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.

The effect of interpersonal psychotherapy on quality of life among breast cancer patients with common mental health disorder: a randomized control trial at Tikur Anbessa Specialized Hospital.

PURPOSE: To determine the effect of interpersonal psychotherapy on anxiety, depression, and quality of life among breast cancer patients with mental health disorders at Tikur Anbessa Specialized Hospital, Ethiopia. METHODS: A two-arm parallel randomized controlled trial study was conducted among 114 (n = 57 intervention, and n = 57 control group) breast cancer patients with common mental health disorder at the oncology center of Tikur Anbessa Specialized Hospital. The hospital anxiety and depression measurement scale was used to assess depression and anxiety disorder and a 30-item quality of life questionnaire was used to assess the quality of life. General linear model analysis was done, confounding factors were controlled, and p < 0.05 was used to declare statistical significance. RESULTS: Patients in the intervention group showed a significant improvement in the anxiety (coefficient - 3.68; 95% CI - 5.67, - 1.69; p < 0.001), depression (coefficient - 3.22; 95% CI - 4.7, - 1.69; p < 0.001), physical functioning (coefficient 10.55; 95% CI 3.13, 17.98; p = 0.006), health-related quality of life (coefficient 21.85; 95% CI 14.1, 29.59; p < 0.001), insomnia (coefficient - 19.56; 95% CI - 31.87, - 7.25; p = 0.002), and fatigue (coefficient - 11.37; 95% CI - 21.49, - 1.24; p = 0.028) respectively. CONCLUSIONS: The adapted Ethiopian version of interpersonal psychotherapy had improved anxiety, depression, and some domains of health-related quality of life. Hence, health programmers should consider incorporating it as a treatment option in oncology centers. TRIAL REGISTRATION NUMBER: PACTR202011629348967 granted on 20 November 2020 which was retrospectively registered.

The burden of injuries in Ethiopia from 1990-2017: evidence from the global burden of disease study.

BACKGROUND: Mortality caused by injuries is increasing and becoming a significant global public health concern. Limited evidence from Ethiopia on road traffic, unintentional and intentional injuries indicate the potential public health impact of problems resulting from such injuries. However, there is a significant evidence gap about the actual national burden of all injuries in Ethiopia. This data base study aimed to reveal the national burden of different injuries in Ethiopia. METHODOLOGY: Data for this study were extracted from the estimates of the Global Burden of Diseases (GBD) 2017 study. Estimates of metrics such as Disability-Adjusted Life Years (DALYs), death rates, incidence, and prevalence were extracted. The metrics were then examined at different injury types, socio-demographic categories such as age groups and sex. Trends of the metrics were also explored for these categories across years from 2007 to 2017. The DALYs and deaths due to injuries in Ethiopia were also compared with other East African countries (specifically Kenya, Tanzania, Uganda, and Zambia) in order to evaluate regional differences across years, by sex and by different injury types such as transport injuries, unintentional injuries, self-harm and interpersonal violence. RESULTS: The age-standardized injury death rate has decreased to 69.4; 95% UI: (63.0-76.9) from 90.11; 95% UI: (82.41-97.73) in 2017 as compared with 2007. Road injury, falls, self-harm and interpersonal violence were the leading causes of mortality from injuries occurring in 2017. The age-standardized injury DALYs rate has decreased to 3328.2; 95% UI: (2981.7-3707.8) from 4265.55; 95% UI: (3898.11-4673.64) in 2017 as compared with 2007. The number of deaths resulting from injuries in 2017 was highest for males, children under 5 years, people aged 15-24. CONCLUSION: The current age-standardized death rate and DALYs from injuries is high and the observed annual reduction is not satisfactory. There is a difference in gender and age regarding the number of deaths resulting from injuries. The data indicates that the current national efforts to address the public health impact of injuries in Ethiopia are not sufficient enough to bring a marked reduction. As a result, a more holistic approach to address all injuries is recommended in Ethiopia.