Exploring spatial variation in BCG vaccination among children 0–35 months in Ethiopia: spatial analysis of Ethiopian Demographic and Health Survey 2016

Objective Tuberculosis is a major public health problem and is the second leading cause of death worldwide. BCG vaccination is a life-saving and important part of standard tuberculosis control measures, particularly in Ethiopia where tuberculosis is endemic. The End Tuberculosis Strategy targets of 2020 have not been achieved. Exploring spatial variations in BCG vaccination among children is vital to designing and monitoring effective intervention programmes. Therefore, this study aimed to explore the spatial variation in BCG vaccination among children in Ethiopia.Design Cross-sectional study design.Setting Ethiopia.Participants Children aged 0–35 months.Primary outcome BCG vaccination coverage.Methods Data from the 2016 Ethiopian Demographic and Health Survey were used and a total of 4453 children aged 0–35 months were included. Spatial autocorrelation analysis, cluster and outlier analysis, hotspot analysis, spatial interpolation, and spatial scan statistics were carried out to identify geographical risk areas for BCG vaccine utilisation. ArcGIS V.10.6 and SaTScan V.9.6 statistical software were employed to explore spatial pattern and significant hotspot areas for BCG vaccination among children.Results BCG vaccination was spatially clustered in Ethiopia at the regional level (Global Moran’s I=0.516, p<0.001). A total of 51 most likely clusters of low BCG vaccination were identified in the Somali and Afar regions (log-likelihood ratio=136.58, p<0.001). Significant secondary clusters were also identified in North West Gambela, South Amhara, South West Addis Ababa, North East Southern Nations, Nationalities, and People’s Region, and South West Oromia.Conclusion A low probability of receiving BCG vaccination was found among children in the Somali and Afar regions. Therefore, these areas should be given attention when designing effective immunisation strategies to improve BCG vaccination among children in order to reduce the burden of tuberculosis in Ethiopia

Incidence and predictors of virological failure among HIV infected children and adolescents on first-line antiretroviral therapy in East Shewa hospitals, Oromia Region, Ethiopia: A retrospective follow up study.

IntroductionDespite gains made from improved antiretroviral therapy coverage in resource limited countries, the occurrence of first line drug resistance remains a priority agenda. To reduce the emergence of resistant viruses, HIV viral load monitoring plays a critical role. However, many resource limited countries have difficulty of monitoring viral load due to economic constraints.There is also limited study regarding viral failure in developing countries. Therefore, this study aimed to assess the incidence and predictors of virological failure among HIV-infected children and adolescents on first-line ART Ethiopia, 2021.MethodsInstitution based retrospective follow-up study was employed on 492 children and adolescents. Data were collected by trained nurses who have experience working in ART clinics. Data were entered using Epi-data version 4.6 and exported to Stata version 14 for analysis. The proportional hazard assumption was checked, and the Weibull regression was fitted. Cox-Snell residual was used to test the goodness of fit, and the appropriate model was selected by AIC. Finally, an AHR with a 95% CI was computed, and variables with a P-value ResultsThe overall incidence rate of virological failure was 4.2, (95% CI: 3.41, 5.22) per 1000 person-months of observation with 20,169 person-months follow-up time. In multivariable analysis living in rural area (AHR = 1.97, 95% CI: 1.15-3.36), poor adherence (AHR = 2.20, 95% CI: 1.24-3.91), lower CD4 Count ConclusionThe incidence rate of virological failure was high. Living in a rural, poor adherence, lower CD4 count, and recent opportunistic infection were independent risk factors associated with virological failure. Hence, it is better to give priority to strengthening the focused evaluation of important variables and managing accordingly

Spatiotemporal patterns of anemia among lactating mothers in Ethiopia using data from Ethiopian Demographic and Health Surveys (2005, 2011 and 2016).

IntroductionMaternal anemia is a worldwide public health problem especially in developing countries including Ethiopia. The burden of anemia among lactating mothers in Ethiopia was higher than those who were neither pregnant nor breastfeeding. To date, there is limited evidence on spatiotemporal patterns of anemia among lactating mothers in the country. Exploring the spatial patterns of maternal anemia is vital to design and monitor effective intervention programs. Therefore this study aimed to explore spatiotemporal patterns of anemia among lactating mothers in Ethiopia over the past one and half-decades.MethodsA total of 11,989 lactating mothers were included from the three consecutive Ethiopian Demographic and Health Surveys(2005, 2011, and 2016). The trend of anemia over the three surveys was showed. Furthermore, spatial autocorrelation analysis, cluster and outlier analysis, hotspot analysis, spatial interpolation, and spatial scan statistics were carried out to identify geographically risk areas of anemia among lactating mothers in Ethiopia. Finally, the most anemia risk areas were detected consistently by different spatial analytic methods in each survey.ResultsAnemia during lactation had an increasing trend from 2011 to 2016 in all regions of Ethiopia. It was also spatially clustered over three survey periods (Moran's I: 0.102-0.256, PConclusionAnemia during lactation was spatially clustered in Ethiopia. High-risk areas were detected in the eastern part of Ethiopia prominently in the Afar and Somali regions. Therefore, public health intervention activities designed in a targeted approach to impact high-risk populations in those hot spot areas wound be helpful to reduce anemia in Ethiopia

Knowledge and attitude of the communities towards COVID-19 and associated factors among Gondar City residents, northwest Ethiopia: A community based cross-sectional study.

