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1.
BMC Public Health ; 24(1): 1734, 2024 Jun 28.
Artículo en Inglés | MEDLINE | ID: mdl-38943130

RESUMEN

BACKGROUND: Poor infant and child feeding practices, in combination with increased rates of infectious diseases, are the main immediate causes of malnutrition during the first two years of life. Non-breastfed children require milk and other dairy products, as they are rich sources of calcium and other nutrients. As far as our search is concerned, there is no evidence on the pooled magnitude and determinants of minimum milk feeding frequency among non-breastfed children in sub-Saharan Africa conducted using the most recent indicators for assessing infant and young child feeding practices published in 2021. Therefore, this study is intended to determine the magnitude and associated factors of minimum milk feeding frequency among non-breastfed children aged 6-23 months in sub-Saharan Africa using the most recent guideline and demographic and health survey dataset. METHODS: Data from the most recent health and demographic surveys, which were carried out between 2015 and 2022 in 20 sub-Saharan African countries, were used. The study comprised a weighted sample consisting of 13,315 non-breastfed children between the ages of 6 and 23 months. STATA/SE version 14.0 statistical software was used to clean, recode, and analyze data that had been taken from DHS data sets. Utilizing multilevel mixed-effects logistic regression, the factors associated with the outcome variable were identified. Model comparison and fitness were assessed using deviance (-2LLR), likelihood ratio test, median odds ratio, and intra-class correlation coefficient. Finally, variables with a p-value < 0.05 and an adjusted odds ratio with a 95% confidence interval were declared statistically significant. RESULTS: The pooled magnitude of minimum milk feeding frequency among non-breastfed children aged 6-23 months in sub-Saharan African countries was 12.39% (95% CI: 11.85%, 12.97%). Factors like maternal educational level [AOR = 1.61; 95% CI (1.35, 1.91)], marital status of the mother [AOR = 0.77; 95% CI (0.67, 0.89)], maternal working status [AOR = 0.80; 95% CI (0.71, 0.91)], media exposure [AOR = 1.50; 95% CI (1.27, 1.77)], wealth index [AOR = 1.21; 95% CI (1.03, 1.42)], place of delivery [AOR = 1.45; 95% CI (1.22, 1.72)], ANC visit attended during pregnancy [AOR = 0.49; 95% CI (0.39, 0.62)], PNC checkup [AOR = 1.57; 95% CI (1.40, 1.76)], child's age [AOR = 0.70; 95% CI (0.53, 0.93)], and residence [AOR = 2.15; 95% CI (1.87, 2.46)] were significantly associated with minimum milk feeding frequency. CONCLUSIONS: In sub-Saharan Africa, the proportion of minimum milk feeding frequency among non-breastfed children aged between 6 and 23 months was low. The likelihood of minimum milk feeding frequency increases with high levels of education, unemployment, media exposure, rich wealth status, being unmarried, having a child born in a health facility, getting PNC checks, being between 6 and 8 months old, and living in an urban area. Hence, promoting women's education, increasing the economic status of the household, disseminating nutrition information through media, strengthening maternal health service utilization like health facility delivery and PNC services, and giving prior attention to mothers with older children and from rural areas are strongly recommended.


Asunto(s)
Encuestas Epidemiológicas , Análisis Multinivel , Humanos , África del Sur del Sahara , Lactante , Femenino , Masculino , Conducta Alimentaria , Adulto , Lactancia Materna/estadística & datos numéricos , Leche
2.
BMC Pregnancy Childbirth ; 23(1): 745, 2023 Oct 23.
Artículo en Inglés | MEDLINE | ID: mdl-37872486

RESUMEN

INTRODUCTION: Tetanus is a major public health problem caused by clostridium tetani. Although it is vaccine-preventable, the case fatality rate among neonates in areas with poor immunization coverage and limited access to clean deliveries reaches 80-100%. Vaccination of pregnant mothers with the tetanus toxoid (TT) vaccine is the most effective way to protect against neonatal tetanus. This study aimed to examine the spatial distribution and determinants of tetanus toxoid immunization among pregnant mothers using the 2016 EDHS data. METHOD: Secondary analysis of the Ethiopia Demographic and Health Survey 2016 was done to assess the spatial distribution and determinants of tetanus toxoid vaccine among pregnant women in Ethiopia. Spatial autocorrelation analysis and hot spot analysis were used to detect spatial dependency and spatial clustering of the tetanus toxoid vaccine in Ethiopia. Spatial interpolation was used to predict the tetanus toxoid vaccine coverage in unsampled areas. The multilevel binary logistic regression model was fitted to identify factors associated with tetanus toxoid vaccination. An adjusted odds ratio with 95% CI was calculated and used as the measure of association and a p-value less than 0.05 were considered statistically significant. RESULT: From the total of 7043 pregnant women, 42.4% of them have taken at least two doses of tetanus toxoid immunization. Spatial clustering of TT immunization was observed in the Northern, Southwestern and Southwestern parts of Ethiopia. Whereas, low TT coverage was observed in the Eastern and Western parts of the country. Increased ANC visits and the richest economic status favored TT immunization, whereas living in Addis Ababa and Dire Dewa cities decreased the TT immunization coverage. CONCLUSION: The finding of this study reveals that TT immunization had spatial dependency, with the highest immunization coverage observed in the Northern, Southwestern and Southeastern parts of the Country. Thus, geographically targeted interventions should be implemented particularly in the eastern and western parts of the country.


