Current khat ( Catha edulis F.) use among Ethiopian women and its association with anemia and underweight: A cross-sectional analysis from Ethiopian Demographic and Health Survey

Background: Chewing fresh leaves of Catha edulis (khat) is a popular pastime activity among Ethiopians where 12% women chew it. Reports show that khat use has been associated with poor nutritional status. This study aimed to determine whether khat chewing is linked to underweight and anemia. Method: We analyzed data from the 2016 Ethiopian Demographic and Health Survey (EDHS). The EDHS used two stage stratified cluster sampling to collected data from 16,650 households. We used data from a total of 15,683 respondents and 1904 respondents who chewed ever chewed khat in their lives. We used Pearson’s chi-square, and logistic regression while stratifying by residence (urban vs rural) to control for confounders. Result: Our results indicated 10.7% (95%CI: 10.92,11.26) of women chewed khat for an average of 16.5 days in the previous month. A woman’s current khat chewing status was significantly associated with age, educational level, region, religion, wealth group, and marital status. Women aged 40–44 were significantly more likely to chew (AOR = 2.89,) compared to those aged 15–19. Compared with Protestant women, Muslim women were 210 times more likely (AOR = 210, 95% CI 102,435.7) to chew and women in the poorest wealth quintile had 73% higher odds (AOR = 1.73, 95% CI 1.22,2.44) of chewing khat when compared with the richest. Anemia was not associated with a woman’s chewing status, whereas rural women who chewed khat for more than 26 days in a month had a 78% increased risk (OR = 1.78) of being underweight when compared to non-chewers. Conclusion: Khat chewing is associated with sociodemographic factors and current khat use is associated with a higher risk of underweight among women living in rural areas. Implementing targeted awareness campaigns for women about the risks of khat chewing is recommended

Roll back malaria - an African success story in Eritrea

No Abstract

Dengue fever outbreaks in Eritrea, 2005-2015: a case for strengthening surveillance, control and reporting

BACKGROUND: The geographic distribution and burden of dengue is increasing globally. This study aims to evaluate dengue outbreaks and to substantiate the need for strengthened surveillance, reporting and control in Eritrea. METHODS: Data from two cross-sectional dengue epidemic investigations in 2005 and 2010 were analyzed. Samples were tested for dengue virus-specific IgM and IgG antibodies using capture enzyme-linked immunosorbent assays. Dengue vectors' breeding attributes were characterized and epidemic risk indices determined. National routine surveillance weekly reports from 2005 to the second quarter of 2015 were analyzed for spatiotemporal trends. RESULTS: Dengue outbreaks increased in Eritrea from 2005 to 2015 with clinical presentation varying markedly among patients. The house and container indices for Aedes aegypti were 40 and 39.6 % respectively, with containers having A. aeqypti varying significantly (P < 0.04). Serum from 33.3 % (n = 15) and 88 % (n = 26) of clinical dengue cases in Aroget sub-Zoba (district) of Gash Barka Zoba (region) contained anti-DENV IgM antibody in 2005 and 2006, respectively. The national surveillance data from 2005 to 2015 indicate an overall spatiotemporal increase of dengue fever. CONCLUSIONS: The increase in dengue outbreaks has been confirmed in Eritrea and necessitates strengthening of surveillance and health worker and laboratory capacity, as well as targeted vector control interventions

Cost analysis of an integrated disease surveillance and response system: case of Burkina Faso, Eritrea, and Mali

<p>Abstract</p> <p>Background</p> <p>Communicable diseases are the leading causes of illness, deaths, and disability in sub-Saharan Africa. To address these threats, countries within the World Health Organization (WHO) African region adopted a regional strategy called Integrated Disease Surveillance and Response (IDSR). This strategy calls for streamlining resources, tools, and approaches to better detect and respond to the region's priority communicable disease. The purpose of this study was to analyze the incremental costs of establishing and subsequently operating activities for detection and response to the priority diseases under the IDSR.</p> <p>Methods</p> <p>We collected cost data for IDSR activities at central, regional, district, and primary health care center levels from Burkina Faso, Eritrea, and Mali, countries where IDSR is being fully implemented. These cost data included personnel, transportation items, office consumable goods, media campaigns, laboratory and response materials and supplies, and annual depreciation of buildings, equipment, and vehicles.</p> <p>Results</p> <p>Over the period studied (2002–2005), the average cost to implement the IDSR program in Eritrea was $0.16 per capita,$0.04 in Burkina Faso and $0.02 in Mali. In each country, the mean annual cost of IDSR was dependent on the health structure level, ranging from$35,899 to $69,920 at the region level,$10,790 to $13,941 at the district level, and$1,181 to $1,240 at the primary health care center level. The proportions spent on each IDSR activity varied due to demand for special items (e.g., equipment, supplies, drugs and vaccines), service availability, distance, and the epidemiological profile of the country.</p> <p>Conclusion</p> <p>This study demonstrates that the IDSR strategy can be considered a low cost public health system although the benefits have yet to be quantified. These data can also be used in future studies of the cost-effectiveness of IDSR.</p

Progress Towards Elimination of Trachoma as a Public Health Problem in Eritrea: Results of a Systematic Review and Nine Population-based Prevalence Surveys Conducted in 2014.

