Mapping development and health effects of cooking with solid fuels in low-income and middle-income countries, 2000-18 : a geospatial modelling study

Background More than 3 billion people do not have access to clean energy and primarily use solid fuels to cook. Use of solid fuels generates household air pollution, which was associated with more than 2 million deaths in 2019. Although local patterns in cooking vary systematically, subnational trends in use of solid fuels have yet to be comprehensively analysed. We estimated the prevalence of solid-fuel use with high spatial resolution to explore subnational inequalities, assess local progress, and assess the effects on health in low-income and middle-income countries (LMICs) without universal access to clean fuels.Methods We did a geospatial modelling study to map the prevalence of solid-fuel use for cooking at a 5 km x 5 km resolution in 98 LMICs based on 2.1 million household observations of the primary cooking fuel used from 663 population-based household surveys over the years 2000 to 2018. We use observed temporal patterns to forecast household air pollution in 2030 and to assess the probability of attaining the Sustainable Development Goal (SDG) target indicator for clean cooking. We aligned our estimates of household air pollution to geospatial estimates of ambient air pollution to establish the risk transition occurring in LMICs. Finally, we quantified the effect of residual primary solid-fuel use for cooking on child health by doing a counterfactual risk assessment to estimate the proportion of deaths from lower respiratory tract infections in children younger than 5 years that could be associated with household air pollution.Findings Although primary reliance on solid-fuel use for cooking has declined globally, it remains widespread. 593 million people live in districts where the prevalence of solid-fuel use for cooking exceeds 95%. 66% of people in LMICs live in districts that are not on track to meet the SDG target for universal access to clean energy by 2030. Household air pollution continues to be a major contributor to particulate exposure in LMICs, and rising ambient air pollution is undermining potential gains from reductions in the prevalence of solid-fuel use for cooking in many countries. We estimated that, in 2018, 205000 (95% uncertainty interval 147000-257000) children younger than 5 years died from lower respiratory tract infections that could be attributed to household air pollution.Interpretation Efforts to accelerate the adoption of clean cooking fuels need to be substantially increased and recalibrated to account for subnational inequalities, because there are substantial opportunities to improve air quality and avert child mortality associated with household air pollution. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd.Peer reviewe

Global, regional, and national burden of colorectal cancer and its risk factors, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Funding: F Carvalho and E Fernandes acknowledge support from Fundação para a Ciência e a Tecnologia, I.P. (FCT), in the scope of the project UIDP/04378/2020 and UIDB/04378/2020 of the Research Unit on Applied Molecular Biosciences UCIBIO and the project LA/P/0140/2020 of the Associate Laboratory Institute for Health and Bioeconomy i4HB; FCT/MCTES through the project UIDB/50006/2020. J Conde acknowledges the European Research Council Starting Grant (ERC-StG-2019-848325). V M Costa acknowledges the grant SFRH/BHD/110001/2015, received by Portuguese national funds through Fundação para a Ciência e Tecnologia (FCT), IP, under the Norma Transitória DL57/2016/CP1334/CT0006.proofepub_ahead_of_prin

The global burden of adolescent and young adult cancer in 2019 : a systematic analysis for the Global Burden of Disease Study 2019

