Soil-Transmitted Helminth Reinfection and Associated Risk Factors among School-Age Children in Chencha District, Southern Ethiopia: A Cross-Sectional Study

Mass drug administration (MDA) to the most risky population including school-age children (SAC) is the central strategy to control soil-transmitted helminth (STH) infection. The present study was aimed at estimating the prevalence of STHs reinfection three months posttreatment and associated risk factors among SAC in Chencha district. A cross-sectional study design was employed from April 20 to May 5, 2015, to enroll 408 SAC. Structured questionnaire and Kato-Katz thick smear technique were used to interview parents or guardians and quantify the number of eggs per gram of stool. Pearson chi-square and logistic regression were used to assess the association between predictor variable and STH reinfection. The prevalence of STHs within three months of mass chemotherapy among SAC was 36.8% which is 93.4% of the prevalence (39.4%) before treatment. The estimated prevalence of reinfection (95%CI) for Ascaris lumbricoides, Trichuris trichiura, and hookworms was 23.8% (21.1–28.2), 16.2% (12.7–20.1), and 1.0% (0.3–2.5), respectively. Children of merchant fathers were more likely to be reinfected by STHs in Chencha district. In conclusion, there is rapid reinfection after mass chemotherapy among SAC in Chencha district. Further studies should be carried out to generate cost efficient methods that can supplement mass drug administration to accelerate the control of STHs

Spatial, temporal, and demographic patterns in prevalence of chewing tobacco use in 204 countries and territories, 1990-2019 : a systematic analysis from the Global Burden of Disease Study 2019

Interpretation Chewing tobacco remains a substantial public health problem in several regions of the world, and predominantly in south Asia. We found little change in the prevalence of chewing tobacco use between 1990 and 2019, and that control efforts have had much larger effects on the prevalence of smoking tobacco use than on chewing tobacco use in some countries. Mitigating the health effects of chewing tobacco requires stronger regulations and policies that specifically target use of chewing tobacco, especially in countries with high prevalence. Findings In 2019, 273 center dot 9 million (95% uncertainty interval 258 center dot 5 to 290 center dot 9) people aged 15 years and older used chewing tobacco, and the global age-standardised prevalence of chewing tobacco use was 4 center dot 72% (4 center dot 46 to 5 center dot 01). 228 center dot 2 million (213 center dot 6 to 244 center dot 7; 83 center dot 29% [82 center dot 15 to 84 center dot 42]) chewing tobacco users lived in the south Asia region. Prevalence among young people aged 15-19 years was over 10% in seven locations in 2019. Although global agestandardised prevalence of smoking tobacco use decreased significantly between 1990 and 2019 (annualised rate of change: -1 center dot 21% [-1 center dot 26 to -1 center dot 16]), similar progress was not observed for chewing tobacco (0 center dot 46% [0 center dot 13 to 0 center dot 79]). Among the 12 highest prevalence countries (Bangladesh, Bhutan, Cambodia, India, Madagascar, Marshall Islands, Myanmar, Nepal, Pakistan, Palau, Sri Lanka, and Yemen), only Yemen had a significant decrease in the prevalence of chewing tobacco use, which was among males between 1990 and 2019 (-0 center dot 94% [-1 center dot 72 to -0 center dot 14]), compared with nine of 12 countries that had significant decreases in the prevalence of smoking tobacco. Among females, none of these 12 countries had significant decreases in prevalence of chewing tobacco use, whereas seven of 12 countries had a significant decrease in the prevalence of tobacco smoking use for the period. Summary Background Chewing tobacco and other types of smokeless tobacco use have had less attention from the global health community than smoked tobacco use. However, the practice is popular in many parts of the world and has been linked to several adverse health outcomes. Understanding trends in prevalence with age, over time, and by location and sex is important for policy setting and in relation to monitoring and assessing commitment to the WHO Framework Convention on Tobacco Control. Methods We estimated prevalence of chewing tobacco use as part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 using a modelling strategy that used information on multiple types of smokeless tobacco products. We generated a time series of prevalence of chewing tobacco use among individuals aged 15 years and older from 1990 to 2019 in 204 countries and territories, including age-sex specific estimates. We also compared these trends to those of smoked tobacco over the same time period. Findings In 2019, 273 & middot;9 million (95% uncertainty interval 258 & middot;5 to 290 & middot;9) people aged 15 years and older used chewing tobacco, and the global age-standardised prevalence of chewing tobacco use was 4 & middot;72% (4 & middot;46 to 5 & middot;01). 228 & middot;2 million (213 & middot;6 to 244 & middot;7; 83 & middot;29% [82 & middot;15 to 84 & middot;42]) chewing tobacco users lived in the south Asia region. Prevalence among young people aged 15-19 years was over 10% in seven locations in 2019. Although global age standardised prevalence of smoking tobacco use decreased significantly between 1990 and 2019 (annualised rate of change: -1 & middot;21% [-1 & middot;26 to -1 & middot;16]), similar progress was not observed for chewing tobacco (0 & middot;46% [0 & middot;13 to 0 & middot;79]). Among the 12 highest prevalence countries (Bangladesh, Bhutan, Cambodia, India, Madagascar, Marshall Islands, Myanmar, Nepal, Pakistan, Palau, Sri Lanka, and Yemen), only Yemen had a significant decrease in the prevalence of chewing tobacco use, which was among males between 1990 and 2019 (-0 & middot;94% [-1 & middot;72 to -0 & middot;14]), compared with nine of 12 countries that had significant decreases in the prevalence of smoking tobacco. Among females, none of these 12 countries had significant decreases in prevalence of chewing tobacco use, whereas seven of 12 countries had a significant decrease in the prevalence of tobacco smoking use for the period. Interpretation Chewing tobacco remains a substantial public health problem in several regions of the world, and predominantly in south Asia. We found little change in the prevalence of chewing tobacco use between 1990 and 2019, and that control efforts have had much larger effects on the prevalence of smoking tobacco use than on chewing tobacco use in some countries. Mitigating the health effects of chewing tobacco requires stronger regulations and policies that specifically target use of chewing tobacco, especially in countries with high prevalence. Copyright (c) 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.Peer reviewe

