Determinants of exclusive breastfeeding practices in Ethiopia

Background: Despite the demonstrated benefits of breast milk, the prevalence of breastfeeding, in-particular exclusive breastfeeding (EBF), in many developing countries including Ethiopia is lower than the international recommendation of EBF for the first six months of lifeObjective: To assess the practice of EBF and explore its determinants in Ethiopia and provide policy makers and NGOs with relevant information for future planning and interventions.Methods: Raw data collected from nine regions and two city administrations using stratified cluster sampling method by the Ethiopian Demographic Health Survey (EDHS) 2005 were used to study the practice and determinants of EBF countrywide. Analysis was based on children whose age was less than six months and alive at the time of interviewthat was extracted from the women’s database.Results: The overall rates of exclusive and full breastfeeding were 49.0% and 68.2% respectively. Maternal education, marital status, wealth index and age of the child were closely associated with EBF practices, nonetheless, in the hierarchical analysis; being not married, middle/ richer/ richest wealth index, and child age 0-1and 2-3 month wereretained as the predictors of EBF (

Utilization of antenatal care services among teenagers in Ethiopia: A cross sectional study

Background: Teenaged women suffer from a disproportionate share of reproductive health problem. The purpose of this study was to estimate the utilization of antenatal care (ANC) services among teenagers (13-19 years) during delivery in Ethiopia.Methodology: Raw data collected from all part of the country on child bearing aged women using stratified cluster sampling method by the Ethiopian Demographic Health Survey 2005 was used. From the large dataset of women, a total of 994 teenage women at the time of their most recent childbirth five years prior to the survey was selected andanalyzed. Both bivariate and multivariate analyses were performed to determine the differentials of ANC by explanatory variables.Result: Most (60%) of the subjects were in the age group between 18 and 19 years. The vast majority (90%) was from the rural settings and most (87%) were in marital union. Almost three out of four (72.4%) of those who had given birth has no any form of formal education. Over a quarter (27.3%) of most recent childbirths had at least one ANC service, of this, 21% had started their first antenatal visit in the first trimester of pregnancy. The majority (80.4%) of the women who attended ANC delivered at home without being assisted. The major deriving factors forthe utilization of ANC service were education level of women and their male partners, better wealth index and urban residence.Conclusion: Education of partners, rich wealth index and urban residence seemed to encourage teenagers to utilize ANC. Appropriate interventions targeting teenaged women with poor socioeconomic status is recommended with more emphasis on the rural underserved segment of population

HIV positive status disclosure to sexual partner among women attending ART clinic at Hawassa University Referral Hospital, SNNPR, Ethiopia

Background: Disclosure of HIV positive status has key role in the prevention and control of HIV/AIDS. Reports of non-disclosure and negative outcome of disclosure are common. Thus, disclosure of HIV positive status is a theme that demands investigation.Objective: The objective of this study was to determine the magnitude and outcome of HIV positive status disclosure to sexual partner among women living with HIV/AIDS and attending Hawassa University Referral Hospital, South Nations and Nationalities Peoples Region (SNNPR) during a period of March to April 2008.Methods: A cross sectional survey was conducted at Hawassa University  Referral Hospital. Single population proportion formula was used to determine sample size. Using a structured and pre-tested questionnaire, data on disclosure were collected through interview. After explaining purpose of the survey, data collection was continued until the required sample was obtained. Then, data were entered using EPI info version 2002 statistical package and cross checked for reliability. Using SPSS 12.1 for windows statistical package, analysis was done. Results: Overall 85.7% of the women had disclosed their HIV positive status to sexual partner. Main barriers of disclosure reported by non-disclosed subjects were; fear of abandonment, fear of break-up in relationship and fear of stigma. More than 59% of the women with regular sexual partner faced negative partner reaction after disclosure. Compared with married women, those women who were in a cohabiting relationship were less likely to disclose their HIV status to sexual partners (AOR 0.16; 95% CI 0.04, 0.60); women who did not know HIV status of their sexualpartners were less likely to disclose their HIV positive status than their counter parts (AOR 0.02; 95% CI 0.00, 0.08) and women who had been on ART for more than one year were more likely to disclose their HIV positive status than the reference groups (AOR 8.62; 95% CI 1.35, 55.22).Conclusion: HIV positive status disclosure to sexual partner in this study was higher than what was reported in other studies in Ethiopia, for Mettu and Gore (69%) but slightly lower than the report from Jimma (94.5%) and Addis Ababa (92%). Negative partner reaction following disclosure was higher. Effectively addressing issues of disclosure was recommended to encourage disclosure and cope with negative reactions after disclosure in People Living with HIV/AIDS (PLWHA). Besides, currently existing Information Education Communication (IEC) interventions on HIV/AIDS should be strengthened, to reduce negative partner reaction following disclosure. [Ethiop. J. Health Dev. 2010;24(1):9-14

