Identifying competencies for an advanced practice physiotherapy role within an interprofessional chronic pain clinic.

BACKGROUND: Advanced practice physiotherapy (APP) models of care have shown success in access, safety, satisfaction, and care quality for musculoskeletal pain conditions in various settings. Yet, there is a gap in defining competencies for physiotherapists to be the initial point of contact for people with chronic pain. This study aims to identify and agree upon the competencies necessary for a physiotherapist to fulfill the role of an APP in an interprofessional chronic pain clinic. METHODS: Three focus groups were conducted using a Nominal Group Technique and a modified Delphi process. Consensus on the competency, defined as agreement by ≥ 75% of participants, was sought. RESULTS: Twenty-three experts (17 healthcare providers and six individuals with chronic pain) participated in the focus group discussions. Twenty completed the follow-up Delphi surveys. Ten essential competencies for an APP role in interprofessional chronic pain clinics were identified and achieved consensus: 1) use an evidence-based approach to practice; 2) communicate effectively with the patient; 3) perform a comprehensive assessment; 4) determine pain-related diagnoses; 5) develop therapeutic relationships; 6) provide appropriate care; 7) support patients through transitions in care; 8) collaborate with members of the interprofessional team; 9) advocate for the needs of the patients; and 10) use a reflective approach to practice. CONCLUSION: This study identified ten competencies essential for physiotherapists to fulfill an APP role within interprofessional chronic pain clinics. These competencies serve as a foundation for informing a training program and future research evaluating the effectiveness of the APP model in this setting.

How low back pain is managed-a mixed methods study in 32 countries. Part 2 of Low Back Pain in Low- and Middle-Income Countries Series.

BACKGROUND: The Lancet Series of Low Back Pain (LBP) highlighted the lack of LBP data from low- and middle-income countries (LMICs). The study aimed to describe (1) what LBP care is currently delivered in LMICs, and (2) how that care is delivered. METHODS: An online mixed-methods study. A Consortium for LBP in LMICs (n=65) was developed with an expert panel of leading LBP researchers (>2 publications on LBP) and multidisciplinary clinicians and patient partners with five years of clinical/lived LBP experience in LMICs. Quantitative data were analyzed using descriptive statistics. Two researchers independently analyzed qualitative data using deductive and inductive coding and developed a thematic framework. FINDINGS: Forty-seven (85%) of 55 invited panel members representing 32 LMICs completed the survey (38% women; 62% men). The panel included clinicians (34%), researchers (28%), educators (6%), and patient partners (4%). Pharmacotherapies and electrophysiological agents were the most used LBP treatments. The Thematic Framework comprised of eight themes: (1) Self-management is ubiquitous; (2) Medicines are the cornerstone; (3) Traditional therapies have a place; (4) Society plays an important role; (5) Imaging use is very common; (6) Reliance on passive approaches; (7) Social determinants influence LBP care pathway; and (8) Health systems are ill-prepared to address LBP burden. INTERPRETATION: LBP care in LMICs did not consistently align with the best available evidence. Findings will help research prioritization in LMICs and guide global LBP clinical guidelines. FUNDING: The lead author's Fellowship was supported by the International Association for the Study of Pain.

Cross-cultural translation, adaptation, and validation of the stroke-specific quality of life (SSQOL) scale 2.0 into Amharic language.

