Almost all working adults have at least one risk factor for non-communicable diseases: Survey of working adults in Eastern Ethiopia.

INTRODUCTION: The disease burden and mortality related to Non-communicable Diseases (NCD) increased in the last couple of decades in Ethiopia. As a result, an estimated 300,000 deaths per annum were due to NCD. According to a World Health Organization report, 39% of the total deaths in Ethiopia were attributable to NCD. Rapid urbanization characterized by unhealthy lifestyles such as tobacco and/or alcohol use, physical inactivity, low fruits and vegetable consumption, and overweight drive the rising burden of NCD. However, studies on risk factors for NCD and associated variables are limited among working adults in Eastern Ethiopia. Therefore, this study aimed to examine the magnitude of the risk factors of NCD and associated factors among working adults in Eastern Ethiopia. METHODS: A cross-sectional study was carried out among 1,200 working adults in Eastern Ethiopia that were selected using a simple random sampling technique from December 2018 to February 2019. Data were collected following the World Health Organization Stepwise Approach to NCD Risk Factor Surveillance (WHO STEP) instruments translated into the local language. A total of five risk factors were included in the study. The Negative Binomial Regression Model was used to determine the association between NCD risk factor scores and other independent variables. Adjusted incidence rate ratio (AIRR) with a 95% Confidence Interval (CI) was used to report the findings while the association was declared significant at a p-value of less than 0.05. STATA version 16.1 was used for data clearing, validating and statistical analysis. RESULTS: Totally, 1,164 (97% response rate) participants were employed for analysis. Overall, 95.8% (95% CI: 94.4-96.7%) of the participants had at least one of the five risk factors of NCD. Furthermore, the proportion of participants that had all NCD risk factors was 0.3%. Among the participants, 47.5% were alcohol drinkers, 5.1% were current smokers, 35.5% were overweight, 49.1% exercise low physical activity, and 95% had less than five portions of fruits and vegetables intake per day. Higher risk factor scores were associated with those of advanced age (AIRR = 1.24; 95% CI: 1.01-1.53 in 35-44 age group and AIRR = 1.28; 95% CI: 1.01-1.62 in 45-54 age group), and the ones who are higher educational level (AIRR = 1.23; 95% CI: 1.07-1.43 for those who have completed secondary school and AIRR = 1.29; 95% CI: 1.11-1.50 for those who have completed college education). CONCLUSION: The overwhelming majority (95.8%) of the participants had at least one risk factor for non-communicable diseases. The risk score of non-communicable diseases was higher among those with advanced age and who completed secondary and above levels of education. In a nutshell, the finding shows the need for lifestyle modification and comprehensive non-communicable diseases prevention programs for working adults in Eastern Ethiopia

Khat use and related determinants among pregnant women within Haramaya, Ethiopia: a mixed methods study

IntroductionKhat, a green leafy plant grown in East Africa and throughout the Arabian Peninsula, is chewed for its psychoactive and amphetamine-like effects, serving as a significant aspect of culture, economic livelihood, and global trade. Khat consumption during pregnancy has been associated with adverse effects, including anemia, premature rupture of membranes, and low birth weight, among others.MethodsThis cross-sectional, explanatory sequential mixed methods study was conducted in the Haramaya District of eastern Ethiopia using a questionnaire and focus group discussions. Questionnaires assessed socio-demographic information, pregnancy history, and diet, including khat use. Data were analyzed using SPSS v28 to include descriptive statistics, proportions, odds ratios, binary logistic regression, and chi-square analysis. FGDs expanded on the knowledge, attitudes, and practices of khat in the region, including pregnant or lactating women from two different kebeles. Two independent reviewers conducted a qualitative content analysis to examine the qualitative findings from the FGDs. Transcripts from the focus groups were entered into NVivo 14 to aid in capturing salient themes.ResultsA total of 444 pregnant women with a median age of 25 years completed the questionnaire. Two-thirds of the women, 66.9%, reported currently consuming khat while pregnant, and 72.7% of them reported daily consumption. The FGD analysis resulted in the discovery of five themes: Economic Livelihood, Maternal Significance, Medicinal Implications of Khat, Pesticide Use, and Social and Cultural Applications.DiscussionThis study revealed an alarming high prevalence of khat consumption among pregnant women in the Haramaya District, highlighting the pressing need for long-term studies to assess the health consequences. The role of khat as both an economic staple and an energy source for daily activities underscores the challenges in curbing its use. The documented health risks associated with the chemicals used in khat cultivation, including cancer, call for interventions to enhance safe agricultural practices in households involved in khat farming