Asunto(s)
Toxoide Tetánico , Tétanos , Recién Nacido , Femenino , Embarazo , Humanos , Tétanos/prevención & control , Mujeres Embarazadas , Etiopía , Vacunación , Demografía
3.
BMC Pediatr ; 23(1): 475, 2023 09 19.
Artículo en Inglés | MEDLINE | ID: mdl-37726683

RESUMEN

BACKGROUND: Perinatal asphyxia is one of the preventable and treatable causes of neonatal mortality. However, it is the fifth-largest cause of under-five mortality. Even with management advancements, it remains one of the key public health issues in underdeveloped countries, including Ethiopia. Comorbidities are also understated; therefore, adequate information regarding the incidence of death and its predictors is required. METHODS: A four-year retrospective follow-up study was conducted from October 3 to November 2, 2022. From a total sample size, of 655, 616 data were collected by nurse through follow-up reviews charts using Kobo Toolbox software. The data was exported to STATA Version 14 for analysis. The Cox proportional hazard assumption was checked, and the model for the data was selected using Akaike Information Criteria. Finally, an adjusted hazard ratio with 95% CI was computed, and variables with a P-value < 0.05 in the multivariable analysis were taken as significant predictors of death. RESULT: The overall incidence of mortality was 38.86/1000 (95% CI: 33.85-44.60). The median time of follow-up was 15 days (95% CI: 14-20). The proportion of deaths was 202 (32.79%, 95% CI: 29.18-36.61) among neonates with perinatal asphyxia. While the distance from health facility > 10 km is (AHR: 2.25; 95% CI: 1.60-3.17), direct oxygen (AHR: 1.83; 95% CI: 1.35-2.48), APGAR score (Appearance, Pulse, Grimace, Activity, and Respiration) < 3 at the fifth minute (AHR: 2.63; 95% CI: 1.03-6.73), prolonged rupture of membrane (AHR: 1.41; 95% CI: 1.02-1.94), and stage III hypoxic ischemic encephalopathy (AHR: 2.02; 95% CI: 1.18-3.47) were predictors of mortality among neonates with perinatal asphyxia. CONCLUSION: According to this study's findings, high neonatal mortality due to perinatal asphyxia requires proper intervention regarding membrane rupture, APGAR score (Appearance, Pulse, Grimace, Activity, and Respiration), oxygen use, stage III hypoxic-ischemic encephalopathy, and residence distance.


Asunto(s)
Asfixia , Hipoxia-Isquemia Encefálica , Recién Nacido , Femenino , Embarazo , Humanos , Etiopía/epidemiología , Estudios de Seguimiento , Incidencia , Estudios Retrospectivos , Centros de Atención Terciaria
4.
BMC Health Serv Res ; 23(1): 185, 2023 Feb 22.
Artículo en Inglés | MEDLINE | ID: mdl-36814248

RESUMEN

INTRODUCTION: Family planning services allow individuals to achieve desired birth spacing, family size, and contribute to improved health outcomes for infants, children, women, and families, and prevent unintended pregnancy. Births resulting from unintended pregnancies can have negative consequences Children from unintended pregnancies are more likely to experience poor mental and physical health during childhood. Even though many international organizations work to ensure universal access to sexual and reproductive health services, reproductive health service utilization is concentrated among individuals with rich socioeconomic status. Therefore, this study aimed to assess the presence of socioeconomic inequality in modern contraceptive utilization and its contributors in sub-Saharan African countries. METHODS: A total of 466,282 weighted reproductive-aged women samples from DHS data SSA countries were included in the study. Erreygers normalized concentration index and its concentration curve were used to assess socioeconomic-related inequality in modern contraceptive utilization. Decomposition analysis was performed to identify factors contributing to socioeconomic-related inequality. RESULTS: The weighted Erreygers normalized concentration index for modern contraceptive utilization was 0.079 with Standard error = 0.0013 (P value< 0.0001); indicating that There is small amount but statistically significant pro rich distribution of wealth related in equalities of modern contraceptive utilization among reproductive age women. The decomposition analysis revealed that mass media exposure, wealth index., place of residency, and distance of health facility were the major contributors to the pro-rich socioeconomic inequalities in modern contraceptive utilization. CONCLUSION AND RECOMMENDATION: In this study, there is a small amount but statistically significant pro rich distribution of modern contraceptive utilization. Therefore, give priority to modifiable factors such as promoting the accessibility of health facilities, media exposure of the household, and improving their country's economy to a higher economic level to improve the wealth status of the population.


Asunto(s)
Anticonceptivos , Servicios de Planificación Familiar , Embarazo , Lactante , Niño , Humanos , Femenino , Adulto , Factores Socioeconómicos , Embarazo no Planeado , África del Sur del Sahara , Conducta Anticonceptiva
5.
BMC Infect Dis ; 22(1): 569, 2022 Jun 23.
Artículo en Inglés | MEDLINE | ID: mdl-35739462

RESUMEN

INTRODUCTION: The Bacille-Calmette-Guerin (BCG) vaccination remains the primary strategy to prevent severe disseminated TB in young children, particularly in high TB-burden countries such as Ethiopia. Accurate knowledge of vaccination coverage in small geographical areas is critically important to developing targeted immunization campaigns. Thus, this study aimed to investigate the spatiotemporal distributions and ecological level determinants of BCG vaccination coverage in Ethiopia. METHOD: Bacille-Calmette-Guerin immunization coverage and geographical information data were obtained from five different Demographic and Health Surveys, conducted in Ethiopia between 2000 and 2019. Data for independent variables were obtained from publicly available sources. Bayesian geostatistical models were used to predict the spatial distribution of BCG vaccination coverage in Ethiopia. RESULT: The overall national BCG vaccination coverage between 2000 and 2019 was 65.5%. The BCG vaccine coverage was 53.5% in 2000, 56.9% in 2005, 64.4% in 2011, 79.6% in 2016, and 79.0% in 2019. BCG vaccination coverage increased by 47.6% in Ethiopia from 2000 to 2019, but substantial geographical inequalities in BCG coverage remained at sub-national and local levels. High vaccination coverage was observed in northern, western, and central parts of Ethiopia. Climatic and demographic factors such as temperature, altitude, and population density were positively associated with BCG vaccination coverage. Whereas, healthcare access factors such as distance to health facilities and travel time to the nearest cities were negatively associated with BCG vaccine coverage in Ethiopia. CONCLUSION: Despite substantial progress in national BCG vaccination coverage, marked spatial variation in BCG coverage persists throughout the country at sub-national and local levels. Healthcare access and climatic and demographic factors determined the spatial distribution of BCG vaccination coverage. Maintaining a high level of vaccination coverage across geographical areas is important to prevent TB in Ethiopia.