Background In estimating the global burden of cancer, adolescents and young adults with cancer are often overlooked, despite being a distinct subgroup with unique epidemiology, clinical care needs, and societal impact. Comprehensive estimates of the global cancer burden in adolescents and young adults (aged 15-39 years) are lacking. To address this gap, we analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, with a focus on the outcome of disability-adjusted life-years (DALYs), to inform global cancer control measures in adolescents and young adults. Methods Using the GBD 2019 methodology, international mortality data were collected from vital registration systems, verbal autopsies, and population-based cancer registry inputs modelled with mortality-to-incidence ratios (MIRs). Incidence was computed with mortality estimates and corresponding MIRs. Prevalence estimates were calculated using modelled survival and multiplied by disability weights to obtain years lived with disability (YLDs). Years of life lost (YLLs) were calculated as age-specific cancer deaths multiplied by the standard life expectancy at the age of death. The main outcome was DALYs (the sum of YLLs and YLDs). Estimates were presented globally and by Socio-demographic Index (SDI) quintiles (countries ranked and divided into five equal SDI groups), and all estimates were presented with corresponding 95% uncertainty intervals (UIs). For this analysis, we used the age range of 15-39 years to define adolescents and young adults. Findings There were 1.19 million (95% UI 1.11-1.28) incident cancer cases and 396 000 (370 000-425 000) deaths due to cancer among people aged 15-39 years worldwide in 2019. The highest age-standardised incidence rates occurred in high SDI (59.6 [54.5-65.7] per 100 000 person-years) and high-middle SDI countries (53.2 [48.8-57.9] per 100 000 person-years), while the highest age-standardised mortality rates were in low-middle SDI (14.2 [12.9-15.6] per 100 000 person-years) and middle SDI (13.6 [12.6-14.8] per 100 000 person-years) countries. In 2019, adolescent and young adult cancers contributed 23.5 million (21.9-25.2) DALYs to the global burden of disease, of which 2.7% (1.9-3.6) came from YLDs and 97.3% (96.4-98.1) from YLLs. Cancer was the fourth leading cause of death and tenth leading cause of DALYs in adolescents and young adults globally. Interpretation Adolescent and young adult cancers contributed substantially to the overall adolescent and young adult disease burden globally in 2019. These results provide new insights into the distribution and magnitude of the adolescent and young adult cancer burden around the world. With notable differences observed across SDI settings, these estimates can inform global and country-level cancer control efforts. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd.Peer reviewe

Systematic Review and Meta-Analysis of Good Self-Care Practice among People Living with Type 2 Diabetes Mellitus in Ethiopia: A National Call to Bolster Lifestyle Changes

Background. Self-care practice is the mainstay of management for good glycemic control. Despite the presence of a few pocket studies, no comprehensive study was conducted in Ethiopia to demonstrate the overall good self-care practice among diabetic patients in Ethiopia. Therefore, we intended to conduct this systematic review and meta-analysis to estimate the overall good self-care practice among people living with type 2 diabetes mellitus (T2DM) in Ethiopia. Methods. We systematically searched PubMed, Scopus, Science Direct, Cochrane library, Google scholar, and direct Google to retrieve relevant studies. Forest plot was used to present the pooled estimate of good self-care practice using DerSimonian and Laird’s random-effects model. We checked publication bias using Egger’s test and funnel plot. Potential heterogeneity was tested using the I-squared statistic. Moreover, subgroup and sensitivity analyses were performed. Results. In this review, 12 primary studies (with a total sample size of 4030) were included. Because of the presence of heterogeneity, we employed a random-effects model. After running the random-effects model, the pooled estimate of overall good self-care practice was 51.12% (95% CI: 41.90–60.34). Furthermore, the pooled estimate of good dietary practice was 50.18% (95% CI: 32.75–67.60), good physical exercise practice was 48.29% (95% CI: 34.14–62.43), the good footcare practice was 63.61% (95% CI: 45.56–81.66), and appropriate self-monitoring of the blood glucose level was 31.89% (95% CI: −4.62–68.41). In this meta-analysis, there was serious interstudy variation, but there was no publication bias. Conclusions. The overall good self-care practice among people living with T2DM was low which necessitates the need for designing strategies to increase the self-care practice. The health sector has to bolster awareness creation to allow better plasma glucose control and preventing diabetes-related complications. This trial is registered with CRD42019147694

Parent-Adolescent Communication on Sexual and Reproductive Health Issues and Associated Factors among Preparatory and Secondary School Students of Dabat Town, Northwest Ethiopia

