Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017

A double burden of malnutrition occurs when individuals, household members or communities experience both undernutrition and overweight. Here, we show geospatial estimates of overweight and wasting prevalence among children under 5 years of age in 105 low- and middle-income countries (LMICs) from 2000 to 2017 and aggregate these to policy-relevant administrative units. Wasting decreased overall across LMICs between 2000 and 2017, from 8.4% (62.3 (55.1–70.8) million) to 6.4% (58.3 (47.6–70.7) million), but is predicted to remain above the World Health Organization’s Global Nutrition Target of <5% in over half of LMICs by 2025. Prevalence of overweight increased from 5.2% (30 (22.8–38.5) million) in 2000 to 6.0% (55.5 (44.8–67.9) million) children aged under 5 years in 2017. Areas most affected by double burden of malnutrition were located in Indonesia, Thailand, southeastern China, Botswana, Cameroon and central Nigeria. Our estimates provide a new perspective to researchers, policy makers and public health agencies in their efforts to address this global childhood syndemic

Multidrug-resistant tuberculosis in Ethiopian settings and its association with previous antituberculosis treatment: A systematic review and meta-analysis

Objectives/Background: Efforts to control the global burden of tuberculosis (TB) epidemic have now been jeopardized by the rapid evolution of drug-resistant Mycobacterium tuberculosis (MTB), which are resistant to one or more anti-TB drugs. Multidrug resistant (MDR) TB in Ethiopia may be more prevalent than previously appreciated; thus, up-to-date national drug resistance studies are critically needed. Therefore, this meta-analysis aimed, first, to determine pooled prevalence of MDR TB among newly diagnosed and previously treated TB cases, and second, to measure the association between previous anti-TB exposure and acquisition of MDR-MTB infection. Methods: PubMed and Embase databases were consulted. Studies that reported the prevalence of MDR TB among newly diagnosed and previously treated TB patients were selected. Studies or surveys conducted at a national or subnational level, with reported MDR-TB prevalence or sufficient data to calculate the prevalence, were considered for the analysis. Two authors searched and reviewed the studies for eligibility and extracted the data in predefined forms. Forest plots of all prevalence estimates were performed, and summary estimates were also calculated using random effect models. Associations between previous TB treatment and MDR-MTB infection were examined through subgroup analyses stratified by new and previously treated patients. Results: We identified 16 suitable studies, and found an overall prevalence of MDR TB of 1.7% (95% confidence interval 1.2–2.3%) among newly diagnosed and that of 14.1% (95% confidence interval 10.9–17.2%) among previously treated TB patients, and the observed difference was statistically significant (p <.01). For the past 10 years, the overall MDR-TB prevalence showed a stable time trend. There was an odds ratio of 8.1 (95% confidence interval 7.5–8.7) for previously treated TB patients to develop an MDR-MTB infection compared with newly diagnosed cases. Conclusion: The MDR-TB prevalence remains high, especially in previously treated TB cases. Previous TB treatment was the most powerful predictor for MDR-MTB infection. Hence, strict compliance with anti-TB regimens and improving case detection rate are urgently needed to tackle the problem

Determinants of the Market Outlet Choice of Bamboo Culms (Yushania alpine) Producers in Banja District, Western Ethiopia

Bamboo meets a growing and various bamboo product demand and generates revenue. The study is aimed at analyzing the critical variables that affect the choice of alternative bamboo market outlets. By using two stages sampling procedures, 114 bamboo producers were randomly and proportionally selected. The determinants that affect the choice of bamboo market outlet were analyzed by multivariate probit model. Based on the model result, the probability of bamboo producers to select wholesaler, retailer, processor, and local traders’ outlet were 16.8%, 46.2%, 60.8%, and 54.3%, respectively. The probability of success and failure to select four market outlets were 2.5% and 2.2%, respectively. The result of MVP revealed that family size, total land holding size, amount of culm production, farming experience, distance to the market, and silviculture management practice affected the probability of farmers’ market outlet choice. Therefore, improving the producers’ knowledge and skills through capacity building and creating framers’ organization for collective action can help producers select the right market to sell bamboo products

Vancomycin-Resistant Enterococci and Its Associated Risk Factors among HIV-Positive and -Negative Clients Attending Dessie Referral Hospital, Northeast Ethiopia

