Epidemiology of pre-cancerous cervical lesion and risk factors among adult women in Tigray, Ethiopia.

BACKGROUND: Cervical cancer is a preventable disease if treated early, but remains the second leading cause of cancer-related mortality among women in low and middle-income countries. Data on epidemiology and risk factors in these settings are scarce. This study aimed to assess the prevalence of pre-cancerous cervical lesions and risk factors in Tigray region, Ethiopia. METHODS: A community-based, cross-sectional study was used and 900 participants were 30 recruited using multistage sampling and finally data from 883 were collected using an interviewer administered questionnaire and screening with visual inspection with ascetic acid. Data were collected using an interviewer administered questionnaire and screening with visual inspection with acetic acid from March 2016 to June 2017. Multinomial logistic regression analysis was conducted to estimate predictors. RESULTS: Seventy-nine (8.95%) women were positive for pre-cancer lesion and 35 (3.96%) were suspicious for cervical cancer. We used relative risk ratio (rrr) to estimate the strength of association. Divorced or widowed women had 2.5 and 4.7 times more risk of being positive and suspicious respectively, compared to single women (rrr = 2.5, 95% CI [1.13, 5.52]); (rrr = 4.69, 95% CI [1.00, 21.84]). The risk of having a suspicious result was 68% lower for women with primary education compared to those with no formal education (rrr = 0.32, 95% CI [1.00, 21.84]). History of sexually transmitted infection was associated with positive pre cancer lesion (rrr = 1.91, 95% CI [1.11, 3.27]) whereas, being farmer (rrr = 4.83, 95% CI [1.44, 16.13]), merchant (rrr = 4.85, 95% CI [1.52, 15.46]), bleeding between periods (rrr = 3.26, 95% CI [1.32, 8.04]) and pelvic or back pain (rrr = 2.79, 95% CI [1.18, 6.58]) were associated with suspicious for cancer. CONCLUSION: About 8.9% and 3.96% of the women were positive for pre-cancerous cervical lesion and suspicious for cancer, respectively. The prevalence of pre-cancerous cervical lesion is high as compared to other regional prevalence in the country. Marital status, education, sexually transmitted infection, bleeding, and pelvic pain were risk factors of pre-cancerous cervical lesion'. This finding implies that the sexual exposure, having no permanent husband and being not educated attributes to the high prevalence of pre-cancerous cervical lesion and may aggravate the transmission of HPV."

Coverage, social mobilization and challenges of mass Zithromax administration campaign in South and South East zones of Tigray, Northern Ethiopia: A cross sectional study.

BACKGROUND: The antibiotic treatment of people with trachoma helps to prevent transmission the disease in a community. Currently, Zithromax is the drug recommended for mass drug administration (MDA). MDA should be carried out annually for three to five years in trachoma endemic areas. Coverage survey is essential to track progress towards program goals and to identify communities with poor coverage in order to permit timely and appropriate actions. We assessed mass Zithromax administration coverage, social mobilization and campaign challenges in south and southeast zones of Tigray, Ethiopia. METHOD: We conducted a survey in community in Southern and South East zones of Tigray region from August 15 to August 31, 2016. The survey included nine Woredas. It was supported by qualitative methods. A total of 3741 individuals were enrolled from 933 households using multistage sampling. We used structured questionnaire. In-depth interview and focus group discussion were also applied. Descriptive statistics was performed using SPSS version 20.We thematically analyzed the qualitative data using Atlas 7. RESULT: The overall coverage of Zithromax MDA was 93.3%. It ranges from 90.0% in Seharti Samre to 97.9% in Endamokoni. The coverage was 93.4% for males and 93.1% for females. A higher proportion (98.3%) of children aged 5 to 15 years and 409 (87.8%) under five children took Zithromax. The coverage was 94% in rural and 91.2% in urban. Women development army (43.3%) and health extension workers (32.5%) were the main source of information. Frequent occurrence of drug side effects, rumors, lack of community and leaders' engagement in the campaign, fasting, shortage of human power and short term unavailability of supplies were barriers during the campaign. CONCLUSION: The Zithromax MDA coverage in the study zones was higher than the minimum WHO set criteria of 80%. There was a wide difference in coverage among Woredas and Kebeles. The MDA coverage was lower in urban than rural. Misconceptions and poor mobilization were common challenges. Thus, proper planning, community mobilization and uniform training will need to be done ahead of the campaign in the future.

Desire for birth spacing or limiting and non-use of long acting and permanent contraceptive methods among married women of reproductive age in Aksum Town, North Ethiopia.

BACKGROUND: Long acting and permanent contraceptive methods are the most effective family planning (FP) methods to prevent pregnancy and thereby averting adverse consequences of too many and ill-timed pregnancies. However, long acting and permanent contraceptive methods (LAPMs) are underutilized in Ethiopia for little documented reasons. Therefore, this study is aimed to assess magnitude and factors associated with desire for birth spacing for at least 2 years or limiting child bearing and non-use of LAPMs among married women of reproductive age in Aksum town, Northern Ethiopia. METHODS: A community-based cross-sectional study was conducted in Aksum town, North Ethiopia from May to June, 2015 among 779 randomly selected married women of reproductive age. Data were collected using interviewer administered pre-tested questionnaire. Data were entered using Epi-Info version 6.04 and exported to SPSS version 16 for analysis. Multivariate logistic regression models were fitted to identify factors associated with desire for birth spacing or limiting and not using LAPMs. RESULTS: The total desire for birth spacing or limiting was 69 % and amongst those women 85.2 % were not using LAPM. Education, occupation, husband's attitude towards LAPMs, age, number of pregnancy, regular media exposure and decider on the number of children to bear were significantly associated with desire for birth spacing or limiting. Moreover; education, occupation, husband's attitude towards LAPMs, discussion on family planning with husband, knowledge, attitude and intention to use LAPMs were significantly associated with not using LAPMs. CONCLUSION: Desire for birth spacing or limiting and not using LAPMs is very high in the study area. Therefore, increasing access to family planning information and services with special emphasis on LAPMs and male involvement in the program are very important.