Asunto(s)
Vacuna BCG , Cobertura de Vacunación , Teorema de Bayes , Niño , Preescolar , Etiopía/epidemiología , Humanos , Lactante , Vacunación
6.
BMC Public Health ; 22(1): 1714, 2022 09 09.
Artículo en Inglés | MEDLINE | ID: mdl-36085047

RESUMEN

BACKGROUND: Sexually transmitted infections are serious global public health issue, and their consequences contribute significantly to population morbidity and mortality, especially in Sub-Saharan Africa. However, there is limited information about the sexually transmitted infections related care-seeking behavior in East Africa. Therefore, this study aimed to assess the pooled prevalence of sexually transmitted infections related care-seeking behavior, and associated factors among reproductive-age women in East Africa using the recent Demographic and Health Survey. METHODS: This study was based on recent Demographic and Health Survey of 8 East African countries from 2008/09 to 2018/2019. A total weighted sample of 12,004 reproductive-age women who reported sexually transmitted infections or symptoms of sexually transmitted infections in the last 12 months wereincluded. A multi-level mixed-effect logistic regression model was used and a P-value of < 0.05 was considered a statistically significant level for identification of individual and community level factors and AOR with a 95% l CI was computed. RESULT: The overall prevalence of sexually transmitted infections related care-seeking behavior among reproductive-age women in East African countries was 54.14% [95% CI: 53.25%, 55.03%]. In multilevel analysis: being age 25-34 [AOR = 1.27 95%CI: 1.15-1.41], 35-49 [AOR = 1.26 95%CI: 1.13-1.41], women who attained secondary or above education [AOR = 1.27, 95% CI: 1.09, 1.47], being in rich household [AOR = 1.27, 95% CI 1.14, 1.41], women who were currently pregnant [AOR = 1.29, 95% CI 1.13, 1.47], who had been tested for HIV [AOR = 1.99, 95% CI 1.70, 2.33], women who had one and more than one sexual partner [AOR = 1.18, 95% CI 1.05, 1.34], women who lived in urban area [AOR = 1.16, 95% CI: 1.03, 1.31] and who perceived distance from the health facility was not a big problem was [AOR = 1.13, 95% CI 1.04, 1.23] were significantly associated with sexually transmitted infections related care-seeking behavior. CONCLUSION: sexually transmitted infections related care-seeking behavior is relatively low as compared with other studies.. This study revealed that individual-level variables such as women's age, educational status, household wealth index, pregnancy status, ever been tested for HIV, number of sexual partners, and community-level variables such as residence and distance from a health facility were associated with sexually transmitted infections related care-seeking behavior. Therefore, public health interventions targeting uneducated women, poor households, and adolescents, as well as improving counseling and awareness creation during HIV/AIDS testing and Antenatal care visits, are vital to improving sexually transmitted infections care seeking behavior.


Asunto(s)
Infecciones por VIH , Enfermedades de Transmisión Sexual , Adolescente , Adulto , Estudios Transversales , Femenino , Infecciones por VIH/epidemiología , Humanos , Lactante , Análisis Multinivel , Embarazo , Prevalencia , Conducta Sexual/psicología , Enfermedades de Transmisión Sexual/diagnóstico , Enfermedades de Transmisión Sexual/epidemiología
7.
BMC Public Health ; 22(1): 1523, 2022 08 10.
Artículo en Inglés | MEDLINE | ID: mdl-35948950

RESUMEN

BACKGROUND: Community-Based Health Insurance is an emerging concept for providing financial protection against the cost of illness and improving access to quality health services for low-income households excluded from formal insurance and taken as a soft option by many countries. Therefore, exploring the spatial distribution of health insurance is crucial to prioritizing and designing targeted intervention policies in the country. METHODS: A total of 8,663 households aged 15-95 years old were included in this study. The Bernoulli model was used by applying Kulldorff methods using the SaTScan software to analyze the purely spatial clusters of community based health insurance. ArcGIS version 10.3 was used to visualize the distribution of community-based health insurance coverage across the country. Mixed-effect logistic regression analysis was also used to identify predictors of community-based health insurance coverage. RESULTS: Community based health insurance coverage among households had spatial variations across the country by regions (Moran's I: 0.252, p < 0.0001). Community based health insurance in Amhara (p < 0.0001) and Tigray (p < 0.0001) regions clustered spatially. Age from 15-29 and 30-39 years (Adjusted Odds Ratio 0.46(AOR = 0.46, CI: 0.36,0.60) and 0.77(AOR = 0.77, CI: 0.63,0.96), primary education level 1.57(AOR = 1.57, CI: 1.15,2.15), wealth index of middle and richer (1.71(AOR = 1.71, CI: 1.30,2.24) and 1.79(AOR = 1.79, CI: 1.34,2.41), family size > 5, 0.82(AOR = 0.82, CI: 0.69,0.96),respectively and regions Afar, Oromia, Somali, Benishangul Gumuz, SNNPR, Gambella, Harari, Addis Ababa and Dire Dawa was 0.002(AOR = 0.002, CI: 0.006,0.04), 0.11(AOR = 0.11, CI: 0.06,0.21) 0.02(AOR = 0.02, CI: 0.007,0.04), 0.04(AOR = 0.04, CI: 0.02,0.08), 0.09(AOR = 0.09, CI: 0.05,0.18),0.004(AOR = 0.004,CI:0.02,0.08),0.06(AOR = 0.06,CI:0.03,0.14), 0.07(AOR = 0.07, CI: 0.03,0.16) and 0.03(AOR = 0.03, CI: 0.02,0.07) times less likely utilize community based health insurance than the Amhara region respectively in Ethiopia. CONCLUSION: Community based health insurance coverage among households in Ethiopia was found very low still. The government needs to develop consistent financial and technical support and create awareness for regions with lower health insurance coverage.


