Availability of Adequately Iodized Salt at Household Level and Associated Factors in Dire Dawa, Eastern Ethiopia

In Ethiopia, Iodine Deficiency Disorder has been recognized as a serious public health problem for the past six decades. In 2011, an estimated 12 million school-age children were living with inadequate iodine, and 66 million people were at risk of iodine deficiency. One out of every 1000 people is a cretin mentally handicapped, due to a congenital thyroid deficiency, and about 50000 prenatal deaths are occurring annually due to iodine deficiency disorders. Only 5.7% of the households were using iodized salt in Dire Dawa city Administration, which is below the legal requirement.This study assessed availability of adequately iodized salt at household level and associated factors in Dire Dawa town, East Ethiopia. Community based cross-sectional study was carried out among households in Dire Dawa town during March 16-26, 2015. Multistage sampling technique was used. Data were collected using a pretested and structured questionnaire by a face-to-face interview technique. Bivariate and multivariate analyses were performed to check associations and control confounding. A total of 694 participants were participated. The availability of adequately iodized salt (≥15 parts per million) in the study area was 7.5% (95% CI; 5.6-9.5). Multivariate result showed that health information about iodized salt (AOR=8.96, 95% CI; 4.68-17.16) (p=0.03), good knowledge about iodized salt (AOR=9.23, 95% CI; 3.34-25.5) (p=0.01) and using packed salt (AOR=3.99, 95% CI; 1.48-10.73) (p=0.006) were associated with availability of adequately iodized salt at household level. Availability of adequately iodized salt at household level was very low. Hence, households should be sensitized about importance of iodized salt and its proper handling at the household level

Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BackgroundDisorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021.MethodsWe estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined.FindingsGlobally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378–521), affecting 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7–26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6–38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5–32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7–2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer.InterpretationAs the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed