Knowledge and belief about cause and prevention of onchocerciasis in Bebeka, southwest Ethiopia

BACKGROUND: Ignorance and incorrect beliefs can lead to negligence in prevention, control measures and in seeking appropriate treatment. Involvement of individuals and communities is an important component of Onchocerciasis control activities. To attain community participation and design socially acceptable control strategies, researchers must be familiar with people’s knowledge, beliefs and behavior in relation to Onchocerciasis. Such information is scanty as very few studies have been carried out to understand these issues. The objective of this study was to investigate people’s knowledge and beliefs in relation to the cause and prevention of onchocerciasis in rural areas of Southwest Ethiopia. METHODS: A cross-sectional study was conducted in February 2008 among 450 study participants selected by multistage probability sampling. Data were collected using a pre-tested interviewer administered structured questionnaire which then were analyzed using SPSS for windows version 11.5. RESULTS: All the 450 respondents had heard about onchocerciasis. A range of causes for onchocerciasis were identified. Overall, 248 (55.3%) of respondents had at least one misconception about the cause of onchocerciasis. There is a range of misconceptions about modes of transmission including contact with infected person, airborne, sharing cloths and sexual. Only 10% knew that black fly breeding in fast flowing rivers and streams as a cause for the transmission. Overall 397(88.2%) said that onchocerciasis is preventable, out of which 376 (94.7%) indicated use of drug as the means of preventing onchocerciasis. Nearly three-forth of respondents 334 (74.3%) rated the severity of onchocerciasis as high. Nearly half (48%) rated the magnitude of onchocerciasis in their village as high, and 195 (43.3%) of them stated that they are highly at risk. CONCLUSIONS: While Onchocerciasis is endemic in the study area, large proportion of the community held misconceptions about its causation, transmission, prevention and risk. Therefore, community interventions for onchocerciasis need to include behaviour change communications aimed at dispelling misconceptions and increasing risk perception

KNOWLEDGE AND BELIEF ABOUT CAUSE AND PREVENTION OF ONCHOCERCIASIS IN BEBEKA, SOUTHWEST ETHIOPIA

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The effect of dams and seasons on malaria incidence and anopheles abundance in Ethiopia

Background: Reservoirs created by damming rivers are often believed to increase malaria incidence risk and/or stretch the period of malaria transmission. In this paper, we report the effects of a mega hydropower dam on P. falciparum malaria incidence in Ethiopia. Methods: A longitudinal cohort study was conducted over a period of 2 years to determine Plasmodium falciparum malaria incidence among children less than 10 years of age living near a mega hydropower dam in Ethiopia. A total of 2080 children from 16 villages located at different distances from a hydropower dam were followed up from 2008 to 2010 using active detection of cases based on weekly house to house visits. Of this cohort of children, 951 (48.09%) were females and 1059 (51.91%) were males, with a median age of 5 years. Malaria vectors were simultaneously surveyed in all the 16 study villages. Frailty models were used to explore associations between time-to-malaria and potential risk factors, whereas, mixed-effects Poisson regression models were used to assess the effect of different covariates on anopheline abundance. Results: Overall, 548 (26.86%) children experienced at least one clinical malaria episode during the follow up period with mean incidence rate of 14.26 cases/1000 child-months at risk (95% CI: 12.16 -16.36). P. falciparum malaria incidence showed no statistically significant association with distance from the dam reservoir (p = 0.32). However, P. falciparum incidence varied significantly between seasons (p < 0.01). The malaria vector, Anopheles arabiensis, was however more abundant in villages nearer to the dam reservoir. Conclusions: P. falciparum malaria incidence dynamics were more influenced by seasonal drivers than by the dam reservoir itself. The findings could have implications in timing optimal malaria control interventions and in developing an early warning system in Ethiopia

Prevalence of household food insecurity and associated factors in drought-prone pastoralist communities in Borana, Oromia, Ethiopia