Asunto(s)
Seguros de Salud Comunitarios , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Etiopía , Composición Familiar , Encuestas Epidemiológicas , Humanos , Persona de Mediana Edad , Análisis Multinivel , Análisis Espacial , Adulto Joven
8.
BMC Pediatr ; 22(1): 301, 2022 05 23.
Artículo en Inglés | MEDLINE | ID: mdl-35606750

RESUMEN

BACKGROUND: Diarrhea is the second most common cause of death in under-five children. Fluid and food replacement during diarrheal episodes have a paramount effect to avert morbidity and mortality. However, there is limited information about feeding practices. This study aimed to assess the prevalence of drinking or eating more and associated factors during diarrhea among under-five children in East Africa using demographic and health surveys (DHSs). METHODS: Secondary data analysis was done on DHSs 2008 to 2018 in 12 East African Countries. Total weighted samples of 20,559 mothers with their under-five children were included. Data cleaning, coding, and analysis were performed using Stata 16. Multilevel binary logistic regression were performed to identify factors associated with drinking or eating more during diarrheal episodes. Adjusted Odds Ratio (AOR) with a 95% CI, and p-value < 0.05 were used to declare statistical significance. RESULTS: Prevalence of drinking or eating more than usual during diarrhea disease in East Africa was 26.27%(95% CI: 25.68-26.88). Mothers age > 35 years (AOR: 1.14, 95% CI: (1.03, 1.26), mothers primary education (AOR: 1.17, 95% CI: 1.06,1.28), secondary education (AOR: 1.43,95% CI: 1.27,1.61), and higher education (AOR: 1.42,95% CI: 1.11,1.81), occupation of mothers (agriculture, AOR: 2.2, 95% CI: 1.3-3.6), sales and services, AOR = 1.20, CI:1.07,1.34), manual, AOR =1.28,95% CI: 1.11,1.44), children age 1-2 years (AOR =1.34,95% CI: 1.22,1.46) and 3-4 years (AOR =1.36,95% CI: 1.20,1.55), four and more antenatal visits (AOR: 1.14,95% CI: 1.03,1.27), rich wealth status (AOR:1.27,95% CI: 1.16,1.40), birth in health facility (AOR = 1.19, 95%CI: 1.10, 1.30) and visit health facility (AOR = 1.12, 95%CI: 1.03, 1.22) were associated with drinking or eating more. CONCLUSION: The prevalence of drinking or eating more is low in East Africa. Maternal age, occupation, antenatal care visit, marital status, educational status, wealth status, place of delivery, visiting health facility, and child age were significantly associated with drinking or eating more during diarrheal episodes. Health policy and programs should focus on educating mothers, improving the household wealth status, encouraging women to contact health facilities for better feeding practices of children during diarrheal episodes.


Asunto(s)
Diarrea , Adulto , África Oriental/epidemiología , Niño , Preescolar , Diarrea/epidemiología , Etiopía/epidemiología , Femenino , Encuestas Epidemiológicas , Humanos , Lactante , Estado Civil , Análisis Multinivel , Embarazo , Prevalencia
9.
BMC Pediatr ; 22(1): 495, 2022 08 22.
Artículo en Inglés | MEDLINE | ID: mdl-35996110

RESUMEN

BACKGROUND: Accessibility and utilization of postnatal newborn check-ups within 2 days after delivery are critical for a child's survival, growth, and development. However, the service delivery is not yet improved and fluctuates across the geographical locations in Ethiopia. Therefore, this study aimed to assess the spatial distribution and determinants of newborns not received postnatal check-ups within 2 days after birth in Ethiopia. METHODS: A secondary data analysis of the Ethiopia Demographic and Health Survey (EDHS) 2016 was done among live births within 2 years preceding the survey. A multilevel binary logistic regression model was fitted to identify the factors associated with the outcome variable. Adjusted Odds Ratio with 95% (Confidence Interval) was calculated and used as a measure of associations and variables with a p-value < 0.05, were declared as statistically significant. RESULTS: A total of 4036 live newborns in Ethiopia were included in the analysis, of whom half (51.21%) were females. The mean age of the mothers was 33+ SD 1.3, and more than 60 % (61.56%) of the mothers were not educated. The national prevalence of newborns not receiving postnatal check-ups within 2 days after birth was 84.29 (95% CI: 83.10-85.41) with significant spatial variations across the study area. Mothers who had no ANC visits were 58% higher than (AOR = 0.42(0.27-0.66) mothers who had > 4 ANC visits. Mothers who gave birth at home and others were 80% (AOR = 0.02(0.01-0.29) and 25% (AOR = 0.76(0.59-0.99), higher than mothers delivered at hospital. Rural mothers were 1.90 times higher (AOR = 1.90(1.29-2.81) than urban mothers, and mothers live in administrative regions of Afar 66% (AOR = 0.34(0.16-0.69), Oromia 47% (AOR = 0.53(0.30-0.91), Somali 60% (AOR = 0.40 (0.22-0.74),Benishangul 50% (AOR = 0.50 (0.27-0.92), SNNPR 67% (AOR = 0.33(0.19-0.57), Gambela 70% (AOR = 0.30 (0.16-0.56), Harari 56% (AOR = 0.44 (0.25-0.78), and Dire Dawa70% (AOR = 0.30 (0.17-0.54) were higher than Addis Abeba for not receiving postnatal checkup of new born within the first 2 days, respectively. CONCLUSIONS: Low postnatal check-up utilization remains a big challenge in Ethiopia, with significant spatial variations across regional and local levels. Spatial clustering of not receiving postanal check-ups within 2 days was observed in Afar, Oromia, Gambela, Benishangul, SNNPR, Harari, and Dire Dawa regions. Residence, ANC visits, place of delivery, and administrative regions were significantly associated with not receiving postnatal check-ups. Geographically targeted interventions to improve ANC follow-up and institutional delivery should be strengthened.


Asunto(s)
Parto Domiciliario , Etiopía/epidemiología , Femenino , Humanos , Recién Nacido , Masculino , Madres , Análisis Multinivel , Parto , Embarazo , Análisis Espacial
10.
Front Public Health ; 12: 1364865, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38756896