BACKGROUND: The stroke-specific quality of life 2.0 (SSQOL 2.0) scale is a valid, reliable instrument which has been widely used as a patients reported outcome measure among stroke survivors. However, the SSQOL scale has not been validated and used in any Ethiopian language. This study aimed to translate, culturally adapt, and test the psychometric properties of the SSQOL scale 2.0 in Amharic, which is the official and working language with about 34 million (23%) speakers in Ethiopia. METHODS: The adapted English version of the SSQOL 2.0 scale was translated into Amharic and then back-translated to English. An expert committee translated and created a final Amharic version of SSQOL (SSQOL-AM) scale. Pre-field testing (pilot and cognitive debriefing) was conducted with 15 post-stroke subjects. The SSQOL-Am was administered to 245 stroke survivors from four referral hospitals to determine the psychometric properties. Cronbach's alpha and Intra-class correlation coefficient were used to calculate the internal consistency and test-retest reliability, spearman's correlation for the convergent validity of the SSQOL-Am scale. The Standard Error of Measurement (SEM), Minimum Detectable Change (MDC), Bland Altman Limit of Agreement (LOA), Confirmatory Factor Analysis, and Exploratory Factor Analysis were also determined. RESULTS: The SSQOL-Am demonstrated excellent test-retest reliability (ICC = 0.93), internal consistency (Cronbach's alpha = 0.96), SEM 0.857, MDC 1.94, and good LOA. As postulated, the mobility domain of the tool demonstrated a significantly strong correlation with the physical function domain of the SF-36 (rho = 0.70, p < 0.001). CONCLUSIONS: The SSQOL-Am is a valid and reliable outcome measure. The tool can be used in both clinical practice and research purposes with Amharic speaking post-stroke survivors.

An Interpretative Phenomenological Analysis of Living with Chronic Low Back Pain in Ethiopia.

Background: People with chronic low back pain experience myriads of problems from living with their condition. This study aimed to explore the lived experience of people with chronic low back pain in Ethiopia. Design: This is a qualitative semi-structured study design which used an interpretative phenomenological analysis approach for data analysis. Participants: Fifteen adults (10 women and 5 men) with chronic low back pain (duration ≥ 3 months) with age ranging from 19 to 66 years old were interviewed. Setting: Participants were recruited from the outpatient departments of the University of Gondar hospital in Gondar, Ethiopia. Methods: Data was collected through an in-depth semi-structured interview. Interviews were audio-recorded and transcribed verbatim. Data were analyzed through an iterative process, beginning with a line-by-line coding to identify the lived experience of chronic low back pain. Findings: Five main themes related to the lived experience of people with chronic low back pain emerged: 1) CLBP impacts life on a day-to-day basis, 2) The invisibility of pain results in misunderstanding, misjudgment, and loneliness, 3) The cause of pain is a mystery, 4) The search for the cure is a quest, 5) Each person has their ways of managing, coping, and living with pain. Conclusion: The findings from this study improve our understanding of the experience of people with chronic low back pain and its impact on their day-to-day life in Ethiopia. The findings from this study could inform the development of culturally centered chronic low back pain interventions such as self-management programs in the Ethiopian context.

Severe malaria-related disability in African children: a scoping review.

PURPOSE: Disability is a consequence of severe malaria for a significant proportion of African children. This scoping review aims to describe the impact of severe malaria on African children according to current literature using an international biopsychical classification and framework of disability and functioning. MATERIALS AND METHODS: MEDLINE, EMBASE, Global Health, and CINHAL databases were searched for original research conducted on African children aged 0-18 using terms related to severe malaria and components of disability. Independent and dependent variables were extracted and classified using the World Health Organization's International Classification of Functioning, Disability, and Health-Children and Youth version (ICF-CY) using standardized coding methods. RESULTS: Seventy-two percent of the measured variables in the 34 included studies were coded as "body functions," (i.e., impairments), such as mental, neuromusculoskeletal, movement, and sensory functions, and 23.3% of variables were coded as "activities and participation" (i.e., activity limitations/participation restrictions), such as difficulties with general tasks and demands, communication, mobility, interpersonal interactions, and relationships. "Environment" variables such as family support, health access, education, or societal attitudes were not found in the included studies. CONCLUSIONS: Existing peer-reviewed quantitative research of severe malaria-related disability is focused on neurological sequelae, with less research about activity limitations and participation restrictions.

