Geographical Variations and Factors Associated with Childhood Diarrhea in Tanzania: A National Population Based Survey 2015-16

BACKGROUND: Diarrhea remains the leading cause of morbidity and mortality among under 5 children in low- and middle-income countries. In Tanzania, diarrhea remains one of the major public health problems. This study aimed to investigate spatial variations and the factors correlated with diarrhea in under five children.METHODS: This is a secondary data analysis using data from the population-based cross section Tanzanian Demographic and Health Survey 2015-16 data. Spatial analysis was done using the Bernoulli model from SaTScan™ software, and a generalized linear mixed model was used to identify the factors associated with childhood diarrhea.RESULTS: The overall reported prevalence of childhood diarrhea for the under five children in Tanzania was 12.1% (95%CI 11.3%-12.9%). The SaTScan spatial statics analysis revealed that diarrhea in children was not random. The odds of diarrhea were 7.35 times higher (AOR= 7.35; 95%CI: 5.29, 10.22) among children in the 6- 11 months age group compared to children within the 48-59 months of age. As mother’s age increased, the risk of diarrhea for the under five children decreased whereas the highest risk of diarrhea was observed in the two rich income brackets richer (AOR=1.70, 95%CI=1.30, 2.22), and richest (AOR= 1.05, 95%CI=1, 1.09). The odds of diarrhea were 1.25 times higher (AOR=1.25, 95%CI=1.06, 1.46) among children with unsafe stool disposal compared to those with safe disposal.CONCLUSION: The socio-demographic factors associated with diarrhea among children were mother’s age in years, current age of the child, wealth index and child stool disposal

Sex trafficking awareness and associated factors among youth females in Bahir Dar town, North-West Ethiopia: a community based study

BACKGROUND: Sex trafficking is a contemporary issue in both developed and developing countries. The number of trafficked women and young girls has increased globally. Females aged 18–25 are the most targeted group of trafficking. Although the problem is evident in Ethiopia, there are no studies that explored sex trafficking awareness among females. Therefore, the aim of this study was to assess sex trafficking awareness and associated factors among youth females in Bahir Dar town, North-West Ethiopia. METHODS: A community based cross-sectional study design was employed to collect data from February 1(st)-30(th) 2012 from a total of 417 youth females. The participants in the study were selected using systematic random sampling techniques. A structured Amharic questionnaire was used to collect data. Data were entered, cleaned and analyzed using SPSS 16.0. Descriptive statistics were used to describe data. Logistic regression analysis was used to identify factors associated with sex trafficking awareness. RESULT: Two hundred forty-nine (60%) of the participants reported that they had heard or read about sex trafficking. Television (64%), friends (46%) and radio (39%) were the most frequently mentioned sources of information about sex trafficking. About 87% and 74% of the participants mentioned friends and brokers respectively as mediators of sex trafficking. Having TV at home (AOR = 2. 19, 95% CI: 1.31-3.67), completing grade 10 or more (AOR = 2. 22, 95% CI: 1.18-4.17), taking training on gender issues (AOR = 3. 59, 95% CI: 2.11-6.10) and living together with parents (AOR = 3. 65, 95% CI: 1.68-7.93) were factors found associated with sex trafficking awareness. CONCLUSION: In this study, sex trafficking awareness was low among youth females. Having TV at home, living together with someone and being trained on gender issues were predictors of sex trafficking awareness. Therefore, providing education about sex trafficking will help to increase sex trafficking awareness among youth females

Occupational Exposure to Blood and Body Fluids Among Health Care Professionals in Bahir Dar Town, Northwest Ethiopia

AbstractBackgroundHealth care professionals (HCPs) are at high risk of contracting blood-borne infections due to their occupational exposure to blood and body fluids (BBFs). The incidence of these infections among HCPs are higher in low income countries such as Ethiopia. The aim of the study was to investigate the extent of occupational exposure to BBFs and its associated factors among HCPs in Bahir Dar town, Ethiopia.MethodsA cross-sectional study was used from October 1, 2012 to October 30, 2012. Three hundred and seventeen HCPs were included in the study using a simple random sampling technique. The data were collected using a structured questionnaire and analyzed using SPSS version 16. Bivariate and multivariate analyses were used to identify the factors related to exposure to BBFs.ResultsTwo hundred and nine (65.9%) HCPs were exposed to BBFs in the past year, of which 29.0% were needlestick injuries. Work experience [adjusted odds ratio (AOR) 4.13, 95% confidence interval (CI) 1.56–10.91], inconsistent use of gloves (AOR 1.98, 95% CI 1.04–3.43), and not complying with standard precautions (AOR 1.80, 95% CI 1.00–3.22) were the factors associated with occupational exposure to BBFs.ConclusionA high proportion of HCPs was exposed to BBFs in this study. Occupational exposure to BBFs was determined by the use of gloves and not complying with standard precautions. Ensuring the availability of gloves, training about standard precautions, and motivation of HCPs to implement standard precautions should be emphasized to avoid such exposures