RESUMEN

Background: Measles caused 207,000 deaths worldwide in 2019. Ethiopia ranks among the top 10 countries in the world with the highest number of measles cases. However, the coverage of the second dose of measles-containing vaccine (MCV2) remains low. To increase coverage, the government of Ethiopia launched a nationwide measles vaccination campaign. Despite this intervention, the coverage is still below target, and there is scarce information in the study area. Therefore, this study aimed to assess MCV2 coverage and associated factors among children aged 24-36 months in Gondar city, Central Gondar, Northwest Ethiopia, 2023. Methods: A community-based cross-sectional study was conducted among 621 children aged 24-36 months using a systematic random sampling technique from 25 April to 25 May. A pre-tested, interviewer-administered, and structured questionnaire was used and collected using Kobo Toolbox and then transferred to Stata version 17 for further analysis. The binary logistic regression model was used to identify factors, and the presence of an association was declared using a p-value of <0.05. Similarly, an adjusted odds ratio with a 95% confidence interval was used to interpret the direction and strength of an association. Results: A total of 621 children, with a response rate of 98.1%, participated in the study. The coverage of the second dose of MCV was 75.68% (95% CI: 72.1-78.9). The following factors were significantly associated with measles-containing vaccine second dose (MCV2) coverage: father as the household head (AOR: 3.06, 95% CI: 1.43-6.44), first birth order (AOR: 4.45, 95% CI: 1.21-16.3), four and above antenatal care (ANC) follow-ups (AOR: 5.18, 95% CI:1.62-16.5), postnatal care (PNC) service utilization (AOR: 2.57, 95% CI:1.27-5.15), at least two doses of vitamin A uptake (AOR: 6.39, 95% CI: 2.67-15.2), mothers having high awareness (AOR: 1.97, 95% CI:1.15-3.4), and good perception (AOR: 3.6, 95% CI: 2-6.47) about measles vaccination. Conclusion and recommendations: The coverage of MCV2 in the study area is lower than the national and global target of above 95%. Head of household, birth order, ANC follow-up, PNC service utilization, vitamin A uptake, awareness, and perception of mothers about measles vaccination were significant factors for MCV2 coverage. Creating awareness, increasing the perception of mothers about measles vaccination, and strengthening the ANC and PNC services will increase the coverage.


Asunto(s)
Vacuna Antisarampión , Sarampión , Cobertura de Vacunación , Humanos , Etiopía , Vacuna Antisarampión/administración & dosificación , Estudios Transversales , Femenino , Masculino , Sarampión/prevención & control , Preescolar , Cobertura de Vacunación/estadística & datos numéricos , Encuestas y Cuestionarios , Programas de Inmunización/estadística & datos numéricos , Adulto
11.
Hum Vaccin Immunother ; 20(1): 2370111, 2024 Dec 31.
Artículo en Inglés | MEDLINE | ID: mdl-38946555

RESUMEN

Cervical cancer is the fourth most common cancer, with 99% of cases linked to human papillomavirus (HPV) infection. It reflects global inequity as its burden is highest in low- and middle-income countries. The aim of this study was to determine the HPV vaccination coverage and its determinant factors among young women in the three sub-Saharan African countries. Data from the Demographic and Health Surveys among three sub-Saharan African countries were used for analysis. A total of 4,952 women were included in the study. Stata 14 was used to analyze the data. The determinants of the outcome variable were identified using a multilevel mixed-effects logistic regression model. Factors with p-values < 0.05 at 95% confidence interval were declared statistically significant. About 7.5% young women were vaccinated for HPV vaccine against cervical cancer in the current study. Younger age, use of internet, rich economic class, and individual-level media exposure were found to be favorable conditions, whereas being employed was negatively associated with HPV vaccination. Only few segments of young women in these three countries got HPV vaccination. The authors recommend that increasing internet use, media exposure, and economic level of young women will increase the HPV vaccination rates. Furthermore, creating awareness among employed women will also increase the possibility of HPV vaccination.


Asunto(s)
Encuestas Epidemiológicas , Infecciones por Papillomavirus , Vacunas contra Papillomavirus , Neoplasias del Cuello Uterino , Cobertura de Vacunación , Humanos , Femenino , Vacunas contra Papillomavirus/administración & dosificación , Adulto Joven , Infecciones por Papillomavirus/prevención & control , Cobertura de Vacunación/estadística & datos numéricos , Adolescente , Neoplasias del Cuello Uterino/prevención & control , África del Sur del Sahara/epidemiología , Adulto , Vacunación/estadística & datos numéricos , Conocimientos, Actitudes y Práctica en Salud , Virus del Papiloma Humano
12.
Hum Vaccin Immunother ; 20(1): 2335730, 2024 Dec 31.
Artículo en Inglés | MEDLINE | ID: mdl-38575525

RESUMEN

Rotavirus is the most common cause of diarrhea in children worldwide. In 2016, rotavirus infection resulted in 258 173 300 episodes of diarrhea and 128 500 child deaths in the globe. The study aimed to assess the magnitude of Rotavirus vaccine dose-two dropout and associated factors among children who received rotavirus vaccine dose-one in sub-Saharan African countries. The appended and most recent demographic and health survey (DHS) dataset of 17 sub-Saharan African countries was used for data analysis. A total of 73,396 weighted samples were used. Factors associated with the outcome variable were considered significant if their p-values were ≤ .05 in the multilevel mixed-effect logistic regression model. The overall Rotavirus vaccine dose-two dropouts was 10.77% (95% CI 10.55%, 11.00%), which ranged from 2.77% in Rwanda to 37.67% in Uganda. Being younger, late birth order, having difficulty accessing health facilities, having no media exposure, having no work, having home delivery, having no antenatal follow-up, and having no postnatal checkup were factors significantly associated with the outcome variable. The overall Rotavirus vaccine dose-two dropout was higher in sub-Saharan African countries which implies that vaccine dropout is still a great issue in the region. Special attention should be given to those mothers who are young, who have no work, who give birth at home, who experienced difficulty in accessing health facilities, and late birth orders. Furthermore, targeted interventions should be considered for improving access and utilization of media, antenatal care, and postnatal care services.


