Factors Associated with Gender-Based Violence Perpetration by Male High School Students in Eastern Ethiopia.

Gender-based violence (GBV) perpetration is a severe problem among youths in schools and the community at large. As most studies focused on adults, this study aimed to investigate factors associated with GBV by male high school students in eastern Ethiopia. An institutional based cross-sectional survey was conducted with 1,109 male students aged 15-24 years in eastern Ethiopia in December 2018 using self-administered WHO Multi-Country Study on Women's Health and Life Events and UN Multi-Country study on perpetration. Poisson regression model was used to determine the prevalence ratio. Multivariable analysis showed that having girlfriend, chewing khat, drinking alcohol, watching pornography and being sexually active increased the prevalence of perpetrating any type of GBV (emotional, physical, sexual, and overall GBV) by young male in the last 12 months. Compared to those who did not smoke tobacco, smokers had an prevalence of perpetrating emotional violence (adj. PrR = 1.22, 95% CI = 1.03-1.44) and any type of GBV (adj. PrR = 1.15, 95% CI = 1.00-1.31). Young males who had a mother who had completed Grade 9-12 (adj. PrR = 0.75, 95% CI = 0.59-0.96) had a 25% lower prevalence of perpetrating emotional violence compared to male students who had an illiterate mother. Young males who had used illicit drugs, smoked shisha (adj. PrR = 1.39, 95% CI = 1.10-1.77), and were married (adj. PrR = 1.89, 95% CI = 1.15-3.12) had a higher prevalence of perpetrating sexual violence compared to young males who hadn't used smoked shisha and were not married, respectively. Young males who had discussed reproductive health with their family (adj. PrR = 1.13, 95% CI = 1.03-1.24) and who chewed khat (adj. PrR = 1.26, 95% CI = 1.02-1.55) had a higher prevalence of perpetrating any GBV compared to young men who hadn't discussed reproductive health with their parents and who hadn't chewed khat, respectively. Any type of GBV (emotional, sexual, or physical violence) was significantly associated with several individual and relationship factors. Effective prevention and intervention programs should be focused on education of the influence of pornography, prevention of substance use and interventions for those in romantic relationships could all assist in reducing GBV.

Current Substances Use Among Students in Ethiopia: A Systematic Review and Meta-Analysis of 20-Years Evidence.

BACKGROUND: The use of psychoactive substances is one of the main public health issues worldwide. However, there is a lack of evidence on the magnitude of current substance use among students in Ethiopia. Therefore, this study aimed to provide comprehensive views of the current prevalence of substance use among students in Ethiopia. METHODS: We searched PubMed/Medline, Health InterNetwork Access to Research Initiative (HINARI), Google Scholar, and gray literature sources between 2000 and 2019. The prevalence of current substances with a 95% confidence interval (CI) was estimated using the random-effects model. The results were presented using forest plots, and Cochrane Q-test and I 2 were used to measure the extents of between-study variations. RESULTS: A total of 1543 study articles were identified from electronic databases, and 32 cross-sectional studies were included in the meta-analysis. The prevalence of current use of at least 1 substance was 37.63% (95% CI: 33.66, 41.69), alcohol 27.61% (95% CI: 22.10, 33.48), khat 17.20% (95% CI: 14.03, 20.62), and smoking 9.74% (95% CI: 7.17, 12.64). The prevalence of any substance use in high school students versus university/college students was 41.55% (95% CI: 38.83, 44.29) versus 36.24% (95% CI: 32.37, 40.20), alcohol 24.21% (95% CI: 14.05, 36.11) versus 25.27% (95% CI: 19.76, 31.20), khat 13.82% (95% CI: 8.61, 20.02) versus 17.30% (95% CI:13.75, 21.16), and cigarette 8.30% (95% CI: 1.89, 18.60) versus 9.80% (95% CI: 7.32, 12.58). Meta-regression analysis revealed publication year, sample size, female proportion, and age were not significantly associated with the current use of substances. CONCLUSION: Overall, the current substance use of any substance, alcohol, chewing khat, and smoking cigarettes was relatively high. A significant proportion of high school students were already using substances at an early age. Policymakers should formulate and implement regulations to control the pervasive use of substances by young people around educational institutions at all levels. PROTOCOL REGISTRATION: The protocol has been registered on 19 August 2019 on the International Prospective Register of Systematic Reviews (PROSPERO) with ID: CDR42019130560.

