Lack of Dietary Sources of Iodine and the Prevalence of Iodine Deficiency in Rural Women from Sidama Zone, Southern Ethiopia

Iodine deficiency has been reported to affect a large number of people in Ethiopia. Although significant progress against iodine deficiency disorders (IDD) has been reported worldwide, millions of people remain with insufficient iodine intake. Multiple factors may contribute to iodine deficiency. Hence, the objective of this study was to investigate iodine deficiency and dietary intake of iodine. A crosssectional survey design was used to assess urinary iodine concentration (UIC), goiter and dietary intake of iodine in a sample of 202 non-pregnant women living in three rural communities of Sidama Zone, southern Ethiopia. Urinary iodine concentration was analyzed using the Sandell-Kolthoff reaction, goiter was assessed using palpation and dietary source of iodine was assessed using a food frequency questionnaire. Data were analyzed using selected descriptive and analytical statistical measures with SAS software. Mean (SD) age, mid upper arm circumference (MUAC) and body mass index [BMI - Wt(kg)/(Ht(m))2] were 30.8 (7.9) y, 24.8(2.5) cm and 20 (2.2) respectively. Median UIC was 37.2 μg/L. Participants with UIC <20 μg/L, classified as severely iodine deficient were 22.8%; 46.5% had UIC between 20 to <50 μg/L, classified as moderately iodine deficient, and 27.2 % had UIC in the mild deficiency range of 50 to <100 μg/L. Only 3.5% of the women had UIC ≥ 100 μg/L. The total goiter rate was 15.9%, which was 1.5% visible and 14.4% palpable goiter. A majority of the participants consumed Enset (E. ventricosum), corn and kale frequently and meat was consumed rarely. None of the participants reported ever consuming iodized salt or ever having heard about use of iodized salt. Adjacent communities (Alamura, Tullo and Finchawa) showed significant differences in UIC, goiter rate and frequency of fish and dairy consumption. The findings of the present study revealed that iodine status of the population is a significant public health problem. Hence, there is a need to supply iodized salt in order to achieve the goal of elimination of iodine deficiency disorders in the community.Key words: urinary iodine, goiter, food frequenc

Technical efficiency of peasant farmers in northern Ethiopia: a stochastic frontier approach

Empirical works on efficiency of small farmers has been triggered by Schultz's (1964) popular 'poor-but-efficient hypothesis'. Peasant farmers in traditional agricultural settings are reasonably efficient in allocating their resources and they respond positively to price incentives. If farmers are reasonably efficient, as hypothesized by Schultz, then increases in productivity require new inputs and technology to shift the production frontier upward. If, on the other hand, there are significant opportunities to increase productivity through more efficient use of farmers' resources and inputs with current technology, then a better allocation might be essential. But how to measure and compare their efficiency? The concept of efficiency measurement by means of a frontier method has its origin with Farrell (1957). Several different approaches could be applied (see e.g. Fried et al. .... for an overview). We have chosen for the output-oriented or primal approach, where the central issue is by how much output could be expanded from a given level of inputs. The empirical analysis uses a stratified sample of farm dataset refers for the 1996 and 1997 production years. Farmers in the sample are located particularly in Enderta and Hintalo-Wajerat districts of the Tigrai region. A preliminary analysis showed that productivity differences among farmers are rather small (compared to other studies). There appears to be increasing emphasis by policy-makers on investments in new technologies and inputs rather than efforts aimed at improving the efficiency of less efficient farmers. Obviously, the level of efficiency of peasant (small) farmers has important implications for choice of development strategy. As the choice of development strategy, at least partly rests on the policy makers' conceptions of farm/ farmer-level performances. This analysis is intended to contribute to such strategic choices

Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Background: In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries. Methods: GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw values of the posterior distribution. Findings: Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates. After taking into account population growth and ageing, the absolute number of DALYs has remained stable. Since 2010, the pace of decline in global age-standardised DALY rates has accelerated in age groups younger than 50 years compared with the 1990–2010 time period, with the greatest annualised rate of decline occurring in the 0–9-year age group. Six infectious diseases were among the top ten causes of DALYs in children younger than 10 years in 2019: lower respiratory infections (ranked second), diarrhoeal diseases (third), malaria (fifth), meningitis (sixth), whooping cough (ninth), and sexually transmitted infections (which, in this age group, is fully accounted for by congenital syphilis; ranked tenth). In adolescents aged 10–24 years, three injury causes were among the top causes of DALYs: road injuries (ranked first), self-harm (third), and interpersonal violence (fifth). Five of the causes that were in the top ten for ages 10–24 years were also in the top ten in the 25–49-year age group: road injuries (ranked first), HIV/AIDS (second), low back pain (fourth), headache disorders (fifth), and depressive disorders (sixth). In 2019, ischaemic heart disease and stroke were the top-ranked causes of DALYs in both the 50–74-year and 75-years-and-older age groups. Since 1990, there has been a marked shift towards a greater proportion of burden due to YLDs from non-communicable diseases and injuries. In 2019, there were 11 countries where non-communicable disease and injury YLDs constituted more than half of all disease burden. Decreases in age-standardised DALY rates have accelerated over the past decade in countries at the lower end of the SDI range, while improvements have started to stagnate or even reverse in countries with higher SDI. Interpretation: As disability becomes an increasingly large component of disease burden and a larger component of health expenditure, greater research and developm nt investment is needed to identify new, more effective intervention strategies. With a rapidly ageing global population, the demands on health services to deal with disabling outcomes, which increase with age, will require policy makers to anticipate these changes. The mix of universal and more geographically specific influences on health reinforces the need for regular reporting on population health in detail and by underlying cause to help decision makers to identify success stories of disease control to emulate, as well as opportunities to improve. Funding: Bill & Melinda Gates Foundation. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licens

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

Household demand for improved water supply services in Mekelle City, Northern Ethiopia

With population growth and urbanization, demand for improved water services has been growing. It is imperative therefore to examine different factors that influence demand for improved water services and the resultant welfare changes. Using cross-sectional household survey data collected through structured questionnaire from ten administrative units in Mekelle City, we estimate household willingness to pay models and identify major determinant factors of demand for improved water service. In order to help us do this, we considered selection issues and estimated models using the Heckman Two-Step Estimator. Our results show that the amount of bid (amount of money households would be willing to pay) that households (already connected to private taps) would be willing to pay is positively associated with household income, ownership of the house, price of vended water and the practice of water purification. For households who are not connected to private taps, the amount they would be willing to pay for (improved) private tap connection is positively associated with formal education, housing status and gender. We also investigate the welfare gains and losses as a result of improved water service. Analytical results show that, as the number of households who subscribe to improved water service increases, there is a gain in surplus for households and revenue (producer surplus) for the municipality

Risk perception and management in smallholder dairy farming in Tigray, Northern Ethiopia

Empirical studies on smallholder dairy farmers' risk perceptions and management strategies have still received little attention in agricultural research of developing countries. This study focuses on farmers' risk perception and management strategies of smallholder dairy farms in urban and peri-urban areas of Tigray in northern Ethiopia. Based on data collected from a sample of 304 smallholder dairy farm households, we used descriptive statistics for analyzing farmers' risk attitude and factor analysis for analyzing and classifying risk sources and management strategies. The majority of dairy farmers considered themselves risk takers towards farm decision that may have a positive impact on technology adoption. Factor analysis identified technological, price/market, production, financial, human, and institutional factor as major sources of risks. In addition, factor analysis indicates that disease reduction, diversification, financial management, and market network are perceived as the most effective risk management strategies. Our findings indicate that perceptions of risk and management strategies are farmer-specific; therefore, policy-makers need to consider tailor-made strategies that would address farmers' individual motives to manage risks and shocks