Prevalence and Determinants of Chronic Malnutrition Among Under-5 Children in Ethiopia

Objectives: This paper studied the prevalence and determinants of chronic malnutrition in under-5 children from the 2011 Ethiopian Demographic and Health Survey dataset.  Methods: The 2011 EDHS collected data on the nutritional status of children by measuring the height and weight of all children under age five in the sampled households, and calculated anthropometric indicators using the new WHO (2006) growth standards. Children whose height-for-age Z-score was below minus two standard deviations (−2 SD) from the median of the WHO reference population are considered stunted or chronically malnourished and if Z-scores are between −3 SD ≤ Z-score < −2 SD were identified as moderately stunted and if below −3 SD as severely stunted. Some variables were computed by combining information for original variables. The 2011 Ethiopian DHS dataset was obtained for further analysis from MEASURE DHS after permission. Complete anthropometric data for 9,611 children aged 0 to 59 months were analyzed.  Results: The overall prevalence of stunting in children was 42.3%, with 20.4% severely stunted. Socio-demographic factors were significantly associated with both severe and moderate forms of stunting. Multivariate analysis showed that parents' education, household wealth index, age of household head, child's age, months of breast-feeding, place of delivery, media exposure, mother's BMI and residential differentials were the underlining determinants of stunting. Conclusions: Chronic malnutrition in children is a public health problem in Ethiopia specifically as children grow older to age three. To achieve the Millennium Development Goal target of 34% malnutrition prevalence by 2015, it is imperative to have specific interventions focusing on causes that directly influence stunting in children.

Prevalence and associated factors of hypertension among adults in Gondar, Northwest Ethiopia: a community based cross-sectional study

BACKGROUND: Hypertension is a growing public health problem in many developing countries including Ethiopia. However, its prevention and control has not yet received due attention. This study aimed to determine the prevalence and associated factors of hypertension among adults in Gondar city, North-West Ethiopia. METHODS: A community based cross-sectional study was conducted in April 2012 in Gondar city. Participants aged 35 years and older were recruited using multi-stage random sampling technique. Data were collected by face-to-face interview technique after verbal informed consent. Additionally, weight, height and Blood Pressure (BP) of participants were measured following standard procedures. Hypertension was defined as having Systolic BP ≥140 mmHG or Diastolic BP≥ 90mmHG or reported use of regular anti-hypertensive medications prescribed by professionals for raised BP. Data were collected by clinical nurses and then entered into a computer using Epi Info version 3.5.3 and exported to SPSS version 20 for analysis. Multiple logistic regressions were fitted and Odds ratios with 95% confidence intervals were calculated to identify associated factors. RESULTS: A total of 679 participants were included in this study. About one in –five participants (21.0%) were aged 65 years or older. Obesity among all participants was 5.6%. Hundred ninety two (28.3%) were hypertensive of whom more than a third (37.0%) did not know they had hypertension. Family history of hypertension (AOR = 2.71, 95%CI; 1.37-5.36), obesity (AOR = 5.50, 95%CI; 2.07-14.62), self reported diabetes (AOR = 4.15, 95%CI; 1.77-9.72), age ≥ 55 years (AOR=3.33, 95%CI; 1.88-5.90) and not continuously walking for 10 minutes per day (AOR = 2.86, 95%CI; 1.15-7.12) were factors associated with hypertension. CONCLUSION: There was a high prevalence of hypertension probably indicating a hidden epidemic in this community. Age ≥ 55 years, obesity, family history of hypertension, physical inactivity and self reported diabetes were associated with hypertension. Hence, we recommend the design and implementation of community based screening programs

Incidence and correlates of low birth weight at a referral hospital in Northwest Ethiopia