AbstractBackground: Food security is a central component of the development agenda in pastoralist communities, especially among those who reside in drought-prone areas.Objective: This study measured the prevalence of household food insecurity and associated factors among pastoralist communities of Borana, Ethiopia. Methods and materials: A community-based cross-sectional study was conducted between July and August 2015 in two pastoralist communities in Borana Zone, Oromia, Ethiopia. Data were collected from 1,058 randomly sampled households through an interviewer-administered structured questionnaire. The data were analysed using SPSS version 21.0. Results: The mean household food insecurity score was 18.21 (value range: 0.00-27.00). Overall, 82.33% of the households were severely food insecure, with 14.56% moderately food insecure. Ownership of private farming land, reliance on crop farming as the main economic activity (β=1.47, p=0.016), and one-way walk time to water sources (β=0.01, p=0.001) were significantly associated with household food insecurity (p&lt;0.05). Likewise, increased family size (β=0.49, p=0.001) and lack of education (β=1.41, p=0.025) were significantly associated with food insecurity. In contrast, dependence on small business (petty trade and shop) as the main economic activity (β=5.14, p=0.001); ownership of milking cow (β=-0.25, p=0.001), bull/heifer (β=-0.16, p=0.002), goat (β=-0.14, p=0.001) or pullet (β=-1.17, p=0.001); ownership of various assets, such as forage (β=-2.50, p=0.009); and participation in village-level saving schemes (β=-1.41, p=0.044) were all significantly associated with reduced household food insecurity. Conclusions: Household food insecurity was widespread in the pastoralist communities of Borana, Ethiopia, affecting a high number of households in all domains: food anxiety, food quality, and quantity of food at the household level. As there were factors that were linked to food insecurity in the study pastoralists, evidence-based innovative interventions via a combination of measures in a medium-to-long-term development plan are vital for sustained household food security. [Ethiop. J. Health Dev. 2021; 35(1):38-49] Keywords: Pastoralist, resilience, food resiliency, food insecurity, Borana, Ethiopi

The influence of the Gilgel-Gibe hydroelectric dam in Ethiopia on caregivers' knowledge, perceptions and health-seeking behaviour towards childhood malaria

<p>Abstract</p> <p>Background</p> <p>Malaria remains the most important public health problem in tropical and subtropical areas. Mothers' or caregivers' ability to recognize childhood malaria-related morbidity is crucial as knowledge, attitudes and health seeking behavior of caregivers towards childhood malaria could influence response to signs of the disease.</p> <p>Methods</p> <p>A total of 1,003 caregivers in 'at-risk' villages in close proximity to the Gilgel-Gibe hydroelectric dam in south-western Ethiopia, and 953 caregivers in 'control' villages further away from the dam were surveyed using structured questionnaires to assess their knowledge, perceptions and health seeking behaviour about childhood malaria.</p> <p>Results</p> <p>Malaria (<it>busa</it>) was ranked as the most serious health problem. Caregivers perceived childhood malaria as a preventable ('at-risk' 96%, 'control' 86%) and treatable ('at-risk' 98% and 'control' 96%) disease. Most caregivers correctly associated the typical clinical manifestations with malaria attacks. The use of insecticide-treated nets (ITNs) was mentioned as a personal protective measure, whereas the role of indoor residual spraying (IRS) in malaria prevention and control was under-recognized. Most of the caregivers would prefer to seek treatment in health-care services in the event of malaria and reported the use of recommended anti-malarials.</p> <p>Conclusion</p> <p>Health education to improve knowledge, perceptions and health-seeking behaviour related to malaria is equally important for caregivers in 'at risk' villages and caregivers in 'control' villages as minimal differences seen between both groups. Concluding, there may be a need of more than one generation after the introduction of the dam before differences can be noticed. Secondly, differences in prevalence between 'control' and 'at-risk' villages may not be sufficient to influence knowledge and behaviour.</p

Subnational mapping of HIV incidence and mortality among individuals aged 15–49 years in sub-Saharan Africa, 2000–18 : a modelling study