Promoting the use of a comprehensive biopsychosocial disability framework and classification system for severe malaria will provide a framework that other researchers, policymakers, and rehabilitation professionals can consider when looking at the best ways to support outcomes for children with severe malaria.Using a framework of the ICF-CY, we have highlighted the need for better research into child functioning outcomes in severe malaria research, especially within the domain of child participation.Policymakers should be encouraged to support better holistic evaluation, support, and rehabilitation of children who have had severe malaria.

Health care providers' understanding of self-management support for people with chronic low back pain in Ethiopia: an interpretive description.

BACKGROUND: Healthcare providers play a key role in supporting people with chronic low back pain to self-manage their condition. The study aimed at exploring how health care providers understand and conceptualize self-management and how they provide self-management support for people with chronic low back pain in Ethiopia. METHODS: Health care providers who have supported people with low back pain, including medical doctors and physiotherapists, were approached and recruited from three hospitals in Ethiopia. This study employed an interpretive descriptive approach using semi-structured interviews. FINDINGS: Twenty-four participants (7 women; 17 men) with a median age of 28 (range 24 to 42) years and a median of 9.5 years (range 1 to 11 years) of helping people with chronic low back pain were interviewed. Seven major themes related to health care providers' understanding of self-management support for people with chronic low back pain in Ethiopia emerged. The findings show that self-management was a new concept to many and health care providers' had a fragmented understanding of self-management. They used or suggested several self-management support strategies to help people with CLBP self-manage their condition without necessarily focusing on enhancing their self-efficacy skills. The participants also discussed several challenges to facilitate self-management support for people with chronic low back pain. Despite the lack of training on the concept, the providers discussed the potential of providing self-management support for people with the condition. CONCLUSIONS: Self-management was a new concept to health care providers. The providers lack the competencies to provide self-management support for people with chronic low back pain. There is a need to enhance the health care providers' self-management support competencies through training.

Cross-cultural adaptation and validation of the Amharic version of Roland Morris Disability Questionnaire in people with low back pain in Ethiopia.

PURPOSE: Cross-culturally translate, adapt, and validate Roland Morris Disability Questionnaire (RMDQ) in Amharic language in Ethiopia. METHODS: The English version RMDQ was translated into Amharic and back-translated into English. An expert review committee reviewed the translations and created Amharic version of the RMDQ (RMDQ-Am). Pilot testing and cognitive debriefing of the RMDQ-Am were conducted with a sample of 20 individuals with LBP. The RMDQ-Am was administered to 240 individuals with LBP from three rehabilitation centers to determine its psychometric properties. Internal consistency of the tool was determined by Cronbach's alpha. Test-retest reliability was determined by the Intraclass correlation coefficient. The Standard Error of Measurement (SEM), Minimum Detectable Change (MDC), and the Bland Altman Limit of Agreement (LOA) was also determined. The Short-Form Health Survey (SF-36) Bodily Pain and Physical Functioning subscales were used to assess convergent validity. Exploratory Factor Analysis (EFA) was used to determine the dimensionality of the tool. RESULTS: RMDQ-Am demonstrated good internal consistency (α = 0.88), excellent test-retest reliability (ICC = 0.91), SEM (1.64), MDC (3.55), and good LOA. There is a significant moderate correlation between RMDQ-Am and the Physical Functioning (Rho = -0.62, p < 0.01) and Bodily Pain (BP) (Rho = -0.41, p < 0.01) subscales of the SF-36. Exploratory Factor Analysis demonstrates that the Amharic version of RMDQ is a primary one and secondary four-factor model [The Kaiser Meyer Olkin = 0.877, X2 (df) =1413.278/190, p < 0.001]. CONCLUSION: RMDQ-Am is a reliable and valid tool that can be used in both clinical practice and research with the Ethiopian LBP population.IMPLICATION FOR REHABILITATIONDespite LBP being a concern in Ethiopia, the magnitude of disability related to this phenomenon is not studied in the country, mainly due to the absence of validated LBP specific patient-reported outcome measures such as the Roland Morris Disability Questionnaire (RMDQ).The RMDQ was successfully translated, adapted, and validated into the Amharic language and the Ethiopian context (RMDQ-Am).The RMDQ-Am is a reliable outcome measure among the Ethiopian population with LBP, as demonstrated by the good internal consistency (α = 0.88) and excellent test-retest reliability (ICC = 0.91).There is a moderate negative correlation between the RMDQ-Am and the Physical Functioning (Rho = -0.62, p < 0.01) and Bodily Pain (Rho = -0.41, p < 0.01) subscales of the SF-36.The RMDQ-Am can be used in clinical and research settings to measure LBP-related disability and its impact among individuals living with LBP in Ethiopia.