Background: Weight at birth is a good indicator of the newborn’s chances for survival, growth, long-term health and psychosocial development. Low birth weight (LBW) babies are significantly at risk of death, contributing to the high perinatal morbidity and mortality in developing countries. Hence, this study aims to assess the incidence and associated factors of low birth weight (LBW) in Gondar University Hospital deliveries. Methods: A cross-sectional study, conducted on 305 live births from May 1- July 30, 2010. Information on independent variables was collected from the mothers just before discharge using a structured interview questionnaire. Neonatal weight was measured using standard beam balance. Both interviews and weight measurements were done by two trained midwives. Gestational age was determined by last normal menstrual period and/or ultrasound examinations. Results: The mean and standard deviations of the birth weights were 2976 ±476 grams. Incidence of LBW (birth weight <2500 grams) was 17.1% (95%CI 13.3%, 21.6%). LBW was associated with first delivery (AOR=2.85), lack of antenatal care follow up (AOR= 5.68) or infrequent visits and being HIV positive (AOR=3.22). More female newborns were with low birth weight than males though the difference was not significant after controlling for potential confounders in the multivariate analysis. Conclusion: There is a high incidence of LBW. Efforts should to enhance national antenatal care utilization in general, and particularly in Gondar, should be encouraged as its absence is closely associated with LBW. Pan African Medical Journal 2012; 12:

Age at menarche and the menstrual pattern of secondary school adolescents in northwest Ethiopia

<p>Abstract</p> <p>Background</p> <p>Population studies on normal and dysfunctional characteristics of menstrual cycles are scarce in Ethiopia. In addition variability in menarcheal age and menstrual characteristics are common. Knowledge on this variability is necessary for patient education and to guide clinical evaluation.</p> <p>Methods</p> <p>A cross sectional study was conducted in two small towns called Dabat and Kola Diba, northwest Ethiopia between April and May 2007. Systematic sampling method was used to select 622 school girls from two secondary schools. A pretested questionnaire prepared in Amharic was used to gather data. Selected girls cooperated in answering the questionnaire in their classrooms under the supervision of the research team. Only 612 of the adolescent females were included in the final analysis, of which 305 were from Koladiba High School and 307 from Dabat.</p> <p>Results</p> <p>The age of the study subjects ranges between 14 and 19 with a mean (standard deviation) of 16.9 ± 1 years. About 92.2% had attained menarche by the time the survey was conducted. The probit analysis of the <it>status quo </it>data yielded a median (CI) age at menarche of 14.8 (13.9-15.3) years. The average age at menarche by recall method was 15.8 ± 1 years. The mean age at menarche was 0.3 years younger for urban females compared with rural ones (p < 0.001). A cycle length between 21 and 35 days was observed in 70.3% of the girls. The mean duration of flow was 4 ± 1.3 days with a range of 2-7 days. The menstrual cycles were irregular in 42.8% of the subjects. The overall prevalence of dysmenorrhoea was 72% among these subjects. Premenstrual symptoms were present in 435 of the females (75.4%). The leading sources of menarcheal information to the adolescents were mothers (39.7%), followed by their friends (26.6%) and teachers (21.8%).</p> <p>Conclusion</p> <p>In this study age of menarche was found to be delayed which is even higher than the findings indicated similar studies conducted in Ethiopia and other African countries. A significant number of students complain of abnormal menstrual cycle, dysmenorrhoea and premenstrual symptoms which call for appropriate counselling and management.</p

DETERMINING THE CONSEQUENCES OF PERSISTENT ESTROGEN DEPLETION IN OLDER AUSTRALIAN WOMEN

Menopause may result in symptoms, primarily vasomotor symptoms, lowered mood and vaginal dryness. The persistence of these symptoms beyond midlife is unknown. In a study of 1,548 Australian women, aged 65+ years, one-third of women had vasomotor symptoms, one fifth had vaginal dryness during intercourse, and one in 7 were distressed by low sexual desire. Vasomotor symptoms were associated with depressive symptoms. Nearly one half had at least one of urinary incontinence, fecal incontinence or pelvic organ prolapse. Few older women receive appropriate treatment for these symptoms, which remain silent and under-treated, despite their concern to older women

Prevalence and associated factors of hypertension among adults in Gondar, Northwest Ethiopia: a community based cross-sectional study