Prevalence of Stunting and Its Associated Factors among Children of 6–59 Months in Arba Minch Health and Demographic Surveillance Site (HDSS), Southern Ethiopia: A Community-Based Cross-Sectional Study

Introduction. Child stunting, which is a chronic length or height growth deficit, has been a devastating public health problem in developing countries. In Ethiopia, stunting remains severe public health problem. The aim of the study was to assess the prevalence of stunting and its associated factors among children of 6–59 months. Methods. The community-based cross sectional study was conducted in the Arba Minch Health and Demographic Surveillance Site, Southern Ethiopia. The simple random sampling method was used to recruit 656 mother-child pairs. Height for age Z score was computed using WHO Anthro version 3.2.2 software. Multivariable logistic regression model was fitted, and adjusted odds ratio (AOR) at p value <0.05 was used to determine statistically significant association between predictors and outcome variable. Result. The prevalence of stunting among children of 6–59 months in the study area was 47.9% (95% CI; 44.0–51.7). The likelihood of stunting was significantly higher among children who live in households with medium (AOR 2.20, 95% CI: 1.43–3.37) and poor (AOR 2.87, 95% CI: 1.72–4.81) wealth status. In addition, children who were not exclusively breast fed (AOR 1.55, 95% CI: 1.07–2.24), whose mothers had not participated in decision of major household purchases (AOR 2.27, 95% CI: 1.21–4.26), and whose mothers lacked decision on freedom of mobility (AOR 1.96, 95% CI: 1.05–3.66) were significantly stunted compared with counterparts. Conclusion. Stunting is a severe public health problem in the area. Therefore, efforts should be taken to enhance maternal empowerment, household wealth, and infant and young child feeding practice for reducing stunting among children

Prevalence and factors associated with stunting and thinness among school-age children in Arba Minch Health and Demographic Surveillance Site, Southern Ethiopia.

INTRODUCTION:Despite consistent economic growth in the country, malnutrition remains one of the major public health problems in Ethiopia. The prevalence of malnutrition and its associated factors are well studied among under-five children. However, there is a paucity of evidence among older children in developing countries including Ethiopia. The aim of the study was to assess the prevalence of stunting and thinness and their associated factors among school-age children. METHODS:A community-based cross-sectional study was conducted among randomly selected 389 school-age children in Arba Minch Health and Demographic Surveillance Site, Southern Ethiopia, during April and May 2017. Height for age and body mass index for age z scores were calculated using WHO Anthro Plus software as indicators of stunting and thinness respectively. A binary logistic regression model was used to assess the association between independent and outcome variables. RESULTS:The prevalence of stunting and thinness were 41.9% (95% CI: 37-47) and 8.0% (95% CI: 5.4-10.8) respectively. The likelihood of stunting was significantly higher among children within the age group of 12-14 years old (AOR = 2.97, 95% CI: 1.78-4.95); children who were male (AOR = 1.94, 95% CI: 1.21-3.10); children living in households with medium wealth terciles (AOR = 2.90, 95%CI: 1.39-6.04); and children who were non-enrolled in schools (AOR = 2.25, 95% CI: (1.37-3.70). Moreover, thinness was 63% less common among children who had a dietary diversity score of <4 food groups (AOR = 0.37, 95%CI: 0.16-0.89). CONCLUSION:The prevalence of thinness is low when compared to the prevalence reported by a single national school health and nutrition survey in Ethiopia. Stunting is a major public health concern. Therefore, this finding warrants the need to implement school health and nutrition programs to improve the nutritional status of school-age children in the study area. The interventions should focus towards both gender and special emphasis should also be given to increase the enrollment of children in schools. In addition, effort should be taken by stakeholders in different hierarchies to improve the family wealth status

Prevalence of Undernutrition and Associated Factors among Lactating Mothers of Angecha District, Kembata Tembaro Zone, Southern Ethiopia