Burden of neck pain and associated factors among smart phone user students in University of Gondar, Ethiopia.

BACKGROUND: Mobile technology has spread rapidly around the globe. In 2018 the numbers of mobile subscribers in Ethiopia hit 66.2 million. Musculoskeletal complaints related to smartphone use in different body parts have been reported ranging from 8.2% to 89.9%. Neck pain has the highest prevalence rate, which ranges from 17.3% to 67.8%. However, there is limited evidence on the burden of neck pain related to Smartphone usage and no research is done in Ethiopia. Therefore, this study was conducted to determine the burden of neck pain and factors associated with smartphone use in Ethiopia. PURPOSE: The objective of this study was to identify the prevalence and factors associated with neck pain among smartphone users at University of Gondar. METHODS: Institutional based cross-sectional study was conducted from November to December 2019 to determine the prevalence and associated factors of neck pain, with a sample of 845 university student smartphone users at University of Gondar, Ethiopia. A self-administered questionnaire adapted from the Nordic musculoskeletal questionnaire was used to collect data. Independent variables which had a significant association were identified using logistic regression models. Results were reported by using texts and frequency distribution tables. RESULTS: Out of 845 questionnaires distributed, 808 students responded; hence, the response rate was 95.6%. The overall prevalence of neck pain among smart phone users in the past 12 months was 47.4% (95% CI, 44.1-50.9%). Attending 5th year (AOR: 3.907, 95% CI: 1. 952-7.82) and 6th year (AOR: 2.93,95% CI: 1,304-6.59), regular physical exercise (AOR: 2.405, 95% CI: 1.549-3.734), cigarette smoking (AOR: 5.415, 95% CI: 2.685-10.919), residency (AOR: 1.681, 95% CI: 1.181-2.391), break while using smartphone (AOR: 3.253 95% CI: 2.252-4.699), used smartphone > 6 hour per day (AOR: 2.782 (1.528 95% CI: 1.528-5.063), used other devises (AOR: 3.158 95% CI: 2.128-4.689), number of social media used daily (AOR: 2.007 95% CI: 1.228-3.2788), used devise for playing game (AOR: 1.484 95% CI: 1.024-2.15) were factors significantly associated with neck pain. CONCLUSION: The current study depicted that nearly half of the study participants reported neck pain in the past 12 months. Attending last year of university, personal characteristics, use of smart phone for longer period, playing game, not taking break, other electronic device use, increased number of social media use were associated with neck pain among smartphone users.

Cross-cultural translation, adaptation, and validation of the Amharic version pain self-efficacy questionnaire in people with low back pain in Ethiopia.