Gender-Based Violence Among Female Senior Secondary School Students in Eastern Ethiopia.

Gender-based violence (GBV) is a major global public health issue due to its short- and long-term adverse effects on women's health. Little is known about the factors associated with physical and emotional violence among female school students in Ethiopia. We determined the magnitude and risk factors of emotional violence, physical violence, sexual violence, and any form of GBV among 1,199 female school students in eastern Ethiopia using the facilitated self-administered questionnaires. The prevalence of any form of GBV in the past 12 months was 53.04% (95% CI: 50.22-55.87). Around 52% (95% CI: 47.61-55.54) of respondents indicated they had experienced all three forms of GBV. The prevalence of emotional violence in the past 12 months was 43.04% (95% CI: 40.22-45.84), physical violence was 43.79% (95% CI: 40.94-46.59), and sexual violence was 31.44% (95% CI: 28.81-34.07). Having a boyfriend, being married, not receiving enough pocket money from family, witnessing violence as a child, using alcohol, being sexually active, and discussing reproductive health with family increased the risk of any form of GBV in the past 12 months. This suggests that early intervention and support to mitigate the long-term adverse impacts of GBV are needed.

Prevalent, uncontrolled, and undiagnosed diabetes mellitus among urban adults in Dire Dawa, Eastern Ethiopia: A population-based cross-sectional study.

OBJECTIVE: Globally, 8.8% of adults were estimated to have diabetes mellitus, with the low-and middle-income countries sharing the largest burden. However, the research evidence for targeted interventions is lacking in sub-Saharan Africa, particularly in Ethiopia. Therefore, this study aimed to assess the prevalence of diabetes mellitus, disaggregated by the epidemiology of diabetes mellitus morbidity and associated factors among adults in Dire Dawa town, Eastern Ethiopia. METHODS: Data from a total of 872 randomly sampled adults aged 25-64 years were obtained for analysis using the World Health Organization STEPwise approach to non-communicable disease risk factors surveillance instruments. We estimated the prevalence of diabetes mellitus disaggregated by the previous diabetes mellitus diagnosis status and by the current blood sugar level control status. The bivariable and multivariable binary logistic regression model was used to identify correlates of diabetes mellitus, along with STATA version 14.2 for data management and analysis. All statistical tests were declared significant at p-value < 0.05. RESULTS: 14.9% (95% confidence interval: 12.1, 17.4) of adults aged 25-64 years had diabetes mellitus in the study sample with 58.5% (95% confidence interval: 49.7, 66.7) on diabetes mellitus medication. Among adults currently taking diabetes mellitus medications, 30.3% (95% confidence interval: 19.8, 45.6) had uncontrolled diabetes mellitus. The magnitude of previously undiagnosed diabetes mellitus was 6.2% (95% confidence interval: 4.8, 8.0) in the study sample and 41.5% (95% confidence interval: 33.3, 50.3) among the diabetics. The odds of diabetes mellitus were higher among adults over the age of 55 years (adjusted odds ratio = 2.1, 95% confidence interval: 1.2, 3.6), currently married adults (adjusted odds ratio = 2.3, 95% confidence interval: 1.2, 4.4), and overweight adults (adjusted odds ratio = 1.6, 95% confidence interval: 1.1, 2.1). Adults with primary education (adjusted odds ratio = 0.4, 95% confidence interval: 0.2, 0.8) and no formal education (adjusted odds ratio = 0.5, 95% confidence interval: 0.2, 0.9) had lower odds of diabetes mellitus. CONCLUSION: The prevalence of diabetes mellitus among adults was high in Dire Dawa, with a third of the diabetics having poor control of their blood sugar levels and, nearly four in ten were previously undiagnosed. Adults who were overweight, currently married, and those over 55 years need to be targeted for regular diabetes health checkups and community-based screening. Also, a mechanism should be instituted to track a patient's adherence to medications and promote diabetes self-care management.

