analysis was performed to identify associated factors of formula feeding practice with an a p-value of less than 0.05 and an adjusted odds ratio of 95% confidence interval.Results: The prevalence of infant formula feeding practices was 25%. Maternal age group of 25– 34 years [AOR = 2.388; 95% CI: 1.295, 4.406], mother’s occupation of private employee [AOR = 6.726; 95% CI: 2.756, 16.413], government employee [AOR = 4.726; 95% CI: 1.895, 8.700] and merchant [AOR = 2.798; 95% CI: 1.066, 7.345], positive attitude to infant formula [AOR = 2.10; CI: 1.09, 4.06], delayed breast milk initiation after delivery [AOR = 3.73; 95% CI: 1.504, 9.252], mothers who had 3 antenatal care [AOR = 2.294; 95% CI: 1.317, 3.997] and source of formula milk information from supermarket/pharmacy [AOR = 6.57; 95% CI: 1.48, 29.16] and from families/friends [AOR = 2.24; 95% CI: 1.24, 4.03] were independent predictors of infant formula feeding practice.Conclusion: This study’s findings revealed that one-fourth of mothers fed infant formula before the age of 6 months. Therefore, we recommended promoting behavior change communication, focusing on attitude change in formula feeding practice and its health consequences, promoting exclusive breastfeeding practice, and strengthening ANC service provision.Keywords: formula feeding practice, infants less than 6 months of age, Ethiopi