BACKGROUND: The Pain Self-Efficacy Questionnaire (PSEQ) is a valid and reliable instrument that evaluates pain self-efficacy beliefs in people with pain conditions. However, it has not been validated and used in Ethiopia. We conducted this study to translate, adapt, and test the psychometric properties of the PSEQ in the Amharic language and Ethiopian context for its use with people experiencing low back pain (LBP). METHODS: The PSEQ was translated into Amharic and then back-translated into English. An expert review committee created a final Amharic version of the tool (PSEQ-Am), followed by pilot testing and cognitive debriefing with a sample of 20 people with LBP. The psychometric properties of the final version of PSEQ-Am were assessed in a sample of 240 people with LBP recruited from three rehabilitation centers in Ethiopia. Cronbach's alpha and Intra-class correlation coefficient were calculated to describe the reliability and internal consistency of the tool. The SF-36-Am bodily pain subscale was used to assess convergent validity. Confirmatory Factor Analysis (CFA) and Exploratory Factor Analysis (EFA) were performed to determine the dimensionality of the instrument. RESULTS: PSEQ-Am demonstrated excellent test-retest reliability (ICC = 0.93) and internal consistency (Cronbach's alpha = 0.91). As hypothesized, the tool demonstrated a significant moderate correlation with the Bodily Pain subscale of the SF-36-Am (Rho = 0.51, p < 0.01). EFA analysis shows that the Amharic version of PSEQ is a dominant one factor and secondary two factor structure. CONCLUSION: This study shows that PSEQ-Am is a reliable and valid tool that can be used in both clinical practice and research in the Ethiopian low back pain population.

Determining the feasibility of a trial to evaluate the effectiveness of phototherapy versus placebo at reducing pain during physical activity for people with knee osteoarthritis: a pilot randomized controlled trial.

BACKGROUND: Although practice guidelines recommend physical activity and exercise for the management of knee osteoarthritis, pain is a common barrier to participation. Phototherapy has been shown to reduce pain intensity for people with knee osteoarthritis, but it is unclear if it reduces pain during physical activity or contributes to improved rehabilitation outcomes. OBJECTIVE: The aim of this study is to assess the feasibility of performing a fully powered randomized controlled trial (RCT) comparing an active phototherapy intervention versus placebo on pain during physical activity for people with knee osteoarthritis. METHODS: A pilot RCT was conducted to test the feasibility of a trial comparing 8-sessions (4 weeks) of active phototherapy versus placebo. People were able to participate if they (1) were an English speaking adult (> 18 years of age), (2) had received a diagnosis of knee osteoarthritis from a physician, and (3) self-reported experiencing pain and disability related to their knee osteoarthritis for > 3 months. Primary outcomes were the feasibility of participant recruitment, retention, assessment procedures, and maintaining high treatment fidelity. Secondary outcomes piloted for a full trial included pain during physical activity (primary outcome of full trial); self-reported pain severity, physical function, stiffness, adherence to prescribed exercise, global rating of change, patient satisfaction, and adverse events; 6-min walk test; and pressure pain threshold. RESULTS: Twenty participants (4 men; 16 women) with knee osteoarthritis and a mean age of 63.95 (SD: 9.27) years were recruited over a 3-week period (6.7 participants per week). Fifteen out of 20 (75%) of participants completed the primary outcome assessment at 4 weeks and 19/20 (95%) of participants were retained and completed the final 16-week assessment. Overall, 89% of all assessment items were completed by participants across all time-points. Fifteen out of 20 participants (75%) completed all 8 treatment sessions. Treatment fidelity was 100% for all completed treatment sessions. No adverse events were reported by participants in either group. CONCLUSIONS: Results suggest that the trial methodology and intervention are feasible for implementation in a fully powered randomized controlled trial to determine the effectiveness of phototherapy at reducing pain during physical activity for people with knee osteoarthritis. TRIAL REGISTRATION: ClinicalTrials.gov , NCT04234685 , January 21, 2020-Retrospectively registered.

Epidemiology of General, Central Obesity and Associated Cardio-Metabolic Risks Among University Employees, Ethiopia: A Cross-Sectional Study.

