Prevalence and factors that influence smokeless tobacco use among adults in pastoralist communities of Borena Zone, Ethiopia: mixed method study

Introduction Deaths due to tobacco consumption are on the rise, from 5.4 million in 2005 to 6.4 million in 2015 and 8.3 million in 2030 of which more than 80% will be in developing countries. Smokeless tobacco use is a significant health risk and cause of disease. Over 300 million people use smokeless tobacco worldwide. More than 250 million adult smokeless tobacco users are in low- and middle-income countries, the total burden of smokeless tobacco use is likely to be substantial. In Ethiopia, nationally representative data on the smokeless tobacco use is not available. Most studies conducted in the country focused on cigarette smoking. Material and Methods A community based cross-sectional study using quantitative and qualitative approaches was conducted from September 14–29, 2015. The study was conducted among adults in pastoralist communities in Borena zone, Ethiopia. A total of 634 households were selected randomly for interview. An interviewer-administered questionnaire and in-depth interview guide was used to assess adults’ practice, attitude, knowledge, and perception on Smokeless Tobacco use. Logistic regression was used to assess association between dependent and independent variables. Results Out of 634 participants, 287 (45.3%) of them were current users of smokeless tobacco. Being Muslim (AOR = .21, 95% CI: .13, .33), being Christian (AOR = .38, 95% CI: .22, .67), and having good health risk perception toward smokeless tobacco use (AOR = .49, 95% CI: .34, .70) were protective factors for smokeless tobacco use, whereas favorable attitude (AOR = 2.12, 95% CI: 1.48, 3.04) and high social pressure towards smokeless tobacco use (AOR = 1.73, 95% CI: 1.21, 2.47) were factors independently associated with smokeless tobacco use. Conclusions This study concludes that smokeless tobacco use is very common in the selected districts of the Borena zone. The practice is strong linked to the lifestyle of the community

Measles outbreak investigation in Ginnir district of Bale zone, Oromia region, Southeast Ethiopia, May 2019

Introduction: measles is a vaccine-preventable viral infection of humans, primarily affecting children <5 years. During early 2019, outbreak of measles occurred in Ginnir district of Bale zone, Southeast Ethiopia. We investigated to describe the outbreak and identify risk factors. Methods: we conducted a descriptive and 1:2 unmatched case-control study in Ginnir district from March 18 to April 29, 2019. Fifty-six cases and 112 controls were recruited. For descriptive study, we identified 1043 cases recorded on the line-list and for case-control study, cases were identified using national standard case-definition. Mothers of case-patients and controls were interviewed using structured questionnaire. We estimated vaccine efficacy (VE) from case-control study. We conducted bivariate and multivariable logistic regression. Results: in four-months period, a total of 1,043 suspected measles cases epidemiologically linked to five laboratory confirmed cases reported. Of which, 555 (53.2%) were males and 714 (68.5%) were <5 years. The median age of cases was 36 months (IQR=12-60 months). The overall attack rate (AR) was 63/10,000 population with case fatality ratio of 0.5% (5 deaths/1043). Infant <9 months were the most affected age groups (AR=31/1000). Majority (79%) of measles cases were not vaccinated against measles. Last-year (2017/18) administrative measle vaccine coverage of the district was 76.7%. Being unvaccinated against measles (AOR=5.4, 95%CI=2.2-13.4), travel history (AOR=4.02, 95%CI=1.2-13.6), contact with measles case-patient (AOR=5.6, 95%CI=2.12-14.4) and mothers knowledge of measles transmission (AOR=0.36, 95%CI=0.15-0.87) were associated with measles infection. VE in children aged 9-59 months was 90% (95%CI=69-97%). Conclusion: this confirmed measles outbreak was caused by failure to vaccinate, as indicated by the high VE, low administrative coverage, and 79% unvaccinated cases. Strengthening routine and supplementary immunization are required

Household Food Insecurity, Low Dietary Diversity, and Early Marriage Were Predictors for Undernutrition among Pregnant Women Residing in Gambella, Ethiopia