Background. Enterococci are becoming the most important public health concern and emerging as multidrug-resistant organisms around the world including Africa particularly in Ethiopia where there is a lack of availability of effective antimicrobial drugs. However, there is a paucity of data on the prevalence and associated risk factors of vancomycin-resistant enterococci in Ethiopia. Objective. This study was aimed to assess the prevalence of vancomycin-resistant enterococci and its associated risk factors among HIV-positive and -negative clients. Methods. A comparative cross-sectional study was conducted from February to May, 2017, on 300 participants at Dessie Referral Hospital. Data were gathered using a pretested structured questionnaire, stool samples were collected and inoculated on to bile esculin agar, and presumptive colonies were inoculated in brain-heart infusion broth containing 6.5% NaCl for selective identification of enterococci. Antibiotic susceptibility tests were done using the Kirby–Bauer disk diffusion method. Data were analyzed using SPSS version 22 software package. Results. A total of 300 study participants were enrolled in this study, of which 57.7% were females with a mean age of 34.4, a range of 19–73 years. The overall prevalence of enterococci was 37.3%. The prevalence of VRE was 6.3%. From all isolates, the prevalence of VRE among HIV-positive and -negative clients was 5.9% and 7.4%, respectively. Resistance gentamicin, ampicillin, penicillin, and erythromycin was 37.5%, 34.8%, 34.8%, and 22.3%, respectively. Prevalence of multidrug resistance was (29.5%). Being low in hemoglobin content was significantly associated with VRE. Conclusion. The high prevalence of VRE and multidrug-resistant enterococci in this study signals the emergence of VRE. Detection of VRE in this study indicates decreased antibiotic treatment options of multidrug-resistant enterococci. Therefore, there should be a need to perform continuous surveillance, rational use of antibiotics, and more detailed study using phenotypic and genotypic methods

Hepatitis B and C Viruses’ Infection and Associated Factors among Pregnant Women Attending Antenatal Care in Hospitals in the Amhara National Regional State, Ethiopia

Introduction. Hepatitis virus infection is a major public health burden and silent killer disease in sub-Saharan Africa, including Ethiopia. Therefore, this study aimed to investigate the prevalence of hepatitis B and C viruses and associated factors among pregnant women attending an antenatal clinic in three tertiary hospitals in Amhara National Regional State, Ethiopia. Methods. A cross-sectional study was conducted among 1121 pregnant women. Data on sociodemographic and associated factors were collected using a structured questionnaire. Serum samples were tested for hepatitis B surface antigen (HBsAg) and anti-hepatitis C virus antibody (anti-HCV) using ELISA. SPSS version 20 was used for data analysis, and a multivariable logistic regression analysis was used to assess the relationship between factors associated with hepatitis B virus and hepatitis virus C infection. Results. A total of 1121 pregnant women were included in the study. The mean age of study participants was 27.2 ± 4.8 yrs. The majority of pregnant women (895 (79.8%)) were from urban areas. The overall seroprevalence of HBsAg and anti-HCV antibody was 52 (4.6%) and 18 (1.6%), respectively. The coinfection rate of HBV/HCV was 1.4% (1/69). Ten (19.2%) of HBV positive cases were coinfected with HIV. There were no coinfections of HCV and HIV. Interestingly, pregnant women with a history of multiple sexual partners (AOR = 3.2, 95% CI, 1.7–7.6), blood transfusion (AOR = 7.6, 95% CI, 2.9–16.9), family history of HBV (AOR = 3.5, 95% CI, 1.7–7.6), being HIV-positive (AOR = 2.5, 95% CI, 1–5.9), and tattooing (AOR = 2, 95% CI, 1–3.8) were significant predictors of HBV infection. Similarly, young age (17–25 yrs) (AOR = 3.2, 95% CI, 1.8–8.6) and no educational background (AOR = 5, 95 CI, 1.7–14.8) were significant predictors of HCV infection. Conclusions. Hepatitis B and C viruses’ infection was intermediate among pregnant women; some risk factors were significantly associated with the majority of cases. Infants born from these infected mothers are at risk of infection. This calls for screening and integration of HBV prevention of mother-to-child transmission (PMTCT) into HIV. Thus, the provision of health education on hepatitis B and C viruses’ transmission, vaccination, and screening of all pregnant women routinely are essential for the prevention of these viruses