Determinants of default to fully completion of immunization among children aged 12 to 23 months in south Ethiopia: unmatched case-control study

Introduction: Immunization is a cost effective interventions of vaccine preventable disease. There is still, 2.5 million children die by vaccine preventable disease every year in developing countries. In Ethiopia, default to fully completion of child immunization is high and determinants of default to completions are not explored well in the study setting. The aim of the study was to identify determinants of default to fully completion of immunization among children between ages 12 to 23 months in Sodo Zurea District, Southern Ethiopia. Methods: Community based unmatched case-control study was conducted. Census was done to identify cases and controls before the actual data collection. A total of 344 samples (172 cases and 172 controls) were selected by simple random sampling technique. Cases were children in the age group of 12 to 23 months old who missed at least one dose from the recommended schedule. Bivariable and multivariable binary logistic regression was used to identify the determinant factors. Odds ratio, 95%CI and p - value less than 0.05 was used to measure the presence and strength of the association. Results: Mothers of infants who are unable to read and write (AOR=8.9; 95%CI: 2.4, 33.9) and attended primary school (AOR=4.1; 95% CI:1.4-15.8), mothers who had no postnatal care follow up (AOR=0.4; 95%CI: 0.3, 0.7), good maternal knowledge towards immunization (AOR= 0.5; 95% CI: 0.3, 0.8) and maternal favorable perception towards uses of health institution for maternal and child care (AOR= 0.2; 95% CI: 0.1, 0.6) were significant determinant factors to default to fully completion of immunization. Conclusion: Working on maternal education, postnatal care follow up, promoting maternal knowledge and perception about child immunization are recommended measures to mitigate defaults to complete immunization.Pan African Medical Journal 2016; 2

The Burden of Internal Conflict on Expanded Programs on Immunization in Northwest Ethiopia: Implementation Science Study

AbstractBackground: Despite the rapid progress in immunization service delivery systems worldwide, populations in areas of conflict often have limited or no access to lifesaving vaccines. Hence, evidence generation and translation for context-specific strategies and tailored action would be important, before, during and after an acute humanitarian emergency.Aim: To explore factors affecting immunization service delivery during and after conflict among internally displaced communities in Northwest Ethiopia.Methods: Qualitative and quantitative (record review) methods were applied, phenomenological study design and in-depth interviews were applied to collect the lived experiences of participants in the affected areas. Transcribed and translated data were analyzed and thematized using open code software. A Twenty-four-month record review of quantitative data was analyzed descriptively using an excel sheet to develop immunization coverage trends for tracer antigens.Results: We found that the immunization program had seriously deteriorated during and after the conflict in the study area. The monthly EPI service report in the affected areas showed a decline with the lowest records in December and January when the internal conflict was peak. Security problems, displacement of health workers, destruction of health infrastructures, mixing of the displaced community in the host community and poor coordination among stakeholders and partners, clients having other emergent needs and shortages of resources were important factors for immunization services.Conclusion: Vaccination service delivery was found to have significantly declined in the study area. Security problems affected not only the service utilizers but also the service providers’ wing as well. Coordination of stakeholders and strong leadership systems are crucial in maintaining optimum vaccination service delivery even at the time of conflict. [Ethiop. J. Health Dev. 2021; 35(SI-3):39-48]Key words: Conflict, internally displaced, Immunization service

Availability of adequately iodized in Northwest Ethiopia: a cross-sectional study

Abstract Background Universal salt iodization is the most cost-effective, safe and sustainable strategy to eliminate iodine deficiency disorders. However, little is known about the availability of adequately iodized salt in the northwestern part of Ethiopia. Thus, the aim of this study was to assess the availability of adequately iodized salt at the household level and associated factors in Dabat District, northwest Ethiopia. Methods A community-based cross-sectional study was conducted from February 21 to March 31, 2016. We included 705 households in the study. A stratified multistage followed by simple random sampling technique was employed to select households. The level of salt iodine content was determined using the rapid field test kit. Accordingly, the value of <15 parts per million (PPM) and ≥15 PPM with the corresponding color chart on the rapid test kit were used to classify the level of iodine content in the sampled salt. A multivariable binary logistic regression model was fitted to identify factors associated with the availability of adequately iodized salt. Adjusted Odds Ratio (AOR) with the corresponding 95% Confidence Interval (CI) was calculated to show the strength of association. Results This study indicated that about 33.2% [95% CI: 29.6, 36.7%] of households had adequately iodized salt. Urban residence (AOR = 2.15, 95% CI: 1.23, 3.76), use of packed salt (AOR = 2.23, 95% CI: 1.01, 4.89), and good respondents' knowledge on iodized salt use (AOR = 1.49, 95% CI: 1.08, 2.08) were positively associated with the availability of adequately iodized salt. However, longer distance to buy salt was inversely related with availability of adequately iodized salt (AOR = 0.68, 95% CI: 0.48, 0.99). Conclusions The availability of iodized salt is well under the WHO recommendation in Dabat District in spite of the fact that Ethiopia has been implementing universal salt iodization since the last five years. Therefore, intensifying strategies targeting to enhance community awareness on the benefit and handling practice of iodized salt is essential to improve availability of iodized salt. In addition, the focus needs to be on improving accessibility of iodized salt

Contraceptive utilization and associated factors among HIV positive women on chronic follow up care in Tigray Region, Northern Ethiopia: a cross sectional study.