PURPOSE: To assess Eritrea's progress towards elimination of trachoma as a public health problem, we reviewed and compiled current knowledge on the distribution and burden of trachoma in Eritrea, then undertook further population-based surveys where indicated, with support from the Global Trachoma Mapping Project (GTMP). METHODS: For the systematic review, undertaken in March 2014, we searched (1) PubMed, using the terms ((blind* or trachoma or trichiasis) AND Eritrea); (2) the online database of rapid assessments of avoidable blindness; (3) our own grey literature collections; and (4) the Global Atlas of Trachoma database. In June and July 2014, we conducted nine population-based prevalence surveys, for each of which 30 villages were systematically selected with probability proportional to population size; in each village, 30 households were systematically selected. All consenting residents of selected households aged ≥1 year were examined by GTMP-certified graders for signs of trachoma. Data on household-level access to water and sanitation were also collected. RESULTS: One previous rapid assessment of avoidable blindness, three peer-reviewed publications, and two grey literature reports detailing sets of trachoma prevalence surveys conducted in 2006 and 2011, respectively, were located. Post-intervention impact surveys were needed in seven evaluation units (EUs, framed at sub-Zoba-level: population range 40,000-120,000) of Debub and Northern Red Sea, while baseline surveys were needed in two EUs of Anseba. Four of the seven impact survey EUs and both baseline survey EUs returned trachomatous inflammation-follicular prevalences in 1-9-year-olds of ≥5%; six of the seven impact survey EUs and one of the two baseline survey EUs returned trichiasis prevalences in ≥15-year-olds of ≥0.2%. The prevalence of access to water and sanitation varied widely between EUs. CONCLUSION: Interventions are still required in Eritrea to eliminate trachoma as a public health problem. Data from these surveys will guide the Ministry of Health to undertake programme planning using a sound evidence base

A steep decline of malaria morbidity and mortality trends in Eritrea between 2000 and 2004: the effect of combination of control methods

BACKGROUND: Malaria is a huge public health problem in Africa that is responsible for more than one million deaths annually. In line with the Roll Back Malaria initiative and the Abuja Declaration, Eritrea and other African countries have intensified their fight against malaria. This study examines the impact of Eritrea's Roll Back Malaria Programme: 2000–2004 and the effects and possible interactions between the public health interventions in use. METHODS: This study employed cross-sectional survey to collect data from households, community and health facilities on coverage and usage of Insecticide-Treated Nets (ITNs), Indoor Residual Spraying (IRS), larvicidal activities and malaria case management. Comparative data was obtained from a similar survey carried out in 2001. Data from the Health Management Information System (HMIS) and reports of the annual assessments by the National Malaria Control Programme was used to assess impact. Time series model (ARIMA) was used to assess association. RESULTS: In the period 2000–2004, approximately 874,000 ITNs were distributed and 13,109 health workers and community health agents were trained on malaria case management. In 2004, approximately 81% households owned at least one net, of which 73% were ITNs and 58.6% of children 0–5 years slept under a net. The proportion of malaria cases managed by community health agents rose from 50% in 1999 to 78% in 2004. IRS coverage increased with the combined amount of DDT and Malathion used rising from 6,444 kg, in 2000 to 43,491 kg, in 2004, increasing the population protected from 117,017 to 259,420. Drug resistance necessitated regimen change to chloroquine plus sulfadoxine-pyrimethamine. During the period, there was a steep decline in malaria morbidity and case fatality by 84% and 40% respectively. Malaria morbidity was strongly correlated to the numbers of ITNs distributed (β = -0.125, p < 0.005) and the amount (kg) of DDT and Malathion used for IRS (β = -2.352, p < 0.05). The correlation between malaria case fatality and ITNs, IRS, population protected and annual rainfall was not statistically significant. CONCLUSION: Eritrea has within 5 years attained key Roll Back Malaria targets. ITNs and IRS contributed most to reducing malaria morbidity