BACKGROUND: Evidence suggests that middle and low-income countries such as Ethiopia are facing the growing epidemic of both communicable and non-communicable diseases creating a burden on their economy and healthcare system. The increasing prevalence of non-communicable diseases is attributed to sedentarism, lifestyle changes, nutritional transition, and the presence of other cardiometabolic risk factors. Therefore this study was designed to assess the prevalence and association of overweight, obesity, and cardio-metabolic risks and to explore if there was any agreement among the anthropometric measurements among the academic employees of the University of Gondar, Ethiopia. METHODS: An institutional-based cross-sectional study was conducted using the WHO stepwise approach and recommendations on 381 academic staff of the university. In addition, physical measurements such as weight, height, waist and hip circumferences, and biochemical measures such as blood pressure and fasting blood glucose level (peripheral blood samples by finger puncture) were measured using standardized tools. RESULTS: The mean age of the participants was 33.5 (95% CI: 32.7, 34.2) years. The prevalence of obesity among the study participants calculated by body mass index, waist circumference (WC), waist-height ratio (WHtR), and waist-hip ratio (WHR) was 13.1%, 33.6%, 51.9%, and 58.5% respectively. The prevalence of diabetes was 4.7% among which 1.3% was not diagnosed prior to this study. About 53 (13.9%) of the study sample were found to be hypertensive (HTN) (6.3% known versus 29 7.6% newly diagnosed). Among the participants, 39.4% and 23.4% were found to be pre-hypertensive and pre-diabetic respectively. WC was significantly associated with hypertension (AOR = 5.14; 2.503, 9.72), pre-DM (AOR = 4.03; 2.974, 5.96), DM (AOR = 3.29; 1.099, 6.01). In addition, WHtR was significantly associated with Pre-HTN (AOR = 2.69; 1.49, 4.58), HTN (AOR = 2.066; 1.008, 6.31), and DM (AOR = 1.855; 0.76, 4.32). On the contrary, both WHR and general obesity measured by BMI were not significantly associated with pre-HTN, HTN, pre-DM and DM groups. CONCLUSION: This study results revealed the variable prevalence between general obesity and the anthropometric indices (IDF cutoff) defining central obesity; WC, WHtR, and WHR among the participants. The result of this study suggests that the constructs of central obesity, not BMI has to be used to screen risks of cardio-metabolic risks among Ethiopians.

Sanitation predictors of childhood morbidities in Ethiopia: evidence from Dabat Health and Demographic Surveillance System.

BACKGROUND: Failure to provide adequate sanitation services to all people is perhaps the greatest development failure. Globally, billions of people have no access to improved sanitation facilities. Though the link between sanitation and childhood morbidities is established globally, the evidence is limited in rural parts of Ethiopia. This survey was, therefore, designed to determine the prevalence of common childhood morbidities and to identify sanitation predictors in rural parts of northwest Ethiopia. METHODS: A re-census reconciliation, which is a cross-sectional design, was employed from October to December 2014. All households found in the research and demographic sites were included as study subjects. A questionnaire and an observational checklist were used to collect data. Households' sanitation performances, house type, illumination, household energy sources, water supply, and waste management were assessed. The occurrence of childhood morbidities was determined from the occurrence of one or more water, sanitation, and hygiene (WASH) preventable diseases. Multivariable binary logistic regression analysis was done to identify the association of sanitation factors with childhood morbidities on the basis of adjusted odds ratio (AOR) with 95% confidence interval (CI) and p value < 0.05. RESULTS: About 575 (7.00%) of under-five children had hygiene- and sanitation-related diseases. Gastrointestinal and respiratory health problems accounted for 287 (49.91%) and 288 (50.09%), respectively. Childhood morbidities among under-five children were associated with poor housing condition [AOR = 1.27, 95% CI = (1.04, 1.54)], dirty cooking energy sources [AOR = 1.52, 95% CI = (1.22, 1.89)], volume of water below 20 l/p/d [AOR = 1.95, 95% CI = (1.19, 3.18)], and narrow-mouthed water storage containers [AOR = 0.73, 95% CI = (0.56, 0.96)]. CONCLUSION: A significant proportion of under-five children had childhood morbidities in the study area. Housing condition, cooking energy sources, volume of water collected, and type of water storage containers were factors associated with the occurrence of childhood morbidities. Enabling the community to have the access to a safe and continuous supply of water and proper disposal of wastes, including excreta, is necessary with particular emphasis to the rural communities and semi-urban areas to reduce the occurrence of childhood morbidities.