Gender-Based Violence Perpetration by Male High School Students in Eastern Ethiopia.

Gender-based violence (GBV) perpetration is a global public health problem due to its detrimental effect on health and education. This study aims to determine the prevalence of gender-based violence perpetration by male students in eastern Ethiopia. A cross-sectional study was conducted in eastern Ethiopia in December 2018. A total of 1064 male students were involved in the study. Data were collected using an adaptation of the WHO Multi-Country Study self-administered questionnaire on the Women Health and Life Event. Descriptive statistics were calculated using STATA version 14. The prevalence of gender-based violence committed by a male in the last 12 months was 55.83% (95% CI: 52.84-58.82%). The prevalence of emotional abuse against an intimate or non-partner was 45.86% (95% CI: 42.87-48.86%), physical abuse was 45.77% (95% CI: 42.77-48.77%), and sexual abuse was 31.11% (95% CI: 28.32-33.90%). The perpetration of multiple types of gender-based violence (emotional, physical, and sexual) was 47.15% (95% CI: 43.15-51.25%), with 17.72% (95% CI: 14.75-21.03%) reporting emotionally and physically violent acts, 14.21% (95% CI: 11.51-17.27%) reporting emotionally violent acts only, and 12.88% (95% CI: 10.29-15.82%) reporting physically violent acts only. There were statistically significant differences between the age of participants who committed acts of all forms of GBV in the "ever" timeframe and the past 12 months (p < 0.001). Effective prevention and intervention strategies should be developed at the school level to reduce gender-based violence perpetration.

Clustering of Elevated Blood Pressure, Elevated Blood Glucose, and Abdominal Obesity Among Adults in Dire Dawa: A Community-Based Cross-Sectional Study.

BACKGROUND: Evidence shows that the presence of a single component of the metabolic syndrome (MetS) increases the risk of developing the MetS later in life. This study estimated the prevalence and associated factors of abdominal obesity, elevated blood pressure, elevated blood glucose, and the 3-factor MetS components among urban adults in Dire Dawa, East Ethiopia. METHODS: Community-based cross-sectional data were collected from 872 adults aged 25-64 years. The joint interim statement (JIS) was used to define the MetS components. The dependent outcome variables were both the individual and the 3-factor MetS components. A robust variance Poisson regression model was used to directly estimate the prevalence ratio (PR) of risk factors. RESULTS: The prevalence of the 3-factor MetS components (abdominal obesity, elevated blood pressure, and elevated blood glucose) was 9.5% (95% CI: 7.7, 11.7). Women had two times higher prevalence of the 3-factor MetS components compared with men, 11.6% (95% CI: 9.2, 14.5) vs 5.2% (95% CI: 3.2, 8.5). A higher prevalence of abdominal obesity, 46.4% (95% CI: 43.1, 49.8), followed by a raised blood pressure, 42.7% (95% CI: 39.4, 46.0), was observed among study subjects. The presence of a single MetS component had an associated cluster of other components: 33.7% of subjects with elevated blood glucose, 22.3% with elevated blood pressure, and 20.5% with abdominal obesity had also the 3-factor MetS components. Age, sex, body mass index, waist circumference, and physical activity were significantly associated with the individual components or the 3-factor MetS components. CONCLUSION: A higher prevalence of the individual components and the presence of clustering with a single factor identified call for the need of community screening. Interventions targeting both abdominal and general obesity through physical activity and lifestyle modification can contribute towards reducing cardiometabolic risk factors with due attention given to women and older adults.

Prevalence of lifetime substances use among students in Ethiopia: a systematic review and meta-analysis.