Background. A significant number of adolescents as well as young men and women aged 10 to 24 years die each year in the world due to avoidable sexual and reproductive health problems such as unwanted pregnancy, unsafe abortion, and sexually transmitted infections, including HIV/AIDS. This is attributed to low access to and/or uptake of sexual and reproductive health services. Objective. To assess parent-adolescent communication on sexual and reproductive health issues and associated factors among secondary and preparatory school students in Dabat town, northwest Ethiopia, 2018. Methods. An institution-based cross-sectional study was conducted from April 1 to 10, 2018, using multistage sampling technique. Data were collected from 550 participants using structured, pretested, and self-administered questionnaire; entered into Epi Info version 7; and analyzed using SPSS version 20. Both bivariate and multivariable logistic regression analyses were employed, and variables with less than 0.05 P value in the multivariable regression were considered as statistically significant. Adjusted odds ratio with 95% CI was used to determine the strengths and directions of associations. Result. This study revealed that 48.5% of the participants discussed sexual and reproductive health issues with parents. Male sex (AOR = 1.6; 95% CI: 1.1–2.25), family income greater than ETB 1,000 (AOR = 1.6; 95% CI: 1.02–2.57), good knowledge of sexual and reproductive health (AOR = 1.5; 95% CI: 1.03–2.09), and favorable attitude to sexual and reproductive health issues (AOR = 1.9; 95% CI: 1.29–2.67) were factors significantly associated with parent-adolescent communication on the issues. Conclusion. This study showed that the proportion of parent-adolescent communication on sexual and reproductive health issues was low. Male sex, family income greater than ETB 1,000, and good knowledge and favorable attitude of adolescents had significant association with the communication

Attitude towards tele rehabilitation-based therapy services and its associated factors among health professional working in specialized teaching hospitals in Amhara region, Northwest Ethiopia

Background: Tele-rehabilitation is part of Tele-health (TH) which provides a rehabilitation service at a distance through using telecommunication technology. The lack of skilled staff, accessibility concerns, high transportation costs, lengthy waiting times, and mobility issues make face-to-face rehabilitation treatment difficult. Therefore, this study aimed to assess attitudes and its associated factors of health professionals towards TR services. Method: An institutional-based cross-sectional study design was conducted among 408 health professionals from March to April 2021. A simple random sampling technique was applied to select study participants. Epi-data 3.1 versions software was used for data entry, and SPSS version 20 was used for the analysis. A bi-variable and multivariable logistic regression was used to determine factors associated with the attitude of health professionals towards tele-rehabilitation. Result: A total of 408 participants enrolled in the study, with a response rate of 95.5%. The majority 285(69.9%) of health professionals had good attitude towards tele rehabilitation-based treatment services. Good knowledge of tele rehabilitation [AOR = 1.76, 95%, CI: 1.078, 2.879], digitally literate [AOR = 1.74, 95%, CI: 1.028, 2.954], perception on security and privacy [AOR = 0.56, 95%,CI: 0.333, 0.944], and owns smart mobile phone [AOR = 1.9,95%,CI: 1.007, 3.781] were significantly associated with attitude towards tele rehabilitation service. Conclusion: In this study the majority of the respondents had a good attitude towards tele rehabilitation services. Having own mobile, knowledge towards tele rehabilitation, digital literacy, perception on security and privacy to rehabilitation were found to be factors associated with attitude towards tele rehabilitation service. Therefore, the government and other responsible entities should consider enacting systems and strategies to encourage the use of mobile technologies for the management of disability, chronic diseases and for rural patients

Status of perceived social support and its associated factors among inmate prisoners in Northwest Amhara, Ethiopia

Objective: The objective of this study was to determine the level of social support and associated factors in selected prison institutions in Amhara region, Ethiopia. Result: Prisoners that had good social support from their family, friends, and significant others were 64.7%, (95% CI 60.9%, 68.4%). The odds of social support was higher among those educated and rural prisoners. However, it was found to be lower among non-Orthodox Christian prisoners and prisoners who were discriminated. Social support is buffering tool for social difficulties and hardships faced by prisoners while they are in prison and very helpful to reduce mental health morbidities and their consequences, hence should be strengthened