Epidemiology and factors associated with peripheral neuropathy among HIV infected patients in Gondar, Ethiopia: A cross-sectional study.

BACKGROUND: Antiretroviral therapy has surely increased the life expectancy of people living with HIV. However, long term complications like HIV associated sensory neuropathy has a negative impact on quality of life among people living with HIV (PLHIV). In Ethiopia, lack of data on magnitude of the burden and predictors of HIV associated sensory neuropathy in many resource limited setting has led to under diagnosis and eventually under management of HIV-SN. Hence, this study was set out to establish the burden of HIV-associated sensory neuropathy and, its association with demographic, health and clinical characteristics among people living with HIV in Ethiopia. METHODS: Cross-sectional study was conducted to assess the prevalence of HIV-associated sensory neuropathy and the associated factors among adult HIV patients at University of Gondar Teaching Hospital, Gondar, Ethiopia. Brief Peripheral Neuropathy Screening tool validated by AIDs Clinical trial group was used for screening HIV-associated sensory neuropathy. Data were analyzed descriptively and through uni- and multivariate logistic regression. RESULTS: In total 359 adult PLHIV with a mean age of 36.5± 9.07 years participated, their median duration of HIV infection was 60 months (IQR 36-84) and their median CD4 count 143cells/µL (IQR 69.5-201.5). Age above 40 years, anti-tuberculosis regimen, tallness, and exposure to didanosine contained antiretroviral therapy were found to be associated with HIV-associated sensory neuropathy (AOR 1.82, 1.84, 1.98 and 4.33 respectively). CONCLUSIONS: More than half of the HIV patients who attended HIV care clinic at University of Gondar hospital during the study period were found to present with peripheral sensory neuropathy. Higher age, tallness, TB medication, and didanosine in ART were significantly associated with HIV-SN as screened by effective diagnostic (BPNS) tool.

Prevalence of disability and associated factors in Dabat Health and Demographic Surveillance System site, northwest Ethiopia.

BACKGROUND: Despite the high burden of disability in Ethiopia, little is known about it, particularly in the study area. Hence, this study aimed to investigate the prevalence and factors associated with disability at Dabat Health and Demographic Surveillance System (HDSS) site, northwest Ethiopia. METHOD: A population-based study was conducted from October to December 2014 at Dabat HDSS site. A total of 67,395 people were included in the study. The multivariable binary logistic regression analysis was employed to identify factors associated with disability. The Adjusted Odds Ratio (AOR) with a 95% Confidence Interval (CI) was estimated to show the strength of association. A p-value of <0.05 was used to declare statistical significance. RESULTS: One thousand two hundred twenty-eight individuals were reported to have a disability giving a prevalence rate of 1.82%, of which, about 39% was related to a vision disability. The high odds of disability were observed among the elderly (≥50 years) [AOR: 4.49; 95% CI: 1.95, 10.33], severely food in-secured [AOR: 2.11; 95% CI: 1.59, 2.80], and separated marital status [AOR: 7.52; 95% CI: 1.18, 47.84]. While having a paid job [AOR: 0.46; 95% CI: 0.28, 0.77], being in the richest quintile [AOR: 0.55; 95% CI: 0.41, 0.75], and high engagement in work-related physical activities [AOR: 0.36; 95% CI: 0.27, 0.49] were inversely associated with the disability. CONCLUSION: Disability is a major public health problem, and the burden is noticeable in the study area. Vision disability is the highest of all disabilities. Thus, efforts must be made on educating the public about disability and injury prevention. Measures that reduce disability should target the elderly, the poorer and the unemployed segment of the population.