Asunto(s)
Vacunas contra Rotavirus , Niño , Humanos , Femenino , Embarazo , Análisis Multinivel , Diarrea/prevención & control , África del Sur del Sahara/epidemiología , Demografía
13.
Front Public Health ; 12: 1359572, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38751581

RESUMEN

Background: One of the biggest breakthroughs of contemporary medicine is measles vaccination. It is essential for the total elimination of measles. Understanding the magnitude and determinants of effective second-dose measles vaccination coverage is a critical task. Accordingly, we set out to check the best available evidence of the pooled second-dose measles vaccination coverage among under-five children in East Africa. Method: We searched electronic databases such as PubMed, Google Scholar, Cochrane, and others. Two reviewers separately carried out the search of the Joanna Briggs Institute, selection of studies, critical appraisal, and data extraction. A third party was involved in resolving the disagreement among the reviewers. Seven studies included in this study, four from Ethiopia, two from Kenya, and one from Tanzania were cross-sectional and published in English language, with publication dates before 29 November 2023. Articles lacking full-text, the intended outcome, and that are not qualitative studies were excluded from the analysis. The Microsoft Excel checklist was used to extract the data and then exported to STATA 11. In addition, I2, Funnel plots, and Egger's test were employed to measure heterogeneity and detect publication bias, respectively. A random effect model was used. Result: The meta-analysis includes a total sample size of 4,962 children from seven articles. The pooled prevalence of second-dose measles vaccination among under-five children in East Africa was found to be 32.22% [95% CI; (18.82, 45.63)], and the significant factors were as follows: birth order (1.72; OR = 95% CI: 1.32, 2.23), information about measles-containing second-dose vaccine (MCV 2) (7.39; OR = 95% CI: 5.21, 10.50), mother's marital status (1.47; OR = 95% CI: 1.05, 2.07), complete immunization for other vaccines (2.17; OR = 95% CI: 1.49, 3.17), and distance of vaccination site (3.31; OR = 95% CI: 2.42, 4.53). Conclusion: The current study found that pooled prevalence of second-dose measles vaccination coverage among under-five children was still very low. It was also observed that birth order, distance of the vaccination site, complete immunization for other vaccines, mother's marital status, and information about MCV were factors associated with second-dose measles vaccination. These factors imply that there is a need for countries and their partners to act urgently to secure political commitment, expand primary health service and health education, and increase vaccination coverage.


Asunto(s)
Vacuna Antisarampión , Sarampión , Cobertura de Vacunación , Humanos , Vacuna Antisarampión/administración & dosificación , Sarampión/prevención & control , Cobertura de Vacunación/estadística & datos numéricos , Preescolar , Lactante , África Oriental , Estudios Transversales , Femenino , Vacunación/estadística & datos numéricos , Masculino
14.
PLoS One ; 18(11): e0289095, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-38033131

RESUMEN

INTRODUCTION: Despite gains made from improved antiretroviral therapy coverage in resource limited countries, the occurrence of first line drug resistance remains a priority agenda. To reduce the emergence of resistant viruses, HIV viral load monitoring plays a critical role. However, many resource limited countries have difficulty of monitoring viral load due to economic constraints.There is also limited study regarding viral failure in developing countries. Therefore, this study aimed to assess the incidence and predictors of virological failure among HIV-infected children and adolescents on first-line ART Ethiopia, 2021. METHODS: Institution based retrospective follow-up study was employed on 492 children and adolescents. Data were collected by trained nurses who have experience working in ART clinics. Data were entered using Epi-data version 4.6 and exported to Stata version 14 for analysis. The proportional hazard assumption was checked, and the Weibull regression was fitted. Cox-Snell residual was used to test the goodness of fit, and the appropriate model was selected by AIC. Finally, an AHR with a 95% CI was computed, and variables with a P-value < 0.05 in the multivariable analysis were taken as significant predictors of virological failure. RESULTS: The overall incidence rate of virological failure was 4.2, (95% CI: 3.41, 5.22) per 1000 person-months of observation with 20,169 person-months follow-up time. In multivariable analysis living in rural area (AHR = 1.97, 95% CI: 1.15-3.36), poor adherence (AHR = 2.20, 95% CI: 1.24-3.91), lower CD4 Count <200 cells/mm3 (AHR = 2.57, 95% CI: 1.27-5.18) and 201-350 cells/mm3 (AHR = 2.44, 95% CI: 1.28-4.67) respectively, and recent OI (AHR = 4.60, 95% CI: 2.38-8.90) are significantly associated with virological failure. CONCLUSION: The incidence rate of virological failure was high. Living in a rural, poor adherence, lower CD4 count, and recent opportunistic infection were independent risk factors associated with virological failure. Hence, it is better to give priority to strengthening the focused evaluation of important variables and managing accordingly.


Asunto(s)
Antirretrovirales , Infecciones por VIH , Humanos , Niño , Adolescente , Estudios de Seguimiento , Estudios Retrospectivos , Incidencia , Etiopía/epidemiología , Antirretrovirales/uso terapéutico , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/epidemiología , Hospitales , Convulsiones/tratamiento farmacológico
15.
PLoS One ; 18(8): e0289050, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37527266

RESUMEN

INTRODUCTION: Respiratory distress syndrome is the major cause of neonatal death. However, data on the mortality and predictors related to respiratory distress syndrome were scarce. Hence, this study aimed to assess the incidence and predictors of death among neonates admitted with respiratory distress syndrome in West Oromia Referral Hospitals, Ethiopia, 2022. METHODS: A retrospective follow-up study was conducted among 406 neonates admitted with respiratory distress syndrome at five referral hospitals from, 1 January 2019 to, 31 December 2021 in West Oromia, Ethiopia. The data were collected using a structured checklist and participants were selected using simple random sampling technique. The data were entered into Epi data version 4.6.0.2 and exported to STATA version 14 for cleaning, coding and analysis. The Kaplan-Meier curve was used to estimate survival time. The Weibull regression model was fitted to identify the predictors of mortality and variables with a P-value < 0.05 was taken as significant predictors of mortality. RESULT: Four hundred six neonates with respiratory distress syndrome were included in the analysis. The overall incidence of neonatal mortality was 59.87/1000 neonates-days observations (95%CI: 51.1-70.2) with a proportion of 152 (37.44%) (95% CI: 32.7-42.2). The median time of follow-up was 11 days (95% CI: 10-23). Very low birthweight (AHR = 4.5, 95%CI: 2.0-10.9) and low birth weight (AHR = 3.1, 95%CI: 1.4-6.6), perinatal asphyxia (AHR = 2.7, 95%CI: 1.8-4), Chorioamnionitis (AHR = 2.2, 95%CI: 1.4-3.5) and multiple pregnancies (AHR = 2.2, 95%CI: 1.4-3.4) increased the hazard of death, whereas, antenatal corticosteroid administration (AHR = 0.33, 95%CI: 0.2-0.7) was negatively associated with neonatal mortality. CONCLUSION AND RECOMMENDATION: High mortality rate of neonates with respiratory distress syndrome was observed. Chorioamnionitis, perinatal asphyxia, low birth weight and multiple pregnancies increase the, mortality hazard while administering antenatal corticosteroids decreases it. Thus, administering corticosteroids- before giving birth and special emphasis on children with Chorioaminoitis, asphyxia, low birth weight and multiple pregnancies is important for reducing neonatal mortality.