Prevalence and determinants of incomplete or not at all vaccination among children aged 12–36 months in Dabat and Gondar districts, northwest of Ethiopia: findings from the primary health care project

Objective Ethiopia is one of the Africa’s signatory countries for implementation of the primary healthcare strategy including immunisation. In Ethiopia, however, 16% of child death is due to vaccine-preventable disease. Thus, this study aimed to assess the prevalence and determinants of incomplete or not at all vaccination among children aged 12–36 months in Dabat and Gondar districts, Northwest Ethiopia.Study design The study is community-based cross-sectional study.Study setting Dabat and Gondar Zuria districts, Northwest Ethiopia.Participants Mothers/caregivers with children aged 12–36 months were enrolled in the study. Participants were randomly selected through systematic sampling and a total of 603 participants were included in the analysis.Methods A binary logistic regression analysis was done. In the multivariable logistic regression analysis, a p value of <0.05 and adjusted OR (AOR) with 95% CI were used to identify statistically associated factors with incomplete or not at all vaccination.Outcomes Incomplete or not at all vaccination.Results The prevalence of incomplete or not at all vaccinated children was 23.10% (95% CI 16.50 to 29.70). The multivariable analysis revealed that the odds of incomplete or not at all vaccination were higher among mothers who had no antenatal care (ANC) visit (AOR: 1.81, 95% CI 1.21 to 4.03) and no postnatal care (PNC) visit (AOR=1.52, 95% CI 1.05 to 2.25).Conclusions In the study area, nearly one-fourth of children are incompletely or not at all vaccinated. Our finding suggests that ANC and PNC visits are key determinants of incomplete or not at all vaccination. Thus, in low-resource settings like Ethiopia, the health system approaches to improved ANC and PNC services should be intensified with more effective advice on child immunisation to reduce vaccine preventable disease

High Hidden Burden of Diabetes Mellitus among Adults Aged 18 Years and Above in Urban Northwest Ethiopia

Background. Ethiopia is one of the sub-Saharan African countries with a rapidly increasing burden of diabetes mellitus (DM). There is limited updated information about the community-based burden of the disease and its associated factors in Ethiopia which is very crucial to plan effective prevention and control measures against the disease. This study is aimed at determining the burden of DM and its associated factors in urban northwest Ethiopia. Methods. A community-based cross-sectional study was conducted from April to May 2019 among residents aged≥18 years in Gondar town and urban kebeles (lowest administrative units of the country) of Health and Demographic Surveillance System site (HDSS) in Dabat district. A multistage sampling technique was used to select 773 participants. World Health Organization (WHO) stepwise approach for noncommunicable disease surveillance was used to collect the data. Fasting blood glucose FBS≥126 mg/dl was used to diagnose DM. Descriptive statistics were done to describe the variables of the study. Prevalence with its 95% confidence interval (CI) was estimated. Binary logistic regression model was fitted, variables with p value < 0.05 were considered to have a significant association with the outcome, and odds ratio (OR) was used to measure the strength of association. Result. Of the total participants, 6.34% (95% CI; 4.82, 8.29) were found to be diabetic. Of these, 40 (81.6%) were newly diagnosed. Besides, the prevalence of prediabetes was 9.31% (95% CI: 7.45, 11.58). Increased age (AOR=1.06, 95% CI; 1.04, 1.09) and eating vegetables one to three days per week (AOR =0.29, 95% CI; 0.13, 0.65) were significantly associated with diabetes. Conclusion. The overall prevalence of DM is a bit higher than the national estimate, while the proportion of undiagnosed DM which can easily progress to disabling and life-threatening complications was alarmingly high. Age and frequency of eating vegetables per week were associated with diabetes. In light of this finding, future prevention and control measures against the diseases should consider the identified factors. There should also be improved access to screening services