BACKGROUND: The use of substances is a growing concern in Ethiopia, and their impacts on younger generation have been a concern of different professionals. Even though students are at high-risk of substance abuse, there is lack of comprehensive evidence for policy decision on substance use among students. Therefore, the aim of this systematic review and meta-analysis was to estimate the prevalence of common substances among students in Ethiopia. METHOD: A comprehensive literature searches were done from biomedical databases: PubMed/Medline, African Journal Online, HINARI, Science Direct, and Google Scholar for article published until Dcember 31, 2017, and Addis Ababa Uiversity's electronic library search of unpublished thesis and dissertations. Two authors autonomously selected studies, extracted data, and evaluated quality of studies. The prevalence of lifetime substances use was estimated using the random effects model. Q and I2 statistics were computed to measure the extents of heterogeneity. RESULTS: A total 676 study articles were identified from electronic databases, and 28 of them were included in meta-analysis. The analysis revealed that the lifetime prevalence of any substance use was 52.5% (95% CI 42.4-62.4%), khat 24.7% (95% CI 21.8-27.7%), alcohol 46.2% (95% CI 40.3-52.2%), and smoking cigarette 14.7% (95% CI 11.3-18.5%). Significant heterogeneity was observed but there was no significant publication bias. The lifetime prevalence of khat, alcohol, and cigarette smoking among high school vs university students was 22.5% (95% CI 15.2-30.7%) vs 25.1% (95% CI 21.9-28.5%), 41.4% (95% CI 22.1-62.1%) vs 47.8% (95% CI 39.9-55.7%), and 21.5% (95% CI 12.6-32.1%) vs 12.9% (95% CI 10.1-16.0%), respectively. CONCLUSION: This meta-analysis highlighted the extent of lifetime prevalence of any substance, khat, alcohol, and cigarettes smoking among students in Ethiopia. Significant percent of high school students have exposed to substances. Policy makers should devise and implement strictly binding regulation to curb widespread of substances around educational institution premises at national level. Priority should be given to intervention strategies that help delay first use of substance to prevent problems later in life. Besides, the problem warrants regular national-level educational institutions based studies focusing on the magnitude, trajectory, and consequences of substance use among students. Systematic review registration: PROSPERO CRD42018082635.

Level of physical activity among urban adults and the socio-demographic correlates: a population-based cross-sectional study using the global physical activity questionnaire.

BACKGROUND: Globally, in 2016, 23.3% of adult populations were physically inactive, and it accounts for 9% of the global premature mortality. However, evidence on the level of physical activity was limited in resource-poor settings. This study, therefore, assessed the adult's level of physical activity and its correlates among the urban population in Dire Dawa, eastern Ethiopia. METHODS: A total of 872 randomly selected adults of age 25-64 years in Dire Dawa city, eastern Ethiopia, are included in this analysis. The Global Physical Activity Questionnaire (GPAQ) is used to measure physical activity. Individuals are considered physically active when they achieved metabolic equivalent tasks (MET) minutes of 600 or more per week, and otherwise inactive. A binary logistic regression is used to identify the correlates of physical activity. RESULTS: 54.9% (95% confidence interval (CI) 51.6 to 58.2) of adults were physically active, with a higher proportion of men being physically active than women, 63.9% (95% CI 58.1 to 69.3) versus 50.6% (95% CI 46.5 to 54.6). Among the adults who reported doing physical activity, the highest domain-specific contribution to the total physical activity was from activities at workplaces, and leisure-time activities contributed the least. The proportion of adults who engaged in a high-level physical activity was 37.0% (95% CI 33.9 to 40.3). Male adults were 1.45 times (aOR (adjusted odds ratio) =1.45; 95% CI 1.05 to 1.99) more likely to achieve the recommended level of physical activity. In contrary, unemployed adults (aOR = 0.51; 95% CI 0.35 to 0.75) were less likely to perform the recommended level of physical activity to accrue health benefits. CONCLUSION: Interventions aimed at promoting physical activity should target unemployed and female adults. We recommend further study to explore the contextual factors that hinder physical activity in the study setting.

Prevalence of Hypertension and Associated Factors in Dire Dawa City, Eastern Ethiopia: A Community-Based Cross-Sectional Study.