BACKGROUND: In sub-Sahara Africa, more than 60% of all new HIV infections are occurring in women, infants and young children. Maternal to child transmission is responsible for 90% of childhood HIV infection. Preventing unwanted pregnancy among HIV positive women is imperative to reduce maternal and infant morbidity and mortality. METHODS: A cross-sectional survey was conducted among 964 HIV positive women in selected 12 health centers of Tigray region. In this paper, analysis was restricted only for 847 women who were sexually active and non-pregnant. In each health center the number of study participants was allocated proportionally to the load of HIV positive women in chronic care clinics. The data were entered into EpiData version 3.1, and cleaned and analyzed using Stata version 11.1. Descriptive summary of data and logistic regression were used to identify possible predictors using odds ratio with 95% confidence interval and P-value of 0.05. FINDINGS: Three hundred ninety four (46.5%) of all HIV positive women had intension to have more children. Three hundred seventy five (44.3%) were using contraceptive methods at time of survey. Injectable (70.7%) and male condom (47.6%) were most commonly used type of contraceptives. In the multivariable analysis, women who were urban dwellers (AOR = 2.55; 95% CI: 1.27, 5.02), completed primary education (AOR = 2.27; 95% CI: 1.12, 2.86) and those openly discussed about contraceptive methods with their husbands or sexual partners (AOR = 6.3; 95% CI: 3.42, 11.76) were more likely to use contraceptive. Women who have one or more living children were also more likely to use contraceptive compared with women with no child. CONCLUSION: Less than half of women used contraceptive methods. The use of condoms could impact unintended pregnancies and reduced risks of vertical and sexual transmission. Efforts to increase contraceptive utilization focusing on the barrier methods should be strengthen in HIV/AIDS chronic care units

Poor dietary diversity, wealth status and use of un-iodized salt are associated with goiter among school children: a cross-sectional study in Ethiopia

Abstract Background Globally, more than two billion people are at risk of iodine deficiency disorders, 32% of which are school children. Iodine deficiency has been recognized as a severe public health concern in Ethiopia, however little is known about the problem. Therefore, this study aimed to assess the prevalence of goiter and associated factors among school children (6 to 12\ua0years) in Dabat District, northwest Ethiopia. Methods A school-based cross-sectional study was conducted from February 21 to March 31, 2016. A total of 735 school children were included in the study. A stratified multistage sampling followed by systematic sampling technique was employed to select the study participants. Thyroid physical examination was done and classified according to the World Health Organization recommendations as grade 0, grade 1, and grade 2. The level of salt iodine content was determined using the rapid field test kit. The value 0 parts per million (PPM), <15 PPM and \u226515 PPM with the corresponding color chart on the rapid test kit were used to classify the level of iodine in the sampled salt. A multivariable logistic regression analysis was employed to identify factors associated with goiter. Adjusted Odds Ratio (AOR) with a 95% Confidence Interval (CI) was calculated to show the strength of association. In multivariable analysis, variables with a P -value of <0.05 were considered statistically significant. Results In this community, the overall prevalence of goiter was 29.1% [95% CI: 25.9, 32.6], in which about 22.4 and 6.7% had goiter grade 1 and grade 2, respectively. The age of children (AOR\u2009=\u20091.13; 95% CI: 1.01, 1.26), being housewife mother (AOR\u2009=\u20091.49; 95% CI: 1.08, 2.15), use of unprotected well water source for drinking (AOR\u2009=\u20096.25; 95% CI: 2.50, 15.66), medium household wealth status (AOR\u2009=\u20091.78; 95% CI: 1.18, 2.92), use of inadequately iodized salt (AOR\u2009=\u20092.79; 95% CI: 1.86, 4.19), poor dietary diversity score of the child (AOR\u2009=\u20091.92;95% CI: 1.06, 3.48) and medium maternal knowledge (AOR\u2009=\u20090.65; 95% CI: 0.42, 0.94) were significantly associated with goiter. Conclusions The prevalence of goiter is higher in Dabat District, which confirmed a moderate public health problem. Therefore, regular monitoring of household salt iodine content, improving access to safe water, promoting the importance of diversified food for children is recommended to address the higher burden of iodine deficiency

Geographic variation and associated factors of long-acting contraceptive use among reproductive-age women in Ethiopia: a multi-level and spatial analysis of Ethiopian Demographic and Health Survey 2016 data

Plain language summary Lower and middle-income countries such as Ethiopia face a challenge of an ever increasing population with high maternal mortality. In Ethiopia, the population is estimated to be more than 110 million. High fertility rates, unintended pregnancy, maternal and child mortalities are the main concerns of the country. Accordingly, it is required of the country to make a robust intervention to limit these public concerns. In relation to this, LACs utilization happens to be one of the solutions to solving the concerns. Despite their efficacy, availability, and acceptability the utilization of LACs remains low and varies among different geographic areas. However, the reason is still undefined and geographic variation was not assessed before. In our study, we analyze the Ethiopian demographic and health survey 2016 data to assess the presence of significant geographic variation and associated factors of long-acting contraceptive utilization. Hence, a spatial and multilevel analysis were employed to assess the geographic variation and associated factors of LACs utilization in Ethiopia. A statistically significant geographic variation was observed among different clusters. Clusters with significantly low utilization of LACs were found in the pastoralist (Afar, Gambela, and Somalia) regions of the country. Thus, more organized efforts need to be made to increase the utilization of LACs. Controlling for others: Marital statuses, occupation, future pregnancy interest, urban residence, previous history of abortion, living in the pastoralist community were statistically significant determinant factors of LACs utilization. In conclusion, significant geographic variation of LACs utilization was observed among different clusters. Besides, different socio-demographic, pregnancy, and child health-related variables were significant determinants of LACs utilization

Map of study area (Ethiopia, Tigray region) and location of study health centers.

<p>Map of study area (Ethiopia, Tigray region) and location of study health centers.</p