Availability of Adequately Iodized Salt at Household Level and Associated Factors in Dire Dawa, Eastern Ethiopia

In Ethiopia, Iodine Deficiency Disorder has been recognized as a serious public health problem for the past six decades. In 2011, an estimated 12 million school-age children were living with inadequate iodine, and 66 million people were at risk of iodine deficiency. One out of every 1000 people is a cretin mentally handicapped, due to a congenital thyroid deficiency, and about 50000 prenatal deaths are occurring annually due to iodine deficiency disorders. Only 5.7% of the households were using iodized salt in Dire Dawa city Administration, which is below the legal requirement.This study assessed availability of adequately iodized salt at household level and associated factors in Dire Dawa town, East Ethiopia. Community based cross-sectional study was carried out among households in Dire Dawa town during March 16-26, 2015. Multistage sampling technique was used. Data were collected using a pretested and structured questionnaire by a face-to-face interview technique. Bivariate and multivariate analyses were performed to check associations and control confounding. A total of 694 participants were participated. The availability of adequately iodized salt (≥15 parts per million) in the study area was 7.5% (95% CI; 5.6-9.5). Multivariate result showed that health information about iodized salt (AOR=8.96, 95% CI; 4.68-17.16) (p=0.03), good knowledge about iodized salt (AOR=9.23, 95% CI; 3.34-25.5) (p=0.01) and using packed salt (AOR=3.99, 95% CI; 1.48-10.73) (p=0.006) were associated with availability of adequately iodized salt at household level. Availability of adequately iodized salt at household level was very low. Hence, households should be sensitized about importance of iodized salt and its proper handling at the household level

Adherence to iron and folic acid supplementation and associated factors among antenatal care attendants in Northwest Ethiopia

Iron and folic acid supplementation is the key approach for anemia prevention and control during pregnancy. In Ethiopia only <1% of pregnant mothers ingest the ideal number of tablets. Although, adherence is the most important challenge, literature is dearth and the predictors are undoubtedly recognized. Institution based quantitative cross sectional study design triangulated with qualitative methods was employed among 395 systematically selected pregnant mothers attending antenatal care in Debre Markos town, Ethiopia. Data were collected using interviewer administered structured questionnaire. Data were entered into Epi data and exported to SPSS software. Bivariate and multivariable Logistic regression with the 95% confidence interval was computed. P-value < 0.05 was declared as statistically significant. Eight in-depth interviews were conducted. The data were entered and analyzed using open code software. Adherence rate was 55.5% (95%CI, 50.5%-60.4%). Pregnant mothers who had; history of anemia during current pregnancy [AOR:7.9, 95%CI (4.44-14.01)], primary education (AOR:4.0, 95%CI (1.88-8.54)], secondary education and above (AOR:3.6, 95%CI (1.20-6.94)], good knowledge of iron and folic acid supplementation [AOR:2.1, 95%CI (1.24-3.56)], and early registration for antenatal care (AOR:1.8, 95%CI (1.06-3.11)] were predictors of iron and folic acid supplementation adherence. The rate of adherence was low. Getting medical advice and fear of illness if missed were the primary reasons that enforce mothers to take the tablets. Hence, improving mothers’ knowledge regarding overall aspects of the tablet through better advice, community teaching and the mass media at large, would improve adherence

Birth Preparedness among Women Who Gave Birth in the Last Twelve Months in Jardega Jarte District, Western Ethiopia

