Editorial: Key challenges in meeting MDG 4: Reduction of child mortality

No abstract

Patterns of knowledge and condom use among population groups: Results from the 2005 Ethiopian Behavioral Surveillance Surveys on HIV

Background: Behavioral surveys help interpret the magnitude of HIV/AIDS. We analyzed indicators of knowledge on HIV/AIDS and condom use among different groups of populations selected for behavioral surveillance in Ethiopia. Methods: We used HIV/AIDS Behavioural Surveillance Surveys (BSS) data collected from ten target groups in Ethiopia. These were female sex workers, military personnel, police force, pastoralists, long distance truck drivers, intercity bus drivers, road construction workers, teachers, factory workers and ANC catchment populations. Results: Data from 14,524 individuals were analyzed. The majority were male (63.6%). Knowledge of the three preventive methods (abstinence, faithfulness and consistent condom use), misconceptions and comprehensive knowledge was 57%, 75% and 18.5%, respectively. Female sex workers and the defence force showed positive results in using condom during last sexual encounter and did so consistently with non regular sexual partners and paying partners. Women, pastoralists and the illiterate were negatively impacted. Conclusion: Inadequate and incorrect knowledge on HIV/AIDS was observed with special deficiency among the underserved groups such as pastoralists. Women and the older age group were found to be at a disadvantage. The findings indicate the need to expand prevention activities to hard-to-reach groups and such a certain specific population segments. Population groups such as female sex workers and the defense force that were known to be severely affected by the epidemic and are focus of HIV/AIDS interventions showed positive behaviors. Although this s encouraging, considerable proportion of the study groups did not use condom during sex with non regular partners. This underscores the importance of intensifying interventions across all groups and extended to their localities

Commentary: A brief review of the draft human resources for health strategic plan, Ethiopia; 2009-2020

No Abstrac

Campylobacter enteritis among children in Dembia District, Northwest Ethiopia

Objective: To estimate the magnitude of Campylobacter enteritis in children below fifteen years of age.Design: A cross-sectional survey.Setting: Seven villages found in the outskirts of Kolla Diba town were covered. The town is located 35 kilometres away from Gondar teaching hospital.Participants: Stool specimens were collected from 153 children under fifteen years of age. Caretakers of the children were interviewed using a structured questionnaire.Main outcome measures: Culture result for Campylobacter, culture and biochemical test results for Salmonella and Shigella and direct microscopy results for parasites or ova measures.Results: The prevalence of Campylobacter species was 16/153 (10.5%) and the frequency of isolation was twice as much as Salmonella or Shigella species (5.2% each). Contact with cats and diarrhoea-sick person in the household was associated with isolation of Campylobacter species.Conclusion: Based on the finding and the evidence accumulated, clinical health professionals need to consider Campylobacter species as one of the major causes of diarrhoea in children

Unprotected sex, sexually transmitted infections and problem drinking among female sex workers in Ethiopia

Background: A description of the pattern of use of alcohol and other substances among female sex workers (FSWs) is particularly important because of the high prevalence of HIV in this particular group and their potential for transmitting HIV infection to other groups. However, there is currently lack of systematic studies from developing countries like Ethiopia regarding alcohol use visa vis unprotected sex and STIs. Objective: To describe the association of risky sexual behaviour with alcohol use and problem drinking among female sex workers in Ethiopia. Methods: A total of 2,487 female sex workers aged between of 15 and 49 years were randomly sampled from seven urban centres in Ethiopia and interviewed regarding their sexual behavior and substance use. Results: About 12% of FSWs included in this study reported having unprotected sex during the 12 months prior to the interview. A history of vaginal ulcer or discharge experienced by the FSWs was reported by 5% of the study subjects. Those who reported occasional use of alcohol were found to have a two-fold increase in the odds of havingunprotected sex compared to non-users: adjusted OR (95% CI) = 2.06 (1.28, 3.33). Those who responded positively to at least one question from the four - item questionnaire known as CAGE, and which is used as an indicator for problem drinking, had a 50% increased odds of unprotected sex compared with zero scorers: adj. OR (95% CI) = 1.48 (1.07, 2.05). Those who reported alcohol use on a daily basis were found to have a two-fold increased odds of having sexually transmitted infections (STIs) compared to the non-users of alcohol: adj. OR (95% CI) = 2.50 (1.35, 4.64). Compared to those who were not literate, educational attainment was associated with a lower odds of reporting vaginal discharge or ulcers in those that have attended elementary education: adj. Or (95% CI) = 0.56 (0.35, 0.89.), and secondary education: adj. OR (95% CI) = 0.59 (0.37, 0.93). Conclusion: Unprotected sex and symptoms of STIs were associated with alcohol use, problem drinking and lower educational attainment. The Ethiopian Journal of Health Development Vol. 20 (2) 2006: 93-9

Bibliography on HIV/AIDS in Ethiopia and Ethiopians in the Diaspora: The 2011 Update

