Burden of lower respiratory infections and associated risk factors across regions in Ethiopia: a subnational analysis of the Global Burden of Diseases 2019 study.

OBJECTIVE: This analysis is to present the burden and trends of morbidity and mortality due to lower respiratory infections (LRIs), their contributing risk factors, and the disparity across administrative regions and cities from 1990 to 2019. DESIGN: This analysis used Global Burden of Disease 2019 framework to estimate morbidity and mortality outcomes of LRI and its contributing risk factors. The Global Burden of Disease study uses all available data sources and Cause of Death Ensemble model to estimate deaths from LRI and a meta-regression disease modelling technique to estimate LRI non-fatal outcomes with 95% uncertainty intervals (UI). STUDY SETTING: The study includes nine region states and two chartered cities of Ethiopia. OUTCOME MEASURES: We calculated incidence, death and years of life lost (YLLs) due to LRIs and contributing risk factors using all accessible data sources. We calculated 95% UIs for the point estimates. RESULTS: In 2019, LRIs incidence, death and YLLs among all age groups were 8313.7 (95% UI 7757.6-8918), 59.4 (95% UI 49.8-71.4) and 2404.5 (95% UI 2059.4-2833.3) per 100 000 people, respectively. From 1990, the corresponding decline rates were 39%, 61% and 76%, respectively. Children under the age of 5 years account for 20% of episodes, 42% of mortalities and 70% of the YLL of the total burden of LRIs in 2019. The mortality rate was significantly higher in predominantly pastoralist regions-Benishangul-Gumuz 101.8 (95% UI 84.0-121.7) and Afar 103.7 (95% UI 86.6-122.6). The Somali region showed the least decline in mortality rates. More than three-fourths of under-5 child deaths due to LRIs were attributed to malnutrition. Household air pollution from solid fuel attributed to nearly half of the risk factors for all age mortalities due to LRIs in the country. CONCLUSION: In Ethiopia, LRIs have reduced significantly across the regions over the years (except in elders), however, are still the third-leading cause of mortality, disproportionately affecting children younger than 5 years old and predominantly pastoralist regions. Interventions need to consider leading risk factors, targeted age groups and pastoralist and cross-border communities.

HIV/AIDS-Related Training Coverage Sponsored by Centers for Disease Control and Prevention and Associated Factors at Health Facilities Providing Antiretroviral Therapy in Southern Ethiopia.

BACKGROUND: Large numbers of people living with HIV do not know their HIV status and are not on antiretroviral therapy (ART). In this regard, various gap filling in-service trainings were given for health professionals to achieve the global three ninety-five target by 2020. The objective of this study was to assess Centers for Disease Control and Prevention (CDC) sponsored training coverage and related factors at health facilities providing antiretroviral therapy in southern Ethiopia. METHODS: A facility-based cross-sectional study was conducted in 27 facilities (15 hospitals and 12 health centers) in five zones of southern Ethiopia who were providing ART services in October 2019. A total of 403 health professionals from the 27 facilities were included in the study. Quantitative data were collected, edited, coded, and entered into EpiData version 3.1 and transported to SPSS 20 statistical software for analysis. Descriptive statistics were conducted and data were summarized using tables. RESULTS: From a total of 403 eligible study participants, 396 were included in the study with the response rate of 98.2%. Our study revealed that only 105 (33.5%) took training to conduct HIV testing for patients who were living with the virus. Our study also showed that all 91 health professionals working in HIV care and the treatment unit took pieces of training related to the service. However, only 102 (45.7%) laboratory professionals had training related to sample collection, HIV testing service, and viral load monitoring. Shortages of supply and equipment, space and trained human resources were claimed by 82 (62.6%), 68 (51.9%), and 46 (35.1%) of respondents, respectively. CONCLUSION: Our study showed that there was low coverage of trained staff to deliver HIV testing service and viral load monitoring. However, the coverage was good at HIV/AIDS care, treatment, and prevention units. Almost all health facilities have at least one trained staff member working at each service delivery point.

Modern Health Service Utilization and Associated Factors among Adults in Southern Ethiopia.

Background: The Ethiopian government is striving to improve the health status of its population through the expansion and strengthening of primary health care services in both rural and urban settings of the country. The study aimed to measure modern health service utilization and associated factors in Wolaita Sodo town, Ethiopia. Method: A cross-sectional study design was implemented from May to June 2019 in Wolaita Sodo town, Ethiopia. All 786 study participants were selected by multistage systematic random sampling. Data were collected by face-to-face interviews using a pretested structured questionnaire. Data were collected by an open data kit. Stata window version 15.0 was also employed for statistical analysis. Multiple logistic regression was conducted, and a 95% confidence interval was considered for interpretation. Result: Health service utilization was 77.2% with (95% CI of 74.1%, 80.0%). In terms of health facilities in which they visit, first 50.6% were at the public health center and 25.5% of them were at Teaching and Referral Hospital. Respondents with marital status married and widowed have higher odds of utilizing health services compared to single marital status (AOR: 2.96; 95% CI: 1.7-5.2 and 9.0; 95% CI: 1.69-48.0), respectively. Respondents with middle and highest wealth status have higher odds of health service utilization than poor wealth status with AOR (1.75 95% CI 1.03-2.97 and 1.58 95% CI; 1.01, 2.77). Similarly, respondents who had chronic disease and perceived poor health status have higher odds of health service utilization. Conclusion: Modern health services utilization was found to be unsatisfactory. Being married, wealth status being middle and high, having chronic health conditions, and having poor perceived health status were found to have a statistically significant association with health service utilization.