Childhood diarrhea in high and low hotspot districts of Amhara Region, northwest Ethiopia: a multilevel modeling

Background: Childhood diarrhea is one of the major public health problems in Ethiopia. Multiple factors at different levels contribute to the occurrence of childhood diarrhea. The objective of the study was to identify the factors affecting childhood diarrhea at individual and community level. Methods: A cross-sectional study design was employed from February to March 2015 in high and low hotspot districts of Awi and West and East Gojjam zones in Amhara Region, northwest Ethiopia. Districts with high and low hotspots with childhood diarrhea were identified using SaTScan spatial statistical analysis. A total of 2495 households from ten (five high and five low hotspot) randomly selected districts were included in the study. A semi-structured questionnaire was used to collect data. Data were entered and cleaned in Epi Info 3.5.2 version and analyzed using Stata version 12. A multilevel logistic regression was used to identify factors associated with childhood diarrhea. Results: The prevalence of childhood diarrhea was 13.5 % and did not show significant variation between high [14. 3 % (95 % CI 12.3\u201316.2 %)] and low [12.7 % (95 % CI 10.9\u201314.6 %)] hotspot districts. Individual- and community-level factors accounted for 35 % of childhood diarrhea variation across the communities in the full model. Age of children (6\u201335 months), complementary feeding initiation below 6 months, inadequate hand washing practices, limited knowledge of mothers on diarrhea, lowest wealth status of households, and longer time interval to visit households by health extension workers were factors for increasing the odds of childhood diarrhea at the individual level. At the community level, lack of improved water supply and sanitation and unvaccinated children with measles and rotavirus vaccine were the factors associated with childhood diarrhea. Conclusions: In this study, childhood diarrhea occurrences remained high. Both individual- and community-level factors determined the occurrence of diarrhea. Interventions should consider both individual- and community-level factors to reduce the occurrence of childhood diarrhea

Morbidity and mortality from road injuries: results from the Global Burden of Disease Study 2017

BackgroundThe global burden of road injuries is known to follow complex geographical, temporal and demographic patterns. While health loss from road injuries is a major topic of global importance, there has been no recent comprehensive assessment that includes estimates for every age group, sex and country over recent years.MethodsWe used results from the Global Burden of Disease (GBD) 2017 study to report incidence, prevalence, years lived with disability, deaths, years of life lost and disability-adjusted life years for all locations in the GBD 2017 hierarchy from 1990 to 2017 for road injuries. Second, we measured mortality-to-incidence ratios by location. Third, we assessed the distribution of the natures of injury (eg, traumatic brain injury) that result from each road injury.ResultsGlobally, 1 243 068 (95% uncertainty interval 1 191 889 to 1 276 940) people died from road injuries in 2017 out of 54 192 330 (47 381 583 to 61 645 891) new cases of road injuries. Age-standardised incidence rates of road injuries increased between 1990 and 2017, while mortality rates decreased. Regionally, age-standardised mortality rates decreased in all but two regions, South Asia and Southern Latin America, where rates did not change significantly. Nine of 21 GBD regions experienced significant increases in age-standardised incidence rates, while 10 experienced significant decreases and two experienced no significant change.ConclusionsWhile road injury mortality has improved in recent decades, there are worsening rates of incidence and significant geographical heterogeneity. These findings indicate that more research is needed to better understand how road injuries can be prevented

Burden of injury along the development spectrum : associations between the Socio-demographic Index and disability-adjusted life year estimates from the Global Burden of Disease Study 2017

Background The epidemiological transition of non-communicable diseases replacing infectious diseases as the main contributors to disease burden has been well documented in global health literature. Less focus, however, has been given to the relationship between sociodemographic changes and injury. The aim of this study was to examine the association between disability-adjusted life years (DALYs) from injury for 195 countries and territories at different levels along the development spectrum between 1990 and 2017 based on the Global Burden of Disease (GBD) 2017 estimates. Methods Injury mortality was estimated using the GBD mortality database, corrections for garbage coding and CODEm-the cause of death ensemble modelling tool. Morbidity estimation was based on surveys and inpatient and outpatient data sets for 30 cause-of-injury with 47 nature-of-injury categories each. The Socio-demographic Index (SDI) is a composite indicator that includes lagged income per capita, average educational attainment over age 15 years and total fertility rate. Results For many causes of injury, age-standardised DALY rates declined with increasing SDI, although road injury, interpersonal violence and self-harm did not follow this pattern. Particularly for self-harm opposing patterns were observed in regions with similar SDI levels. For road injuries, this effect was less pronounced. Conclusions The overall global pattern is that of declining injury burden with increasing SDI. However, not all injuries follow this pattern, which suggests multiple underlying mechanisms influencing injury DALYs. There is a need for a detailed understanding of these patterns to help to inform national and global efforts to address injury-related health outcomes across the development spectrum.Peer reviewe