Background. Lack of preparedness for rapid action in the event of obstetric complications was the major problem contributing for delay in receiving skilled obstetric care. This study aimed to assess birth preparedness and factors associated with it among women who gave birth in the last 12 months preceding the survey in Jardega Jarte district, Western Ethiopia. Methods. A community-based cross-sectional study was conducted from January to February 2016. A total of 581 women who gave birth recently were randomly selected for an interview. Data were entered and analyzed using SPSS version 21. Binary logistic regression was performed to identify predictive factors. Statistical significance was declared at p<0.05. Results. From 581 questionnaires distributed, 570 were completed making the response rate 98%. The mean age was 28 with a standard deviation of 5 years. Ninety percent of the respondents were rural in residency. The average family size was 6 with a range of 13. Majority of the respondents were grand multipara, 261(45.6%). Despite the majority (69.3%) of the respondents reported as they made arrangement for birth, only 27.5% of them were well-prepared for birth and its complication management. Urban residency (AOR=3.4, 95% CI: 1.7-6.9), primipara (AOR=5.12, 95% CI: 2.4-10.8), history of obstetric complication (AOR=4.05, 95% CI: 2.4-7.75), and attending antenatal care (AOR=2.9, 95% CI: 1.67-5.16) were independently associated with preparation for birth and its complication. Conclusion. This study revealed that only about a quarter of pregnant women were well-prepared for delivery and complication management. Urban residencies, history of past obstetric complications, availing antenatal care, primipara, and absence of an under-five child in the household during recent delivery were predictors of birth preparedness. On the other hand, availing health service to such rural areas, giving more attention to the grand multiparous mothers with large family size will be important interventions to prevent pregnancy-related complications. Such efforts would benefit from accessing antenatal care and family planning services

Undernutrition and associated factors among adults with mental and neurological disorders in public health hospitals, Eastern Ethiopia, 2019: a cross-sectional study

Abstract Background Poor nutritional status can be consequence of impaired mental health that may lead to involuntary weight gain, weight loss, or deficiency of essential nutrients. However, little has been documented about the nutritional status of adults with mental disorders and the contributing factors in low-income countries like Ethiopia. The aim of this study was to assess the magnitude of undernutrition and associated factors among adults with mental disorders in public hospitals of Eastern Ethiopia. Methods Institution-based, cross-sectional study was conducted among 507 adults with mental disorders from March 1, 2019 to April 1, 2019. Interviewer administered pretested structured questionnaire was used to collect data. Anthropometric data were collected using calibrated weighing scale and height measuring board. Descriptive statistics was computed to describe the data. Bivariable and multivariable logistic regression analyses were applied to identify factors associated with the undernutrition. Odds ratio alongside 95% confidence interval (CI) were estimated to measure the strength of the association. Level of statistical significance was declared at p-value less than 0.05. Results Undernutrition affected 62.7%; 95% CI: (58.3%, 67.7%) of the patients. Undernutrition was associated with meal frequency < 3 per day (adjusted odds ratio [(AOR = 2.07, 95% CI: (1.18, 3.63)], use of multiple medication (adjusted odds ratio [(AOR = 3.02, 95% CI: (1.88, 4.84)], being non-smoker [(AOR = 0.50, 95%CI: (0.25, 0.91)], and use of prescribed diet [(AOR = 0.45, 95%CI: (0.26, 0.78)]. Conclusions The magnitude of undernutrition was high among the study participants. Multiple medication, cigarette smoking, frequency of meal and taking prescribed diet were significantly associated with undernutrition. Nutrition education for patients with mental disorders and their caregivers about the impact of taking multiple medication and substance use needs to be emphasized alongside nutritional screening and support to improve their nutritional status

Trend and causes of adult mortality in Kersa health and demographic surveillance system (Kersa HDSS), eastern Ethiopia: verbal autopsy method