Background. Maternal undernutrition affects the health of both mothers and children and, as a result, has broad impacts on economic and social development. Objective. The aim of this study was to assess magnitude of undernutrition and associated factors among pregnant women in Gambella town, 2014. Methods. Community based cross-sectional study was conducted on 338 randomly selected pregnant women from March to April 2014. Bivariate and multivariable logistic regressions were used for data analysis. Result. The prevalence of undernutrition among pregnant women in Gambella town was 28.6%. Pregnant women who were married before their age of eighteen, who were from food insecure households, and who had low dietary diversity score were nearly four (AOR = 3.9, 95% CI: 2.2–6.9), two (AOR = 2.3, 95% CI : 1.2–3.6), and two (AOR = 2.1, 95% CI: 1.3–4.16) times more likely to be undernourished as compared to their counterparts, respectively. Conclusion. Prevalence of undernutrition among pregnant women in Gambella town was unacceptably high. Stake holders should give due consideration to health education to delay age at first marriage and mainstreaming and strengthening nutritional activities that contribute to reduction of food insecurity and consumption of unbalanced nutrients

Health Care Providers’ Knowledge and Practice Gap towards Joint Zoonotic Disease Surveillance System: Challenges and Opportunities, Gomma District, Southwest Ethiopia

Background. Health care providers play a crucial role for realization of joint zoonotic diseases surveillance by human and animal health sectors, yet there is limited evidence. Hence, this study aimed to determine knowledge and practice gap of health care providers towards the approach for Rabies and Anthrax in Southwest Ethiopia. Methods. A cross-sectional survey was conducted from December 16, 2014, to January 14, 2015. Eligible health care providers were considered for the study. Data were entered in to Epi-data version 3.1 and analyzed using SPSS version 20. Results. A total of 323 (92.02%) health care providers participated in the study. Three hundred sixteen (97.8%) of participants reported that both human and animal health sectors can work together for zoonotic diseases while 96.9% of them replied that both sectors can jointly conduct surveillance. One hundred seventeen (36.2%) of them reported that their respective sectors had conducted joint surveillance for zoonotic diseases. Their involvement was, however, limited to joint outbreak response. Conclusion. There is good opportunity in health care providers’ knowledge even though the practice was unacceptably low and did not address all surveillance components. Therefore, formal joint surveillance structure should be in place for optimal implementation of surveillance

Community Health Seeking Behavior for Suspected Human and Animal Rabies Cases, Gomma District, Southwest Ethiopia.

BACKGROUND:Timely presentation to appropriate health service provider of sick animals/humans from zoonotic diseases like rabies is important for early case/outbreak detection and management. However, data on community's health seeking practice for rabies in Ethiopia is limited. Therefore the objective of this study was to determine community's health seeking behavior on rabies, Southwest Ethiopia. METHODS:A cross-sectional survey was conducted from January 16-February 14, 2015 to collect data from 808 respondents where the respondents were selected using multistage sampling technique. Data were collected using interviewer administered structured questionnaire by trained epidemiology graduate level students. Data were entered to Epidata version 3.1 and analyzed using SPSS version 20 for windows. RESULT:Eight hundred three (99.4%) respondents participated in the study. Out of 28 respondents who reported their family members' exposure to rabies, 8 of them replied that the exposed family members sought treatment from traditional healers. More than nine in ten respondents perceived that humans and domestic animals with rabies exposure should seek help of which 85% of them suggested modern health care facilities as the preferred management option for the sick humans and domestic animals. However, among those who reported sick domestic animals, near to 72% of them had either slaughtered for human consumption, sold immediately, visited traditional healer, given home care or did nothing for the sick domestic animals. CONCLUSION:Majority of the respondents had favorable perception of seeking treatment from modern health care facilities for rabies. However, significant number of them had managed inappropriately for the sick domestic animals from rabies. Hence, raising awareness of the community about management of sick domestic animals from rabies and the need for reporting to both human and animal health service providers is needed

Socio-demographic and economic characteristics of respondents in Gomma district, Southwest Ethiopia, January 16-Februay 14, 2015 (N = 803).

<p>Socio-demographic and economic characteristics of respondents in Gomma district, Southwest Ethiopia, January 16-Februay 14, 2015 (N = 803).</p

Respondents’ actual health seeking behavior for rabies in human and domestic animals, Gomma district, Southwest Ethiopia, January 16-Februay 14, 2015.

<p>Respondents’ actual health seeking behavior for rabies in human and domestic animals, Gomma district, Southwest Ethiopia, January 16-Februay 14, 2015.</p

General health seeking behavior of households for sick family members and domestic animals in Gomma district, Southwest Ethiopia, January 16-Februay 14, 2015.

<p>General health seeking behavior of households for sick family members and domestic animals in Gomma district, Southwest Ethiopia, January 16-Februay 14, 2015.</p