Background. Major reasons for malnutrition, particularly among those who live in low- and middle-income countries, are physiological vulnerability and inadequate intake. The objective of the study was to assess the prevalence of undernutrition and associated factors among lactating mothers of Angecha District, Southern Ethiopia. Methods. A community-based cross-sectional study was conducted among randomly selected lactating mothers in Angecha District from March to April 2017. A pretested structured questionnaire was used to assess the prevalence of undernutrition and associated factors among lactating mothers. Undernutrition was defined as the body mass index of less than 18.5 kg/m2. A multivariable logistic regression model was fitted, and the adjusted odds ratio (AOR) at a p value less than 0.05 was used to determine a statistically significant association between predictors and outcome variables. Result. The prevalence of undernutrition among lactating mothers was 21.2% (95% CI: 17.52, 25.46). The odds of undernutrition were higher among lactating mothers in the younger age group (AOR 4.12 (95% CI: 1.25–13.63), compared to 36–49 years group), dietary diversity less than five food groups (AOR 2.4, 95% CI: 1.35–4.36), and not attending antenatal care (ANC) (AOR 2.90 (95% CI: 1.43–5.86), compared to those who attended ANC for 4 or more times). The odds of undernutrition among lactating women from 3rd quantile wealth index households reduced by nearly half (AOR 0.47, 95% CI: 0.23–0.98) compared to lactating mothers from 1st quantile wealth index households. Conclusion. Nearly one in every five lactating mothers was undernourished. Age, dietary diversity score, ANC visit, and wealth index were found to be the associated factors of undernutrition. Therefore, due attention should have to be given to increase the use of ANC

Exploring Reasons for Low Attendance of Mothers to Growth Monitoring and Promotion Program at Loka Abaya District, Southern Ethiopia: Exploratory Qualitative Study

Background. Different organizations in Ethiopia are currently working on prevention and promotion activities to fight malnutrition among children through a community-based nutrition program. One of these activities with little success is growth monitoring and promotion (GMP). Exploring the reason and better understanding of low attendance of mothers to the GMP program can help to improve the program by incorporating finding. The aim of the study was to explore reasons for low attendance to the GMP program among mothers of under-two children. Method. An exploratory qualitative study design was used to unearth reasons for low attendance of mothers with under-2-year-old child to the GMP program. In-depth interviews were carried out with 13 mothers. The data were analyzed using qualitative content analysis approach. Result. Mothers perceived that GMP is (meant) for unhealthy children (only). Again mothers mentioned community dishonor of mothers with wasted children and method of weighing a child as a community-related reason for low attendance to the GMP program. They also indicated that there was no community conversation and weak counseling of the mothers about child feeding and growth. Perception about “evil eye” was also indicated as a reason for lower attendance of the program. Conclusion. Mothers showed that there was lack of knowledge about GMP. Limited community conversation and weak counseling about child nutrition as a GMP program were explored reasons for low attendance. Other reasons mentioned by the mothers were consideration of “evil eye” and method of weighing a child. Further research is needed to explore the implementation of GMP by health workers and to evaluate the extent of the identified reasons for low attendance to the GMP program by the mother

Knowledge, Attitude and Preventive Practices towards Sexually Transmitted Infection among Preparatory School Students of Arsi Negelle Town

A

Prevalence of heavy episodic drinking and associated factors among adults residing in Arba Minch health and demographic surveillance site : a cross sectional study

BackgroundAlcohol consumption is associated with different types of illnesses; particularly heavy episodic drinking is one of the risk factors for the disease burden of alcohol intake. The aim of the study was to assess the prevalence of heavy episodic drinking and associated factors in Arba Minch Health and Demographic Surveillance Site (HDSS).MethodsA community-based cross-sectional study was conducted in 2017 among adult residents of Arba Minch HDSS. Using Arba Minch HDSS database, 3368 individuals were selected by simple random sampling techniques. From WHO STEPS instruments, step one was applied for this study. Variables with a p-value of less than 0.10 for bivariate analysis entered into a multivariable logistic regression model to outline the independent predictors of the heavy episodic drinking. To assess the presence of an association between dependent and independent variables, a p-value of less than 0.05 was considered.ResultsThe prevalence of heavy episodic drinking was 13.7% (95% CI: 12.6-14.9). The study has shown that heavy episodic drinking was significantly associated with occupation (daily laborer [AOR=0.49; 95% C.I: 0.29-0.85] and housewives [AOR=0.63; 95% C.I: 0.45-0.88] compared with farmers), wealth index (2nd quintiles [AOR =0.55; 95% C.I: 0.41-0.74) and 3rd quintiles [AOR=0.66; 95% C.I: 0.46-0.93] compared with 1st quintiles), and climatic zone (midland [AOR=1.80;95% CI: 1.11-2.93), highland [AOR=1.95;95% CI: 1.19-3.18] compared with lowland). In addition, tobacco use [AOR=4.28;95% CI: 3.38-5.43], and khat use [AOR=4.75; 95% CI: 2.66-8.50) were also associated with heavy episodic drinking among the study participants.ConclusionsMore than one in ten adults reported heavy episodic drinking in the study area. Intervention programs that aim to prevent heavy episodic drinking should be designed appropriately for individuals from lower wealth status, and for highlander