Prevalence of G6PD deficiency and distribution of its genetic variants among malaria-suspected patients visiting Metehara health centre, Eastern Ethiopia.

BACKGROUND: Glucose-6-phosphate dehydrogenase (G6PD) is cytosolic enzyme, which has a vital role for the integrity and functioning of red blood cells. Lower activity of this enzyme leads to the occurrence of acute haemolytic anaemia after exposure to oxidative stressors like primaquine. Primaquine is an important drug for the radical cure of Plasmodium vivax and blocking transmission of Plasmodium falciparum, and thereby enhancing malaria elimination. However, there is a need to identify G6PD deficient individuals and administer the drug with caution due to its haemolytic side effects. The main objective of this study is to determine the prevalence of G6PD deficiency among malaria-suspected individuals. METHODS: A facility-based cross-sectional study was conducted from September 2020 to September 2021 in Metehara Health Centre, Eastern Ethiopia. A structured questionnaire was used to collect the socio-demographic and clinical information of the study participants. Capillary and venous blood samples were collected based on standard procedures for onsite screening, dried blood spot preparation, and malaria microscopy. The G6PD enzyme activity was measured by careSTART™ G6PD biosensor analyzer. Data was entered and analysed by SPSS. RESULTS: A total of 498 study participants were included in the study, of which 62% (309) were males. The overall prevalence of G6PD deficiency based on the biosensor screening was 3.6% (18/498), of which 2.9% and 4.8% were males and females, respectively. Eleven of the G6PD deficient samples had mutations confirmed by G6PD gene sequencing analysis. Mutations were detected in G267 + 119C/T, A376T, and ChrX:154535443. A significant association was found in sex and history of previous malaria infection with G6PD deficiency. CONCLUSIONS: The study showed that the G6PD deficient phenotype exists in Metehara even if the prevalence is not very high. G267 + 119C/T mutation is the predominant G6PD variant in this area. Therefore, malaria patient treatment using primaquine should be monitored closely for any adverse effects.

Geographical variation and determinants of women unemployment status in Ethiopia; A multilevel and spatial analysis from 2016 Ethiopia Demographic and Health Survey data.

BACKGROUND: Unemployment is a major problem in both developed and developing countries. In Ethiopia, women unemployment is particularly high, and this makes it a grave socio-economic concern. The aim of this study is to assess the spatial distribution and identify the determinant factors of women unemployment in Ethiopia. METHODS: The data used for the study is the Ethiopian Demographic and Health Surveys of 2016. A total of 15683 women are involved in the study. Global Moran's I statistic and Poisson-based purely spatial scan statistics are employed to explore spatial patterns and detect spatial clusters of women unemployment, respectively. To identify factors associated with women unemployment, multilevel logistic regression model is used. RESULTS: A spatial analysis showed that there was a major spatial difference in women unemployment in Ethiopia with Global Moran's index value of 0.3 (p<0.001). The spatial distribution of women's unemployment varied significantly across the country. The major areas of unemployment were Afar and Somalia; southwest Tigray; North and west Oromia, and Eastern and southern parts of Amhara. Women with primary level of education(AOR = 0.88, 95%CI: 0.80, 0.98), secondary and above level of education (AOR = 0.71, 95%CI: 0.62, 0.82), women with rich wealth index (AOR = 0.79, 95% CI: 0.70, 0.90), pregnant women (AOR = 1.24, 95% CI: 1.06, 1.5), women with a male household head(AOR = 1.4, 95% CI: 1.28, 1.50), and urban women(AOR = 0.60, 95% CI: 0.50, 0.70) statistically associated with women unemployment. CONCLUSION: The unemployment rate of women in Ethiopia showed variation across different clusters. Improving entrepreneurship and women's education, sharing business experiences, supporting entrepreneurs are potential tools for reducing the unemployment women. Moreover, creating community-based programs that prioritize participation of poor households and rural women as well as improving their access to mass media and the labor market is crucial.