Abstract Background Hypertension is a growing public health problem in many developing countries including Ethiopia. However, its prevention and control has not yet received due attention. This study aimed to determine the prevalence and associated factors of hypertension among adults in Gondar city, North-West Ethiopia. Methods A community based cross-sectional study was conducted in April 2012 in Gondar city. Participants aged 35 years and older were recruited using multi-stage random sampling technique. Data were collected by face-to-face interview technique after verbal informed consent. Additionally, weight, height and Blood Pressure (BP) of participants were measured following standard procedures. Hypertension was defined as having Systolic BP ≥140 mmHG or Diastolic BP≥ 90mmHG or reported use of regular anti-hypertensive medications prescribed by professionals for raised BP. Data were collected by clinical nurses and then entered into a computer using Epi Info version 3.5.3 and exported to SPSS version 20 for analysis. Multiple logistic regressions were fitted and Odds ratios with 95% confidence intervals were calculated to identify associated factors. Results A total of 679 participants were included in this study. About one in –five participants (21.0%) were aged 65 years or older. Obesity among all participants was 5.6%. Hundred ninety two (28.3%) were hypertensive of whom more than a third (37.0%) did not know they had hypertension. Family history of hypertension (AOR = 2.71, 95%CI; 1.37-5.36), obesity (AOR = 5.50, 95%CI; 2.07-14.62), self reported diabetes (AOR = 4.15, 95%CI; 1.77-9.72), age ≥ 55 years (AOR=3.33, 95%CI; 1.88-5.90) and not continuously walking for 10 minutes per day (AOR = 2.86, 95%CI; 1.15-7.12) were factors associated with hypertension. Conclusion There was a high prevalence of hypertension probably indicating a hidden epidemic in this community. Age ≥ 55 years, obesity, family history of hypertension, physical inactivity and self reported diabetes were associated with hypertension. Hence, we recommend the design and implementation of community based screening programs.</p

Predicting CD4 count changes among patients on antiretroviral treatment: Application of data mining techniques

BACKGROUND AND OBJECTIVES: To monitor the progress of therapy and disease progression, periodic CD4 counts are required throughout the course of HIV/AIDS care and support. The demand for CD4 count measurement is increasing as ART programs expand over the last decade. This study aimed to predict CD4 count changes and to identify the predictors of CD4 count changes among patients on ART. METHODS: A cross-sectional study was conducted at the University of Gondar Hospital from 3,104 adult patients on ART with CD4 counts measured at least twice (baseline and most recent). Data were retrieved from the HIV care clinic electronic database and patients` charts. Descriptive data were analyzed by SPSS version 20. Cross-Industry Standard Process for Data Mining (CRISP-DM) methodology was followed to undertake the study. WEKA version 3.8 was used to conduct a predictive data mining. Before building the predictive data mining models, information gain values and correlation-based Feature Selection methods were used for attribute selection. Variables were ranked according to their relevance based on their information gain values. J48, Neural Network, and Random Forest algorithms were experimented to assess model accuracies. RESULT: The median duration of ART was 191.5 weeks. The mean CD4 count change was 243 (SD 191.14) cells per microliter. Overall, 2427 (78.2%) patients had their CD4 counts increased by at least 100 cells per microliter, while 4% had a decline from the baseline CD4 value. Baseline variables including age, educational status, CD8 count, ART regimen, and hemoglobin levels predicted CD4 count changes with predictive accuracies of J48, Neural Network, and Random Forest being 87.1%, 83.5%, and 99.8%, respectively. Random Forest algorithm had a superior performance accuracy level than both J48 and Artificial Neural Network. The precision, sensitivity and recall values of Random Forest were also more than 99%. CONCLUSIONS: Nearly accurate prediction results were obtained using Random Forest algorithm. This algorithm could be used in a low-resource setting to build a web-based prediction model for CD4 count changes

Birth interval and its predictors among married women in Dabat District, Northwest Ethiopia: A retrospective follow up study