Determinants of adolescent fertility in Ethiopia

Background: Worldwide, adolescents suffer from a disproportionate share of reproductive health problem. Throughout the world, over 14 million adolescents aged 15-19 years give birth annually. The purpose of this study was to assess the level and identify proximate and other determinants of adolescent fertility in Ethiopia.Methods: Raw data collected from all part of the country using stratified cluster sampling method by the Ethiopian Demographic Health Survey 2005 (EDHS-2005) was used. After the data for adolescents aged from 15 to 19 years were extracted from the large data set, Multivariate logistic regression model was applied to identify sociodemographic and economic determinants whereas Bongaarts model was used to determine proximate determinants fertility.Results: Of the 3,266 adolescent women, 443 (13.6%) had given birth at least once prior to the survey and 133 (4.1%) were pregnant. Of the 443 adolescents who had at least given birth, the majority (72.7%) had one child while about a quarter (23.2%) had 2 live births and the rest 1.0% gave four live births with a mean number of child ever born of 1.33±0.6. The major factors associated with adolescent fertility were age, educational status, place of residence, employment, marriage, contraceptive use and postpartum infecundability. The odds for increased adolescent fertility was significantly higher in early adolescents (AOR=7.6; 95% CI=6.0 to 9.9), had lower education (AOR=6.7; 95%CI=4.1 to10.9), among rural teens (AOR=3.6; 95%CI=1.9 to 6.9) and currently not working (AOR=1.7; 95%CI= 1.3 to 2.2) than their counterparts. The observed fertility rate of 0.52 children per woman obtained from Bongaarts model of fertility indicated about 1.98 births per woman were averted due to non-marriage, delayed marriage, contraceptive use and postpartum infecundability.Conclusion: Since adolescent fertility is felt to be a problem, concerted efforts are needed to empower adolescents to fight early marriage, promote education and encourage the utilization of family planning targeting the rural teenagers. [Ethiop. J. Health Dev. 2010;24(1):30-38

Page number not for citation purposes 1 Assessment of the household availability of oral rehydration salt in rural Botswana

Introduction: Diarrhea contributed for 17.6% of under-five deaths in Botswana. Oral rehydration salt (ORS) therapy has been the cornerstone in the control of morbidity and mortality secondary to diarrheal diseases. The study was aimed at assessing the household availability of ORS following the nationwide campaign of availing ORS at household level. Methods: A cross sectional community based study was conducted in August 2012. EPI random walk method was used to identify households. Data was collected using interviewers' administered structured questionnaire. SPSS software was used in data entry and analysis. Results: Oral Rehydration Salt (ORS) was available in 50.8% of the households with under-five children. Information on ORS is well disseminated whereas only three-fourth of informed participants had adequate knowledge of ORS preparation. The sources of information were predominantly the Child Welfare Clinic (88.8%). Being grandmother as a care taker was a negative predictor of household availability of ORS (AOR 0.25, 95% CI 0.09-0.69) while respondents who are knowledgeable about ORS preparation were more likely to have ORS available at home (AOR 1.92, 95% CI 1.10-3.34). Conclusion: The campaign has brought a significant coverage in terms of availability of ORS. The health education and community sensitization efforts need to go beyond health facilities via other means like the media  and community based approaches. Approaches aimed at improving the knowledge of care takers on the importance of ORS, its preparation, correct use and restocking are of paramount importance. Availing community based outlet for ORS is an alternative to enhance accessibility.Key words: Oral, Rehydration, Salt, ORS, availability, Botswan