Asunto(s)
Asfixia Neonatal , Corioamnionitis , Síndrome de Dificultad Respiratoria del Recién Nacido , Recién Nacido , Niño , Humanos , Embarazo , Femenino , Estudios de Seguimiento , Estudios Retrospectivos , Etiopía/epidemiología , Incidencia , Asfixia , Mortalidad Infantil , Síndrome de Dificultad Respiratoria del Recién Nacido/epidemiología , Hospitales , Derivación y Consulta , Corticoesteroides
16.
Front Public Health ; 11: 1085279, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36926180

RESUMEN

Background: Despite remarkable improvements in child health services utilization, childhood immunization has been poorly implemented in Ethiopia. However, evidence on the coverage of immunization among children from mothers/caregivers with no education (non-educated mothers were the most identified risk for underutilization of services) are scarce. Therefore, this study aimed to assess the determinants of full immunization coverage among children 12-23 months of age from deviant mothers/caregivers in Ethiopia. Methods: We analyzed data from the 2016 Ethiopia Demographic and Health Survey (EDHS) on a sample of 1,170 children 12-23 months of age identified from deviant mothers/caregivers (mothers/caregivers with no education) through a two-stage stratified sampling. A multilevel mixed-effect binary logistic regression analysis was used to identify the individual and community level determinants of full immunization coverage among children 12-23 months of age with their deviant mothers/caregivers. In the final model, a p-value of < 0.05 and adjusted odds ratio (AOR) with 95% confidence interval (CI) were used to select statistically significant determinants of full immunization coverage. Results: The overall full immunization coverage among children 12-23 months of age identified from deviant mothers/caregivers was 27.4% (95%CI: 25.0, 31.0) in Ethiopia. Deviant mothers/caregivers who are employed (AOR = 1.69, 95%CI: 1.68, 2.45), being in the rich household wealth status (AOR = 2.54, 95%CI: 1.53, 4.22), residing in city (AOR = 5.69, 95%CI: 2.39, 13.61), having one to three (AOR: 3.28, 95% CI: 2.12-5.07) and four and more ANC follow-up during the recent pregnancy (AOR: 3.91, 95% CI: 2.45, 6.24) were the determinants that increased full immunization coverage among children 12-23 months of age. Conclusions: Full immunization coverage among children 12-23 months of age from non-educated mothers/caregivers was low and far behind the national target of coverage. Therefore, a system-wide intervention should be used to enhance employability, wealth status, and key maternal health services like ANC follow-up among non-educated mothers/caregivers to increase their children's full immunization coverage.


Asunto(s)
Cuidadores , Cobertura de Vacunación , Femenino , Embarazo , Humanos , Niño , Etiopía , Análisis Multinivel , Estudios Transversales , Demografía
17.
Sci Rep ; 13(1): 16126, 2023 09 26.
Artículo en Inglés | MEDLINE | ID: mdl-37752329

RESUMEN

Diarrhea refers to the abrupt onset of three or more loose or liquid stools per day. It is the second leading cause of death in infants worldwide. It is an endemic disease and continues to be a serious threat to children in Ethiopia. Despite being a condition that may be prevented, diarrhea can have a negative impact on a child's health. Also, studies have not been able to explore the role of socio-economic characteristics in hindering the treatment. Therefore, this study aimed to explore socio-economic factors that influence treatment of childhood diarrhea. Secondary data analysis was conducted based on the demographic and health surveys data conducted in Ethiopia. A total weighted sample of 1227 under-five children was included for this study. Mixed-effect binary logistic regression analysis was done to identify associated factors of untreated diarrhea. Adjusted Odds Ratio with 95% CI was used to declare the strength and significance of the association. Prevalence of untreated diarrhea among under five children in Ethiopia was 57.32% (95% CI 54.52-60.06%). In the mixed-effect analysis; Children aged 6-11, 12-23, and 24-35 (AOR 0.384, 95% CI 0.187-0.789), 71% (AOR 0.29, 95% CI 0.149-0.596), and 51% (AOR 0.49, 95% CI 0.238-0.995). Children from family number six and above (AOR 1.635, 95% CI 1.102-2.426). Children from middle wealth of family (AOR 1.886, 95% CI 1.170-3.3040). Children from a community with high level of uneducated (AOR 2.78, 95% CI 1.065-3.442) were significantly associated with untreated diarrhea. The prevalence of untreated diarrhea among under-five children in Ethiopia is high. Age of child, family number, household wealth, and community-level educational status were significantly associated with untreated diarrhea among under-five children in Ethiopia. Hence, increasing community educational status, boosting the economic status of the community, and family planning for the community should get due attention.


Asunto(s)
Diarrea , Lactante , Humanos , Niño , Etiopía/epidemiología , Análisis Multinivel , Factores Socioeconómicos , Diarrea/epidemiología , Demografía
18.
BMJ Open ; 13(6): e066975, 2023 06 30.
Artículo en Inglés | MEDLINE | ID: mdl-37399440