Birth intervals (time between two successive live births) if short are associated with diverse complications. We assessed birth interval and its predictors among 613 married women who gave birth from January 1 to December 30, 2008. Data were collected in April 2012. Life table and Kaplan-Meier curve were used to estimate cumulative probabilities and median birth interval, respectively. Log rank test was employed to compare survival between categories of explanatory variables. Cox-proportional hazards model was fitted to compute hazard ratios with their 95% confidence intervals. Median birth interval was 32.6 months (95%CI: 31.2-34.1). The cumulative probabilities of survival at 12, 24, and 36 months were 0.97, 0.82 and 0.56 respectively. Death of the index child (AHR=3.12), contraceptive non use (AHR=4.29) and husband’s education (AHR=2.20) were significant predictors. Birth interval was short. Contraceptive use and paternal education should be given greater attention in addition to prevention of infant and child mortality. (Afr J Reprod Health 2013; 17[2]: 39-45).Si les intervalles entre les naissances (période entre deux naissances vivantes successives) sont courts, ils sont associés à des complications diverses. Nous avons évalué l’intervalle entre les naissances et ses indices chez les 613 femmes mariées qui ont donné naissance à partir du janvier 1 au 30 décembre 2008. Les données ont été recueillies en avril 2012. Des tables de mortalité et de Kaplan-Meier ont été utilisées pour estimer les probabilités cumulées et l&apos;intervalle médian à la naissance, respectivement. Le Test du log rank a été utilisé pour comparer la survie entre les catégories de variables explicatives. Le modèle Cox- à risques proportionnels a été équipé pour calculer les ratios de risque et leurs intervalles de confiance à 95%. L’intervalle médian était de 32,6 mois (95% CI: 31.2 à 34.1). Les probabilités cumulées de survie à 12, 24, et 36 mois étaient de 0,97, 0,82 et 0,56 respectivement. La mort de l&apos;enfant indice (AHR = 3,12), de la non utilisation de la contraception (AHR = 4,29) et de l&apos;éducation du mari (AHR = 2,20) étaient des indices significatifs. L’intervalle entre les naissances était court. L&apos;utilisation du contraceptif et l&apos;éducation paternelle devraient être accordées une plus grande attention, y compris la prévention de la mortalité infantile et juvénile. (Afr J Reprod Health 2013; 17[2]: 39-45)

Determinants of blood pressure control amongst hypertensive patients in Northwest Ethiopia

<div><p>Background</p><p>Controlling blood pressure (BP) leads to significant reduction in cardiovascular risks and associated deaths. In Ethiopia, data is scarce about the level and determinants of optimal BP control among hypertensive patients. This study aimed to assess the prevalence and associated factors of optimal BP control among hypertensive patients attending at a district hospital.</p><p>Methods</p><p>A hospital-based, cross-sectional study was conducted among 392 hypertensive patients who were on treatment and follow-up at a district hospital. A structured questionnaire adopted from WHO approach was prepared to collect the data. Medication adherence was measured by the four-item Morisky Green Levine Scale, with a score ≥3 defined as “good adherence”. Blood pressure was measured, and optimal BP control was 0DEFined as systolic BP < 140 mmHg and diastolic BP<90 mmHg. Both binary and multivariable logistic regressions models were fitted to identify correlates of optimal BP control. All statistical tests were two-sided and a p values <0.05 was considered for statistical significance.</p><p>Results</p><p>The mean age of the participants was 58 years (SD±13 years). Over half (53.8%) were females. Three quarters (77.3%) of the participants were adherent to their medications. The overall proportion of participants with optimally controlled BP was 42.9%.Female sex (Adjusted Odd Ratio(AOR) = 1.94, 95% CI: 1.15, 3.26), age older than 60 years (AOR = 2.95, 95% CI: 1.18, 7.40), consumption of vegetables on most days of the week (AOR = 2.16, 95% CI: 1.25, 3.73), physical activity (AOR = 4.85, 95% CI: 2.39, 9.83), and taking less than three drugs per day (AOR = 3.04, 95% CI: 1.51, 6.14) were positively associated with optimally controlled BP. Poor adherence to medications (AOR = 0.18, 95% CI: 0.09, 0.35), having asthma comorbidity (AOR = 0.33, 95% CI:0.12, 0.88) and use of top added salt on a plate (AOR = 0.20, 95% CI:0.11, 0.36) were negatively associated with optimal BP control.</p><p>Conclusion</p><p>A higher proportion of hypertensive patients remain with un-controlled BP. Modifiable risk factors including poor adherence to medications, lack of physical exercise, adding salt into meals, being on multiple medications and comorbidities were significantly and independently associated with poor BP control. Evidence-based, adherence-enhancing and healthy life style interventions should be implemented.</p></div