Evaluation of Community-Based Trichiasis Surgery in Northwest Ethiopia

Background: Surgery to correct trachomatous trichiasis (TT) is recommended to prevent blindness caused by trachoma. This study evaluated the outcomes of community-based trichiasis surgery with absorbable sutures, conductd in Amhara Regional State, Ethiopia.Methods: A simple random sample of 431 patients was selected from surgical campaign records of which 363 (84.2%) were traced and enrolled into the study. Participants were interviewed and examined for trichiasis recurrence, complications of TT surgery and corneal opacity. Multilevel logistic regression models were used to explore the associations between trichiasis recurrence, corneal opacity and explanatory variables at the eye level.Results: The prevalence of trichiasis recurrence was 9.4% (95% Confidence Interval [CI] 6.6-12.8) and corneal opacity was found in 14.3% (95% CI 10.9-18.3) of the study participants. The proportion of participants with complications of TT surgery was: granuloma 0.6% (95% CI 0.1-2.0); lid closure defects 5.5% (95% CI 3.4-8.4) and lid notching 16.8% (95% CI 13.1-21.1). No factors were identified for trichiasis recurrence. Corneal opacity was associated with increased age (Ptrend=0.001), more than 12 months post surgery (OR=2.7; 95%CI 1.3-5.6), trichiasis surgery complications (OR=2.9; 95%CI 1.4-5.9) and trichiasis recurrence (OR=2.5; 95%CI 1.0-6.3).Conclusion: Prevalence of recurrent trichiasis and granuloma were lower than expected but higher for lid closure defects and lid notching. The majority of the participants reported satisfaction with the trichiasis surgery they had undergone. The findings suggest that recurrence of trichiasis impacts on the patients’ risk of developing corneal opacity but longitudinal studies are required to confirm this.Keywords: Corneal opacity, Trichiasis, Trichiasis recurrence, Ethiopi

Patterns of language and auditory dysfunction in 6-year-old children with epilepsy

In a previous study we reported difficulty with expressive language and visuoperceptual ability in preschool children with epilepsy and otherwise normal development. The present study analysed speech and language dysfunction for each individual in relation to epilepsy variables, ear preference, and intelligence in these children and described their auditory function. Twenty 6-year-old children with epilepsy (14 females, 6 males; mean age 6:5 y, range 6 y–6 y 11 mo) and 30 reference children without epilepsy (18 females, 12 males; mean age 6:5 y, range 6 y–6 y 11 mo) were assessed for language and auditory ability. Low scores for the children with epilepsy were analysed with respect to speech-language domains, type of epilepsy, site of epileptiform activity, intelligence, and language laterality. Auditory attention, perception, discrimination, and ear preference were measured with a dichotic listening test, and group comparisons were performed. Children with left-sided partial epilepsy had extensive language dysfunction. Most children with partial epilepsy had phonological dysfunction. Language dysfunction was also found in children with generalized and unclassified epilepsies. The children with epilepsy performed significantly worse than the reference children in auditory attention, perception of vowels and discrimination of consonants for the right ear and had more left ear advantage for vowels, indicating undeveloped language laterality

Non-communicable diseases in antiretroviral therapy recipients in Kagera Tanzania: A cross-sectional study

Introduction: The aim of this study was to describe the extent of  self-reported non-communicable diseases (NCDs) among highly activeantiretroviral therapy (HAART) recipients in Kagera region in Tanzania and their effect on health-related quality of life (HRQOL). This study was conducted 2 years after HAART administration was started in Kagera region. Methods: The SF-36 questionnaire was used to collect the HRQOLdata of 329 HAART recipients. Questions on the NCDs, socio-demographic characteristics and treatment information were validated and added tothe SF-36. Bivariate analyses involving socio-demographic characteristics and SF-36 scores of the recipients were performed. Multiple logisticregression was employed to compute adjusted odds ratios for different explanatory variables on physical functioning and mental health scores.Results: Respondents who reported having 1 or more NCDs were 57.8% of all the respondents. Arthritis was the commonest NCD (57.8%).Respondents with the NCDs were more likely to have HRQOL scores below the mean of the general Tanzanian population. The populationattributable fraction (PAF) for the NCDs on physical functioning was 0.28 and on mental health was 0.22. Conclusion: Self-reported NCDs were prevalent among the HAART recipients in Kagera region. They accounted for 28% of the physical  functioning scores and 22% of the mental health scores that were below the mean of the general Tanzanian population. Therefore, the integration of NCD care is important in the management of HIV/AIDS

Structural Performance Comparison of Structural Systems Using LIRA and ETABS

This paper investigates a comparison of structural systems of high rise (96m of 30 stories) buildings subjected to gravity load and wind load of speed 90mph. Three structural systems, Moment frame system, Shear wall system, and Tube-in-Tube system of identical base area and loadings are structurally designed, in ETABS and LIRA software. Linear wind response analysis was carried out as per ASCE 7-05. Parameters like fundamental time period, Maximum story displacement, Maximum column axial load and Vertical floor displacement are considered in this study. As per the findings, the maximum story displacement is found to be within the allowable limiting value. Tube-in-Tube system shows a better performance from the other systems for minimizing the story displacement. The modal time period, vertical displacement and Maximum column axial load values are also minimum in Tube -in-tube system