No abstract

Geographic variation and factors associated with female genital mutilation among reproductive age women in Ethiopia: A national population based survey

Background: Female genital mutilation (FGM) is a common traditional practice in developing nations including Ethiopia. It poses complex and serious long-term health risks for women and girls and can lead to death. In Ethiopia, the geographic distribution and factors associated with FGM practices are poorly understood. Therefore, we assessed the spatial distribution and factors associated with FGM among reproductive age women in the country. Method: We used population based national representative surveys. Data from two (2000 and 2005) Ethiopian demographic and health surveys (EDHS) were used in this analysis. Briefly, EDHS used a stratified, two-stage cluster sampling design. A total of 15,367 (from EDHS 2000) and 14,070 (from EDHS 2005) women of reproductive age (15-49 years) were included in the analysis. Three outcome variables were used (prevalence of FGM among women, prevalence of FGM among daughters and support for the continuation of FGM). The data were weighted and descriptive statistics (percentage change), bivariate and multivariable logistic regression analyses were carried out. Multicollinearity of variables was assessed using variance inflation factors (VIF) with a reference value of 10 before interpreting the final output. The geographic variation and clustering of weighted FGM prevalence were analyzed and visualized on maps using ArcGIS. Z-scores were used to assess the statistical difference of geographic clustering of FGM prevalence spots. Result: The trend of FGM weighted prevalence has been decreasing. Being wealthy, Muslim and in higher age categories are associated with increased odds of FGM among women. Similarly, daughters from Muslim women have increased odds of experiencing FGM. Women in the higher age categories have increased odds of having daughters who experience FGM. The odds of FGM among daughters decrease with increased maternal education. Mass media exposure, being wealthy and higher paternal and maternal education are associated with decreased odds of women's support of FGM continuation. FGM prevalence and geographic clustering showed variation across regions in Ethiopia. Conclusion: Individual, economic, socio-demographic, religious and cultural factors played major roles in the existing practice and continuation of FGM. The significant geographic clustering of FGM was observed across regions in Ethiopia. Therefore, targeted and integrated interventions involving religious leaders in high FGM prevalence spot clusters and addressing the socio-economic and geographic inequalities are recommended to eliminate FGM. © 2016 Setegn et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

Khat and alcohol use and risky sex behaviour among in-school and out-of-school youth in Ethiopia

BACKGROUND: Khat (an evergreen plant with amphetamine-like properties) and alcohol are widely consumed among the youth of Ethiopia. However, their relationship to risky sexual behaviour is not well described. This study was conducted to describe the magnitude of risky sexual behaviour (unprotected sex and early initiation of sexual activity) and its association with Khat and alcohol consumption in Ethiopian youths. METHODS: A probabilistic national sample of 20,434 in-school and out-of-school youths aged between 15 and 24 years of age was selected and interviewed regarding their sexual behavior and substance use. RESULTS: Over 20% of out-of-school youth had unprotected sex during the 12-month period prior to interview compared to 1.4% of in-school youth. Daily Khat intake was also associated with unprotected sex: adjusted OR (95% CI) = 2.26 (1.92, 2.67). There was a significant and linear association between alcohol intake and unprotected sex, with those using alcohol daily having a three fold increased odds compared to those not using it: adj. OR (95% CI) = 3.05 (2.38, 3.91). Use of substances other than Khat was not associated with unprotected sex, but was associated with initiation of sexual activity: adj. OR (95% CI) = 2.54 (1.84, 3.51). CONCLUSION: A substantial proportion of out-of-school youth engage in risky sex. The use of Khat and alcohol and other substances is significantly and independently associated with risky sexual behaviour among Ethiopian youths

Barriers and facilitators of maternal health care services use among pastoralist women in Ethiopia: Systems thinking perspective

We explored the barriers and facilitators of maternal health care service use among women in the pastoralist region of Ethiopia. We used a mixed methods design—focus group discussions, key informant interviews, review of the literature and Participatory Ethnographic Evaluation Research (PEER) methods followed by a household survey among randomly chosen pastoralist women of reproductive age (n = 1,499). We used multi-variable regression analyses, and a p value ≤ 0.05 was set to determine statistical significance. In addition, we analysed qualitative data thematically and developed a causal loop diagram using dynamic synthesis methodology to analyse non-linearity, intricate relationships of the variable of interests. In this study, 20.6% of women used modern contraceptive methods, 44.6% had four or more antenatal visits and 38.4% of sampled women received skilled delivery services. We observed multiple individual and community related factors such as education, income and women’s and their partner’s knowledge, perceptions, husband approval, social norms and value-expectations and providers’ gender preferences and health systems factors such as access to health facilities, place of living, provider's cultural competency skills, supplies, delivery positions, economic and political stability, and provider's attitude were linked to maternal health care services utilization among women in pastoralist regions. Approaches towards pastoralists’ health care delivery systems should be responsive to their cultural and political ecology and human agency