BACKGROUND: Hypertension is a major cardiovascular risk factor that is linked with fatal complications and is an overwhelming global challenge. Primary prevention is a key to control hypertension with identification of major risk factors. This study was aimed at assessing the prevalence and factors associated with hypertension. METHODS: Community-based cross-sectional study was conducted among 903 adults aged 25 to 64 years in Dire Dawa City, East Ethiopia. Data were collected using World Health Organization (WHO) STEPwise approach to Surveillance (STEPS) for non-communicable disease (NCD) standard survey tool. Multivariate logistic regression models were used to identify relative effects of distal, proximal, and immediate risk factors of hypertension, and all statistical tests were declared significantly at P-value<0.05. RESULTS: The average SBP and DBP were 124.98±17.18 mmHg and 78.92±10.13 mmHg, respectively. The prevalence of hypertension was 24.43% (95% CI: 21.57, 27.28). Majority (51.64%) of adults were not aware of their elevated blood pressure status. hypertension was significantly associated with the age group 30-44 (aOR 3.61, 95% CI: 2.0, 6.55), 45-54 (aOR 5.36, 95% CI: 2.62, 10.91), and 55-64 (aOR 9.38, 95% CI: 4.73, 18.59), being unemployed (aOR 1.68, 95%CI: 1.03, 2.77), ever smoking (aOR 1.89, 95% CI: 1.04, 2.23), having abdominal obesity (aOR 1.72, 95% CI: 1.13, 2.64), and BMI≥25 kg/m2 (aOR 1.48, 95%CI: 1.01, 2.15). CONCLUSION: Moderately high prevalence of hypertension was observed among adults in study setting demonstrating a major public health problem. Majority of adults with hypertension in study setting were not aware of their elevated BP status highlighting the burden of the hidden morbidity and subsequent complications. Community level intervention and routine assessment of sociodemographic, behavioral, and biophysiological risk factors, screening, and diagnosis of NCDs should be institutionalized to address the occult burden.

Gender-based violence among female youths in educational institutions of Sub-Saharan Africa: a systematic review and meta-analysis.

BACKGROUND: Gender-based violence is a public health issue. The prevalence of gender-based violence is high in Sub-Saharan Africa. Therefore, this study aims to produce an overall summary estimate on the prevalence of gender-based violence according to different types and its risk factors among female youths in educational institutions of Sub-Saharan Africa. METHODS: Studies published in English between 2000 and 2017 were identified by searching electronic databases such as MEDLINE, CINAHL, EMBASE, PsychINFO, and other relevant data bases. Three reviewers independently extracted the data and assessed the quality of studies using the Loney guidelines. The pooled prevalence of gender-based violence and type of GBV was computed using STATA software version 14, and between studies heterogeneity was tested using Cochran's Q test and I2 statistics. Meta-regression analyses were done to identify factors associated with GBV estimates. RESULTS: A total of 1377 articles were produced from different databases, and a final 24 articles were included in the review. The overall prevalence of gender-based violence ranged from 42.3% in Nigeria to 67.7% in Ethiopia. The lifetime prevalence of sexual violence ranged from 4.3 to 76.4%, physical violence ranged from 7.4 to 66.1%, and emotional violence prevalence ranged from 26.1 to 50.8%. The overall pooled prevalence of lifetime GBV (n = 7 studies) was 52.83% [95% CI 39.54-65.90%, I2 = 99.1, P < 0.00]. The pooled estimate of sexual violence (n = 23), 26.22% [95% CI 19.48-33.57%, I2 = 99.39, P < 0.00], physical violence (n = 9), 18.86% [95% CI 10.96-28.3%, I2 = 98.98, P < 0.00], and emotional violence (n = 5), 27.06% [95% CI19.57-35.28%], I2 = 97.1, P < 0.00]. The review showed that gender-based violence was significantly associated with place of residence, witnessing parental violence, substance abuse, marital status, and educational status. CONCLUSIONS: The overall prevalence of overall gender-based violence, sexual, physical, and emotional violence was high in Sub-Saharan Africa. The lowest prevalence of GBV was observed in Nigeria, and it was highest in Ethiopia. However, the results should be interpreted with caution because of high between studies heterogeneity. Evidence from the review part revealed GBV was significantly associated with place of residence, witnessing parental violence, substance abuse, marital status, and educational status. The Sub-Saharan African countries should develop a comprehensive educational institution-based prevention strategy and effective interventions to mitigate gender-based violence and to specifically achieve the SDG5. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD4201073260.