BackgroundCOVID-19 is the novel coronavirus responsible for the ongoing global outbreak of acute respiratory disease and viral pneumonia. In order to tackle the devastating condition of the virus, countries need to attack the virus with aggressive and targeted tactics. Thus, to strengthen the COVID-19 mitigation measures and to give rapid response, there is an urgent need to understand the public's knowledge and attitude about of the pandemic at this critical moment.ObjectiveThis study was aimed to assess the knowledge and attitude of communities about COVID-19 and associated factors among Gondar City residents.MethodsA community based cross-sectional study was done among 623 respondents in Gondar city from April 20-27/2020. Data were collected using a structured questionnaire adapted from different literatures. The data were entered using Epi data version 3.1 and then exported into STATA version 14 for analysis. Bi-variable and multivariable binary logistic regression were performed. Adjusted odds ratio with 95% CI was used to declare statistically significant variables on the basis of p value less than 0.05 in the multivariable binary logistic regression model.ResultsThe overall knowledge and attitude of the community towards COVID19 was 51.85% [95% CI (47.91%-55.78%)] and 53.13% [95% CI (49.20, 57.06%)], respectively. In this study, being married [AOR = 0.60 at 95% CI: (0.42, 0.86)], educational level; primary [AOR = 3.14 at 95% CI: (1.78,5.54)], secondary [AOR = 2.81 at 95% CI: (1.70,4.63)], college and above [AOR = 4.49 at 95% CI: 7.92, 13.98)], and family size [AOR = 1.80, at 95% CI: (1.05, 3.08)] were emerged as statistically significant factors impacting the knowledge of the community about COVID-19. Besides, educational level; primary [AOR = 1.76 at 95% CI: (1.03, 3.01)], secondary [AOR = 1.69 at 95% CI: (1.07, 2.68)], and college & above [AOR = 2.38 at 95% CI: (1.50, 3.79)], and family size; four to six members [AOR = 1.84 at 95% CI (1.27, 2.67)], above seven members [AOR = 1.79 at 95% CI (1.08, 2.96)] were factors identified as significantly attribute for positive attitude of the communities towards COVID-19.ConclusionMore than half of the respondents had better knowledge and attitude regarding COVID-19. Higher educational level and larger family size were significant factors predominantly affecting the knowledge and attitude of the communities towards COVID-19

Community's perceived high risk of coronavirus infections during early phase of epidemics are significantly influenced by socio-demographic background, in Gondar City, Northwest Ethiopia: A cross-sectional -study.

BackgroundEpidemiological studies during the early phase of the coronavirus (COVID-19) pandemics reported different level of people's risk perception in different countries. There is a paucity of data on perceived high risk of COVID-19 and associated factors in Ethiopia. We sought to assess the prevalence of community's perceived high risk about COVID-19 infections and associated factors among Gondar town community.MethodsA cross-sectional study was carried out from April 20 to 27, 2020 in Gondar town community, Northwest Ethiopia. Multistage cluster sampling technique was used to recruit 635 participants. Structured and pre-tested questionnaire was used to collect the data. Descriptive statistics, bivariate and multivariable binary logistic regression were used to summarize the results.ResultsA total of 623 participants were considered in the analysis with a response rate of 98.1%. The prevalence of coronavirus high risk perceptions of the respondents was found to be 23.11% (95% CI; 19.80%-26.43%). Age above 45 years (AOR = 1.41, 95%CI; 1.19-2.66), college and above educational level (AOR = 0.28, 95%CI; 0.21-0.98), and poor knowledge towards COVID-19 virus (AOR = 1.57, 95%CI; 1.09-2.23) were significantly associated with perceived high risk about COVID-19.ConclusionsThe prevalence of perceived high risk of COVID-19 was found to be low. Factors such as age, educational status, and knowledge about COVID-19 virus were found to be independent predictors of perceived high risk towards COVID-19. Government and non-government organizations should use formal and informal means of educating the community

Adherence towards COVID-19 mitigation measures and its associated factors among Gondar City residents: A community-based cross-sectional study in Northwest Ethiopia.

BackgroundConsidering its pandemicity and absence of effective treatment, authorities across the globe have designed various mitigation strategies to combat the spread of COVID-19. Although adherence towards preventive measures is the only means to tackle the virus, reluctance to do so has been reported to be a major problem everywhere. Thus, this study aimed to assess the community's adherence towards COVID-19 mitigation strategies and its associated factors among Gondar City residents, Northwest Ethiopia.MethodsA community-based cross-sectional study was employed among 635 respondents from April 20-27, 2020. Cluster sampling technique was used to select the study participants. Data were collected using an interviewer-administered structured questionnaire. Epi-Data version 4.6 and STATA version 14 were used for data entry and analysis, respectively. Binary logistic regressions (Bivariable and multivariable) were performed to identify statistically significant variables. Adjusted odds ratio with 95% CI was used to declare statistically significant variables on the basis of p ResultsThe overall prevalence of good adherence towards COVID-19 mitigation measures was 51.04% (95%CI: 47.11, 54.96). Female respondents [AOR: 2.39; 95%CI (1.66, 3.45)], receiving adequate information about COVID-19 [AOR: 1.58; 95%CI (1.03, 2.43)], and favorable attitude towards COVID-19 preventive measures were significantly associated with good adherence towards COVID-19 mitigation measures. Whereas, those respondents who had high risk perception of COVID-19 were less likely to adhere towards COVID-19 mitigation measures [AOR: 0.61; 95% CI (0.41, 0.92)].ConclusionsThe findings have indicated that nearly half of the study participants had poor adherence towards COVID-19 mitigation measures. Sex, level of information exposure, attitude towards COVID-19 preventive measures, and risk perception of COVID-19 were factors which significantly influenced the adherence of the community towards COVID-19 mitigation measures. Therefore, it is crucial to track adherence responses towards the COVID-19 preventive measures, scale up the community's awareness of COVID-19 prevention and mitigation strategies through appropriate information outlets, mainstream media, and rely on updating information from TV, radio, and health care workers about COVID-19