Co-occurrence of hypertension and type 2 diabetes: prevalence and associated factors among Haramaya University employees in Eastern Ethiopia

BackgroundBoth hypertension (HTN) and diabetes are public health concerns in low- and middle-income countries, particularly in sub-Saharan African countries. The co-occurrence of HTN and diabetes is associated with an increased risk of mortality, morbidity, and reduced productivity in the working force. In Ethiopia, there is limited evidence on the co-occurrence of HTN and type 2 diabetes (T2DM). Therefore, this study was conducted to assess the co-occurrence of HTN and T2DM and their associated factors among Haramaya University employees in Eastern Ethiopia.MethodsA cross-sectional survey was conducted among 1,200 employees at Haramaya University using a simple random sampling technique from December 2018 to February 2019. Demographic and behavioral factors were collected on a semi-structured questionnaire, followed by measurement of anthropometry and blood pressure. Blood glucose and lipid profile measurements were performed by collecting 6 ml of venous blood samples after 8 h of overnight fasting. Data were entered into EpiData 3.1 version and analyzed using Stata 16 software. Bivariable and multivariable logistic regressions were applied to observe the association between independent variables with co-occurrence of HPN and T2DM using odds ratio, 95% confidence interval (CI), and p-values of ≤ 0.05 were considered statistically significant.ResultsThe prevalence of HTN and T2DM was 27.3 and 7.4%, respectively. The co-occurrence of HTN and T2DM was 3.8%. The study found that being older (AOR = 3.97; 95 % CI: 1.80–8.74), khat chewing (AOR = 2.76; 95 % CI: 1.23–6.18), body mass index ≥ 25 kg/m2 (AOR = 5.11; 95 % CI: 2.06–12.66), and sedentary behavior ≥8 h per day (AOR = 6.44; 95 % CI: 2.89–14.34) were statistically associated with co-occurrence of HTN and T2DM. On the other hand, consuming fruits and vegetables (AOR = 0.10; 95 % CI: 0.04–0.22) and a higher level of education (AOR = 0.39; 95% CI: 0.17–0.89) were negatively statistically associated with the co-occurrence of HTN and T2DM.ConclusionThe co-occurrence of HTN and T2DM was prevalent among the study participants. This may create a substantial load on the healthcare system as an end result of increased demand for healthcare services. Therefore, rigorous efforts are needed to develop strategies for screening employees to tackle the alarming increase in HTN and T2DM in university employees

Predictors of time to recovery from uncomplicated severe acute malnutrition among children in eastern Ethiopia