Abstract Background The health problems of adults have been neglected in many developing countries, yet many studies in these countries show high rates of premature mortality in adults. Measuring adult mortality and its cause through verbal autopsy (VA) methods is becoming an important process for mortality estimates and is a good indicator of the overall mortality rates in resource-limited settings. The objective of this analysis is to describe the levels, distribution, and trends of adult mortality over time (2008-2013) and causes of adult deaths using VA in Kersa Health and Demographic Surveillance System (Kersa HDSS). Methods Kersa HDSS is a demographic and health surveillance and research center established in 2007 in the eastern part of Ethiopia. This is a community-based longitudinal study where VA methods were used to assign probable cause of death. Two or three physicians independently assigned cause of death based on the completed VA forms in accordance with the World Health Organization’s International Classification of Diseases. In this analysis, the VA data considered were of all deaths of adults age 15 years and above, over a period of six years (2008–2013). The mortality fractions were determined and the causes of death analyzed. Analysis was done using STATA and graphs were designed using Microsoft Excel. Results A total of 1535 adult deaths occurred in the surveillance site during the study period and VA was completed for all these deaths. In general, the adult mortality rate over the six-year period was 8.5 per 1000 adult population, higher for males (9.6) and rural residents (8.6) than females (7.5) and urban residents (8.2). There is a general decrease in the mortality rates over the study period from 9.4 in 2008–2009 to 8.1 in 2012–2013. Out of the total deaths, about one-third (32.4%) occurred due to infectious and parasitic causes, and the second leading cause of death was diseases of circulatory system (11.4%), followed by gastrointestinal disorders (9.2%). Tuberculosis (TB) showed an increasing trend over the years and has been the leading cause of death in 2012 and 2013 for all adult age categories (15–49, 50–64, and 65 years and over). Chronic liver disease (CLD) was indicated as leading cause of death among adults in the age group 15–49 years. Conclusion The increasing TB-related mortality in the study years as well as the relative high mortality due to CLD among adults of age 15–49 years should be further investigated and triangulated with health service data to understand the root cause of death

Causes of Death among Children Aged 5 to 14 Years Old from 2008 to 2013 in Kersa Health and Demographic Surveillance System (Kersa HDSS), Ethiopia.

BACKGROUND:The global burden of mortality among children is still very huge though its trend has started declining following the improvements in the living standard. It presents serious challenges to the well-being of children in many African countries. Today, Sub-Saharan Africa alone accounts for about 50% of global child mortality. The overall objective of this study was to determine the magnitude and distribution of causes of death among children aged 5 to 14 year olds in the population of Kersa HDSS using verbal autopsy method for the period 2008 to 2013. METHODS:Kersa Health and Demographic Surveillance System(Kersa HDSS) was established in September 2007. The center consists of 10 rural and 2 urban kebeles which were selected randomly from 38 kebeles in the district. Thus this study was conducted in Kersa HDSS and data was taken from Kersa HDSS database. The study population included all children aged 5 to 14 years registered during the period of 2008 to 2013 in Kersa HDSS using age specific VA questionnaires. Data were extracted from SPSS database and analyzed using STATA. RESULTS:A total of 229 deaths were recorded over the period of six years with a crude death rate of 219.6 per 100,000 population of this age group over the study period. This death rate was 217.5 and 221.5 per 100,000 populations for females and males, respectively. 75% of deaths took place at home. The study identified severe malnutrition(33.9%), intestinal infectious diseases(13.8%) and acute lower respiratory infections(9.2%) to be the three most leading causes of death. In broad causes of death classification, injuries have been found to be the second most cause of death next to communicable diseases(56.3%) attributing to 13.1% of the total deaths. CONCLUSION AND RECOMMENDATION:In specific causes of death classification severe malnutrition, intestinal infectious diseases and acute lower respiratory infections were the three leading causes of death where, in broad causes of death communicable diseases and injuries were among the leading causes of death. Hence, concerned bodies should take measures to avert the situation of mortality from these causes of death and further inferential analysis into the prevention and management of infectious diseases should also be taken

Broad causes of death by year among 5–14 year old children, Kersa HDSS, 2008–2013.

<p>Broad causes of death by year among 5–14 year old children, Kersa HDSS, 2008–2013.</p

Socio-Demographic Characteristics and place of death of the deceased by year among 5 to14 year olds, Kersa HDSS, 2008–2013.

<p>Socio-Demographic Characteristics and place of death of the deceased by year among 5 to14 year olds, Kersa HDSS, 2008–2013.</p

Cause Specific Death rates per 100,000 populations for major causes of death by year among children aged 5 to 14, Kersa HDSS, 2008–2013.

<p>Cause Specific Death rates per 100,000 populations for major causes of death by year among children aged 5 to 14, Kersa HDSS, 2008–2013.</p