Predictors of HIV/AIDS Related Ocular Manifestations among HIV/AIDS Patients in Felege Hiwot Referral Hospital, Northwest Ethiopia

Background. Ocular manifestations in people living with HIV/AIDS are varied and affect almost all the structures of eye leading to visual impairment or blindness. Therefore, the aim of this study was to identify the predictors of HIV related ocular manifestation among ART clinic clients. Methods. Institution based cross-sectional study was employed among ART clients at Felege Hiwot referral hospital, northwest Ethiopia. The study was conducted from 1 January 2013 to 30 January 2013. A total of 369 systematically and randomly selected clients were included in the study. Data were collected using structured questionnaires and ophthalmologic clinical examination. Data were entered and analyzed using SPSS version 16.0. Binary and multivariable logistic regression analyses were computed to identify independent predictors of HIV related ocular manifestation. Results. Twenty-five percent (25.7%) of HIV patients had ocular manifestations. The three most frequent signs were Squamoid Conjuctival growth (26.9%), ophthalmic herpes zoster (22.1%), and Bacterial Conjuctivitis (17.2%). History of eye problem, CD4 count, and visual acuity of the eye were the predictors of HIV related ocular manifestation. Conclusion. In this study, a higher proportion of ocular manifestations were detected in HIV/AIDS patients. Visual acuity and CD4 counts were the independent predictors of ocular manifestations. This finding gives an insight for policy makers and concerned body to integrate ophthalmic examination in ART clinics to improve the health condition of HIV/ADIS patients

Pesticide use safety practices and associated factors among farmers in Fogera district wetland areas, south Gondar zone, Northwest Ethiopia

Background Farmers in developing countries, including Ethiopia, are exposed to agricultural pesticides, including pesticides that are restricted or banned in developed countries. There is little information available on pesticide use safety practices and associated factors among Ethiopian farmers, particularly in the study area. Objective To assess pesticide use safety practices and associated factors among farmers in Fogera district wetland area, Amhara region, Northwest Ethiopia. Methods A community-based cross-sectional study design that employs quantitative and qualitative methods was used from August 25 to September 30, 2021. Four hundred thirty participants were included by using a stratified random sampling technique. Pre-tested interview questionnaires, observational checklists, and key informant and in-depth interview guides were used to collect data. The quantitative data were collected by face-to-face interviews of farmers, whereas the qualitative data were collected by in-depth interviews of selected farmers and key informant interviews of responsible stalk holders. The data were entered into Epi data version 4.6 and analyzed using SPSS version 21. Bi-variable logistic regression was used to identify factors associated with the dependent variable. A p-value of less than 0.05 was used as a cut-off point to declare a statistically significant association between factors and outcome variables. The odds ratio and 95% CI were calculated to describe the strength of the association between factors and outcome variables. The qualitative study included 35 respondents from various backgrounds and levels of expertise, which were analyzed using thematic analysis by open-code 4.03 version software. Result The proportion of good pesticide use safety practices in the study area was 24.4% (95% CI: 21.4%–29.3%). Educational status (adjusted odds ratio (AOR): 3.19, 95% CI: 1.44–6.71), experience of pesticide spraying (AOR: 6.85. 95% CI: 2.426–9.35), knowledge of pesticide usage (AOR: 3.40, 95% CI: 1.459–7.855), access to safety materials (AOR: 2.06, 95% CI: 1.198–3.536), and ever having received training (AOR: 4.93, 95% CI: 2.88–8.59) were factors associated with good safety practice in pesticide use. Qualitatively, limited material access, lack of government attention, insufficient training opportunities, absence of media coverage, weak enforcement of laws, and limited guideline access barred good safety practices for pesticide use. Conclusion The study revealed that good safety practices were low in the study area. Being educated, having experience with pesticide spraying, having good knowledge of pesticide usage, having access to safety materials, and having received pesticide use training all increased the likelihood of good pesticide use practice. Insufficient training opportunities and material access, weak law enforcement, limited access to guidelines, and a shortage of media coverage were challenges identified qualitatively