BackgroundManaging severe acute malnutrition (SAM) involves an outpatient therapeutic program (OTP), targeting more than 80% of SAM children where the quality of primary healthcare remains poor. Treatment success and recovery from SAM remain poor and could be affected by many factors, where such evidence is limited in East Hararghe. This study assessed the predictors of time to recovery from SAM in eastern Ethiopia.MethodsA retrospective cohort study was conducted on 402 records of SAM children under 5 years of age enrolled on OTP at 12 health posts retrieved from 2020 to 2021. We used the Kaplan–Meir estimate along with the p-value of the log-rank test and the survival curve to compare the time to recovery across categories. A multivariable Cox proportional hazard model was fitted to identify predictors of time to recovery from SAM. A p-value below 0.05 was used to declare statistical significance.ResultsA total of 402 records were reviewed, and the cure rate from SAM was 89.6% [95% confidence interval (CI), 87–93]. Moreover, a death rate of 0.7%, a default rate of 9.5%, and a non-responder rate of 0.2% were obtained with a median length of stay of 7 weeks. The median time to recovery was significantly shorter for children from shorter distances from OTP sites with edema, amoxicillin, (p < 0.05). Edema at admission [adjusted hazard ratio (AHR) = 1.74; 95% CI: 1.33–2.29], without diarrhea (AHR = 1.51; 95% CI: 1.18–1.94), taking amoxicillin (AHR = 1.55; 95% CI: 1.19–2.02), shorter travel time to the OTP site (AHR = 1.44; 95% CI: 1.13–1.85), breastfeeding (AHR = 1.60; 95% CI: 1.27–2.02), adequacy of ready-to-use therapeutic food (RUTF) (AHR = 1.22; 95% CI: 0.90–1.65), and new admission (AHR = 1.62; 95% CI: 0.84–3.10) were important predictors of recovery from SAM.ConclusionRecovery from SAM was found to be acceptable in comparison with the Sphere Standards and is predicted by edema, diarrhea, distance from the OTP site, amoxicillin, and RUTF adequacy. These allow for focused interventions that address the identified factors for better recovery from SAM

Determinants of second-dose measles vaccination dropout in Ethiopia: A community-based matched case-control study

Background: Measles vaccination is the most important public health intervention and a cost-effective strategy to reduce morbidity and mortality in under-five children. Although Ethiopia's government developed a measles elimination strategic plan by 2020, the full coverage of immunization was 43 %. Therefore, this study aimed to identify determinants of second-dose measles vaccination (MCV2) dropout among children aged 24–35 months in East Bale Zone, Ethiopia. Method: A community-based matched case-control study was conducted among 351 children (117 cases and 234 controls). Children who received the first dose of measles vaccine but did not receive the second dose were cases, and children who received both doses of measles vaccine were control. The matches were based on age and residence. The data were collected using a structured questionnaire, entered into Epi Data 3.1, cleaned, exported, and analyzed using Stata version 16.1. A multivariable conditional logistic regression analysis was performed. Variables with a P value of <0.05 were considered significant determinants of the dependent variable at the 95 % confidence level. Results: Mothers who were unable to read and write (mAOR: 4.0; 95 % CI: 1.59–10.2), did not receive counseling (mAOR: 3.19; 95 % CI: 1.62–6.27), spent ≥30 min to reach health facilities (mAOR; 2.76, 95 % CI: 1.25–6.1), and did not attend postnatal care (mAOR; 3.46, 95 % CI: 1.58–7.57) were significantly and positively associated with second-dose measles vaccination dropout. In addition, mothers who had poor knowledge of second-dose measles vaccination (mAOR; 3.20, 95 % CI: 1.50–6.70) and waited more than an hour for measles vaccination at health facilities (mAOR; 2.61, 95 % CI: 1.0–6.20) were significantly more likely to experience second-dose measles vaccine dropout. Conclusions: The key factors associated with second-dose measles vaccination dropout are maternal illiteracy, lack of PNC, inadequate maternal knowledge and poor counseling about MCV2 vaccination, long distances travel to healthcare facilities and extended waiting times at vaccination providing sites. Health extension workers emphasize strengthening home visit programs in catchment households to improve mothers' awareness of measles vaccination

In‐hospital mortality and length of stay of patients with hypertensive crisis treated at public hospitals in Harari Regional State, Eastern Ethiopia