RESUMEN

OBJECTIVE: The autonomy of young women in healthcare decision-making has been reported to be lower, particularly in low-income and middle-income countries. This study was conducted to estimate the magnitude and the factors associated with autonomy in healthcare decision-making among youth in East African countries. DESIGN AND SETTING: A population-based, cross-sectional study was conducted with data from the most recent Demographic and Health Surveys conducted in 11 East African countries (Burundi, Ethiopia, Kenya, Comoros, Malawi, Mozambique, Rwanda, Tanzania, Uganda, Zambia, Zimbabwe) conducted from 2011 to 2019. PARTICIPANTS: Weighted sample of 24 135 women aged 15-24 years. PRIMARY OUTCOMES: Healthcare decision-making autonomy. METHODS: A multi-level logistic regression model was used to identify factors associated with women's autonomy in making decisions about their healthcare. Statistical significance was determined using an adjusted OR with 95% CI at a p value less than 0.05. RESULTS: Healthcare decision-making autonomy among youth in East Africa was 68.37% (95% CI 68%, 70%). In a multivariable analysis older aged youths (20-24 years) (adjusted OR (AOR)=1.27; 95% CI 1.19, 1.36), youths having an occupation (AOR=1.34; 95% CI 1.25, 1.53), having employed husband (AOR=1.12 95% CI 1.00, 1.26), exposure to media (AOR=1.18 95% CI 1.08, 1.29), rich wealth index 1.18 (AOR=1.18 95% CI 1.08, 1.29), female household head, youths having secondary and higher education, youths whose husband had secondary and higher education, and country were significant predictors of healthcare decision making autonomy. CONCLUSION: Almost one-third of young women have no autonomy in healthcare decision-making. Older youth, being educated, having an educated husband, having an occupation, having an employed husband, exposure to media, female household head, rich wealth index and country are significant predictors for being autonomous in healthcare decision-making. Public health interventions should target uneducated and unemployed youth, poor families and those without media exposure to increase autonomy in health decisions.


Asunto(s)
Toma de Decisiones , Pueblo de África Oriental , Características del Vecindario , Autonomía Personal , Determinantes Sociales de la Salud , Adolescente , Femenino , Humanos , Estudios Transversales , Atención a la Salud/estadística & datos numéricos , Pueblo de África Oriental/estadística & datos numéricos , Análisis Multinivel , Tanzanía , Características del Vecindario/estadística & datos numéricos , Determinantes Sociales de la Salud/estadística & datos numéricos , África Oriental/epidemiología , Adulto Joven
19.
PLoS One ; 18(6): e0286662, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37289786

RESUMEN

INTRODUCTION: In Ethiopia, the burden of non-breastfeeding is still high despite substantial improvements in breastfeeding. However, the determinants of non-breastfeeding were poorly understood. Therefore, the aim of this study was to identify the maternal -related factors associated with non-breastfeeding. METHODS: An in-depth analysis of data from the Ethiopian Demographic and Health Survey 2016 (EDHS 2016) was used. A total weighted sample of 11,007 children was included in the analysis. Multilevel logistic regression models were fitted to identify factors associated with non-breastfeeding. A p-value < of 0.05 was used to identify factors significantly associated with non-breastfeeding. RESULTS: The prevalence of non-breastfeeding in Ethiopia was 5.28%. The odds of not breastfeeding were 1.5 times higher among women aged 35to 49 years (AOR = 1.5 CI: 1.034, 2.267) than among women aged 15to 24 years. The odds of not breastfeeding were higher among children whose mothers had BMIs of 18.5-24.9 (AOR = 1.6 CI: 1.097, 2.368) and 25-29.9 (AOR = 2.445 CI: 1.36, 4.394) than among women with BMIs of < 18.5. In addition, not breastfeeding was also significantly associated with ANC follow-up, where mothers who had 1-3 ANC follow-up had a 54% decreased odds (AOR = 0.651 CI: 0.46,0.921) compared to mothers who had no ANC follow-up. Demographically, mothers from Somalia region were five times (AOR = 5.485 CI: 1.654, 18.183) and mothers from SNNP region were almost four times (AOR = 3.997 CI: 1.352, 11.809) more likely to not breastfeed than mothers residing in Addis Ababa. CONCLUSIONS: Although breastfeeding practices are gradually improving in Ethiopia, the number of children not breastfed remains high. Individual-level characteristics (women's age, body mass index, and ANC follow-up) and community-level characteristics (geographic region) were statistically significant determinants of non-breastfeeding. Therefore, it is good for the federal minister of Health, planners, policy and decision- makers, and other concerned child health programmers to prioritize both individual and community factors.


Asunto(s)
Lactancia Materna , Madres , Niño , Femenino , Humanos , Etiopía/epidemiología , Análisis Multinivel , Modelos Logísticos
20.
PLoS One ; 18(4): e0284781, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37098031

RESUMEN

INTRODUCTION: Infant mortality declined globally in the last three decades. However, it is still a major public health concern in Ethiopia. The burden of infant mortality varies geographically with the highest rate in Sub-Saharan Africa. Although different kinds of literature are available regarding infant mortality in Ethiopia, an up to date information is needed to design strategies against the problem. Thus, this study aimed to determine the prevalence, show the spatial variations and identify determinants of infant mortality in Ethiopia. METHODS: The prevalence, spatial distribution, and predictors of infant mortality among 5,687 weighted live births were investigated using secondary data from the Ethiopian Demographic and Health Survey 2019. Spatial autocorrelation analysis was used to determine the spatial dependency of infant mortality. The spatial clustering of infant mortality was studied using hotspot analyses. In an unsampled area, ordinary interpolation was employed to forecast infant mortality. A mixed multilevel logistic regression model was used to find determinants of infant mortality. Variables with a p-value less than 0.05 were judged statistically significant and adjusted odds ratios with 95 percent confidence intervals were calculated. RESULT: The prevalence of infant mortality in Ethiopia was 44.5 infant deaths per 1000 live births with significant spatial variations across the country. The highest rate of infant mortality was observed in Eastern, Northwestern, and Southwestern parts of Ethiopia. Maternal age between 15&19 (adjusted odds ratio (AOR) = 2.51, 95% Confidence Interval (CI): 1.37, 4.61) and 45&49(AOR = 5.72, 95% CI: 2.81, 11.67), having no antenatal care follow-up (AOR = 1.71, 95% CI: 1.05, 2.79) and Somali region (AOR = 2.78, 95% CI: 1.05, 7.36) were significantly associated with infant mortality in Ethiopia. CONCLUSION: In Ethiopia, infant mortality was higher than the worldwide objective with significant spatial variations. As a result, policy measures and strategies aimed at lowering infant mortality should be devised and strengthened in clustered areas of the country. Special attention should be also given to infants born to mothers in the age groups of 15-19 and 45-49, infants of mothers with no antenatal care checkups, and infants born to mothers living in the Somali region.


Asunto(s)
Mortalidad Infantil , Madres , Femenino , Lactante , Humanos , Adolescente , Etiopía/epidemiología , Prevalencia , Encuestas Epidemiológicas , Análisis Espacial , Análisis Multinivel
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