Background: High-resolution estimates of HIV burden across space and time provide an important tool for tracking and monitoring the progress of prevention and control efforts and assist with improving the precision and efficiency of targeting efforts. We aimed to assess HIV incidence and HIV mortality for all second-level administrative units across sub-Saharan Africa. Methods: In this modelling study, we developed a framework that used the geographically specific HIV prevalence data collected in seroprevalence surveys and antenatal care clinics to train a model that estimates HIV incidence and mortality among individuals aged 15–49 years. We used a model-based geostatistical framework to estimate HIV prevalence at the second administrative level in 44 countries in sub-Saharan Africa for 2000–18 and sought data on the number of individuals on antiretroviral therapy (ART) by second-level administrative unit. We then modified the Estimation and Projection Package (EPP) to use these HIV prevalence and treatment estimates to estimate HIV incidence and mortality by second-level administrative unit. Findings: The estimates suggest substantial variation in HIV incidence and mortality rates both between and within countries in sub-Saharan Africa, with 15 countries having a ten-times or greater difference in estimated HIV incidence between the second-level administrative units with the lowest and highest estimated incidence levels. Across all 44 countries in 2018, HIV incidence ranged from 2 ·8 (95% uncertainty interval 2·1–3·8) in Mauritania to 1585·9 (1369·4–1824·8) cases per 100 000 people in Lesotho and HIV mortality ranged from 0·8 (0·7–0·9) in Mauritania to 676· 5 (513· 6–888·0) deaths per 100 000 people in Lesotho. Variation in both incidence and mortality was substantially greater at the subnational level than at the national level and the highest estimated rates were accordingly higher. Among second-level administrative units, Guijá District, Gaza Province, Mozambique, had the highest estimated HIV incidence (4661·7 [2544·8–8120·3]) cases per 100000 people in 2018 and Inhassunge District, Zambezia Province, Mozambique, had the highest estimated HIV mortality rate (1163·0 [679·0–1866·8]) deaths per 100 000 people. Further, the rate of reduction in HIV incidence and mortality from 2000 to 2018, as well as the ratio of new infections to the number of people living with HIV was highly variable. Although most second-level administrative units had declines in the number of new cases (3316 [81· 1%] of 4087 units) and number of deaths (3325 [81·4%]), nearly all appeared well short of the targeted 75% reduction in new cases and deaths between 2010 and 2020. Interpretation: Our estimates suggest that most second-level administrative units in sub-Saharan Africa are falling short of the targeted 75% reduction in new cases and deaths by 2020, which is further compounded by substantial within-country variability. These estimates will help decision makers and programme implementers expand access to ART and better target health resources to higher burden subnational areas

Mapping inequalities in exclusive breastfeeding in low- and middle-income countries, 2000–2018

Exclusive breastfeeding (EBF)—giving infants only breast-milk for the first 6 months of life—is a component of optimal breastfeeding practices effective in preventing child morbidity and mortality. EBF practices are known to vary by population and comparable subnational estimates of prevalence and progress across low- and middle-income countries (LMICs) are required for planning policy and interventions. Here we present a geospatial analysis of EBF prevalence estimates from 2000 to 2018 across 94 LMICs mapped to policy-relevant administrative units (for example, districts), quantify subnational inequalities and their changes over time, and estimate probabilities of meeting the World Health Organization’s Global Nutrition Target (WHO GNT) of ≥70% EBF prevalence by 2030. While six LMICs are projected to meet the WHO GNT of ≥70% EBF prevalence at a national scale, only three are predicted to meet the target in all their district-level units by 2030

Community Involvement and Preception towards Malaria Prevention and Control Strategies in Rural Areas of Kersa District in Jimma Zone, Southwest Ethiopia

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The prevalence and factors associated for anti-tuberculosis treatment non-adherence among pulmonary tuberculosis patients in public health care facilities in South Ethiopia: a cross-sectional study

Abstract Background Evidence exists pointing out how non-adherence to treatment remains a major hurdle to efficient tuberculosis control in developing countries. Many tuberculosis (Tb) patients do not complete their six-month course of anti-tuberculosis medications and are not aware of the importance of sputum re-examinations, thereby putting themselves at risk of developing multidrug-resistant and extensively drug-resistant forms of tuberculosis and relapse. However, there is a dearth of publications about non-adherence towards anti-Tb medication in these settings. We assessed the prevalence of and associated factors for anti-Tb treatment non-adherence in public health care facilities of South Ethiopia. Methods This was a cross-sectional survey using both quantitative and qualitative methods. The quantitative study was conducted among 261 Tb patients from 17 health centers and one general hospital. The qualitative aspect included an in-depth interview of 14 key informants. For quantitative data, the analysis of descriptive statistics, bivariate and multiple logistic regression was carried out, while thematic framework analysis was applied for the qualitative data. Results The prevalence of non-adherence towards anti-Tb treatment was 24.5%. Multiple logistic regression analysis demonstrated that poor knowledge towards tuberculosis and its treatment (AOR = 4.6, 95%CI: 1.4-15.6), cost of medication other than Tb (AOR = 4.7, 95%CI: 1.7-13.4), having of health information at every visit (AOR = 3, 95% CI: 1.1-8.4) and distance of DOTS center from individual home (AOR = 5.7, 95%CI: 1.9-16.8) showed statistically significant association with non-adherence towards anti- tuberculosis treatment. Qualitative study also revealed that distance, lack of awareness about importance of treatment completion and cost of transportation were the major barriers for adherence. Conclusions A quarter of Tb patients interrupted their treatment due to knowledge, availability and accessibility of DOTS service. We recommend creating awareness about anti-Tb treatment, and decentralization of drug pick-ups to the lowest level of health institutions