Abstract Hypertensive crisis poses substantial cardiovascular morbidity and mortality. This study aimed to assess in‐hospital mortality, length of stay (LOS), and their predictors among patients with hypertensive crisis treated at public hospitals in Harari Regional State, Eastern Ethiopia. An institutional‐based retrospective cohort study was conducted from October 1 to 31, 2022. The medical records of 328 patients with hypertensive crisis treated at two public hospitals between September 1, 2017 and August 31, 2022 were reviewed. Cox proportional hazards regression and negative binomial regression were used to identify predictors of in‐hospital mortality and LOS, respectively. The in‐hospital mortality rate of patients with hypertensive crisis was 18.94 (95% confidence interval (CI): 12.08–29.70) per 1000 person‐day observation. The median (interquartile range) LOS of these patients was 10 (4–120) hours. Age ≥65 years (adjusted hazard ratio (AHR): 3.30; 95% CI: 1.17– 9.33); increment in initial systolic blood pressure (AHR: 1.040; 95% CI: 1.014–1.066); and having acute brain‐related damage (AHR: 4.02; 95% CI: 1.48–10.88) were predictors of in‐hospital mortality. Rural residence (adjusted incident‐rate ratio (IRR): 1.34; 95% CI: 1.03–1.75); having a history of medication discontinuation (adjusted IRR: 1.59; 95% CI: 1.16–2.18); comorbidity (adjusted IRR: 1.90; 95% CI: 1.49–2.43); acute brain‐related damage (adjusted IRR: 13.32; 95% CI: 9.22–19.24), acute cardiac‐related damage (adjusted IRR: 7.40; 95% CI: 4.90–11.16); and acute kidney injury (adjusted IRR: 7.64; 95% CI: 5.46–10.69) were predictors of LOS. Thus, it is necessary to develop strategies that allow early screening and follow‐up of patients at risk

Additional file: Table S1. of Utilization of youth friendly services and associated factors among youth in Harar town, east Ethiopia: a mixed method study

In-depth interview guide for service providers and youth in Harar town, Ethiopia, 2011. Table S2: Focus Group Discussion guide for youth in Harar town, Ethiopia, 2011. (DOCX 17 kb

Almost all working adults have at least one risk factor for non-communicable diseases: Survey of working adults in Eastern Ethiopia. S1 Dataset

Stata dataset for "Almost all working adults have at least one risk factor for non-communicable diseases: Survey of working adults in Eastern Ethiopia"

Barriers to healthcare data quality and recommendations in public health facilities in Dire Dawa city administration, eastern Ethiopia: a qualitative study

BackgroundMaintaining good quality of healthcare data at various levels is a critical challenge in developing countries. The barriers to healthcare data quality remain largely unexplored in eastern Ethiopia.ObjectiveThis study aimed to assess the barriers to quality of healthcare data in urban public health facilities in the Dire Dawa city administration from 7 April to 7 May 2019.MethodsAn institutional-based qualitative exploratory approach was used among 17 purposefully selected key informants. In-depth interviews were inductively coded using the ATLAS.ti 7.5.4 version software. Inductive analysis was used by semantically analyzing the explicit content of the data to determine our themes.ResultsSeveral key themes and subthemes with different barriers, some of which are mutually non-exclusive, were identified. These include: Organizational Barriers: Lack of an adequate health management information system and data clerk staff, poor management commitment, lack of post-training follow-up, work overload, frequent duty rotation, lack of incentives for good performers, lack of targeted feedback, and poor culture of information use. Behavioral/Individual Barriers: Gaps in the skill of managers and health professionals, lack of adequate awareness of each indicator and its definitions, inadequate educational competence, lack of feeling of ownership, poor commitment, lack of daily tallying, and lack of value for data. Technical Barriers: Lack of a standard form, diverse and too many data entry formats, manual data collection, shortage of supplies, failure to repair system break down in a timely manner, interruption in electricity and network, delay in digitizing health information systems, lack of post-training follow-up, and inadequate supervision. External Barriers: Poor collaboration between stakeholders, dependence on the software program of non-governmental organizations, and very hot weather conditions.ConclusionDiverse and complex barriers to maintenance of data quality were identified. Developing standardized health management information system implementation plans, providing advanced supervisory-level training, supportive supervision, and site-level mentorship may be very effective in identifying and resolving bottleneck data quality issues. Healthcare managers should understand the imperative of data quality and accept responsibility for its improvement and maintenance. Interventions targeted only at supplies will not fully overcome limitations to data quality. Motivation of staff and recognition of best performance can motivate others and can create cooperation among staff