Predictors of modern contraceptive usage among sexually active rural women in Ethiopia: A multi-level analysis.

BACKGROUND: Ethiopia is one of the Sub-Saharan Africa countries with the lowest modern contraceptive prevalence rate and the highest fertility rate. This study aimed to assess individual and community-level predictors of modern contraceptive use among sexually active rural women in Ethiopia. DATA AND METHODS: A sample of 9450 sexual active rural women aged 15-49 was extracted from the 15, 683 nationally representative samples of 2016 Ethiopian Demographic and Health Survey (EDHS). Multi-level logistic regression model was considered to identify determinant factors of modern contraceptive use among sexually active rural women in Ethiopia. RESULT: The prevalence of modern contraceptive use among respondents was 20% in rural Ethiopia. Injection (66.35%) was the most common type of modern contraceptive use. In the last full model of the multilevel analysis, individual and community-level factors accounted for 86.69% of the variation in the use of modern contraceptive methods. Secondary and above-educated women (AOR = 1.39, 95%CI: 1.06, 2.81), having 1-4 living children (AOR = 2.70, 95%CI: 2.07, 3.53), rich wealth status (AOR = 2.26, 95%CI: 1.96, 2.60), married women (AOR = 17.31, 95%CI: 10.72, 27.94), having primary educated husband (AOR = 1.45, 95%CI: 1.27, 1.67) and being working husband (AOR = 2.26, 95%CI: 1.96, 2.60) were significantly positively associated with individual-level factors of the use of modern contraceptive methods. Besides, modern contraceptive use was negatively associated with Muslim women (AOR = 0.29, 95%CI: 0.25, 0.33). Compared to the Tigray region, women living in the Afar, Somali, Harari, and Dire Dawa regions had lower use of modern contraceptive methods. Women who had access to mass media (AOR = 1.35, 95%CI: 1.16, 1.57) were more likely to use contraceptives than their counterparts. CONCLUSION: The prevalence of modern contraceptive use among rural women has very low. Both individual and community-level factors were significant predictors of modern contraceptive use. Consequently, the government and other stakeholders need to address educational opportunities; creating awareness about modern contraception and valuable counseling would increase modern contraceptive methods utilization.

Determinants of institutional delivery in Sub-Saharan Africa: findings from Demographic and Health Survey (2013-2017) from nine countries.

INTRODUCTION: Institutional delivery is a major concern for a country's long-term growth. Rapid population development, analphabetism, big families, and a wider range of urban-rural health facilities have had a negative impact on institutional services in Sub-Saharan Africa (SSA) countries. The aim of this study was to look into the factors that influence women's decision to use an institutional delivery service in SSA. METHODS: The most recent Demographic and Health Survey (DHS), which was conducted in nine countries (Senegal, Ethiopia, Malawi, Rwanda, Tanzania, Zambia, Namibia, Ghana, the Democratic Republic of Congo) was used. The service's distribution outcome (home delivery or institutional delivery) was used as an outcome predictor. Logistic regression models were used to determine the combination of delivery chances and different covariates. RESULTS: The odds ratio of the experience of institutional delivery for women living in rural areas vs urban area was 0.44 (95% confidence interval (CI) 0.41-0.48). Primary educated women were 1.98 (95% CI 1.85-2.12) times more likely to deliver in health institutes than non-educated women, and secondary and higher educated women were 3.17 (95% CI 2.88-3.50) times more likely to deliver in health centers with facilities. Women aged 35-49 years were 1.17 (95% CI 1.05-1.29) times more likely than women aged under 24 years to give birth in health centers. The number of ANC visits: women who visited four or more times were 2.98 (95% CI 2.77-3.22) times, while women who visited three or less times were twice (OR = 2.03; 95% CI 1.88-2.18) more likely to deliver in health institutes. Distance from home to health facility were 1.18 (95% CI 1.11-1.25) times; media exposure had 1.28 (95% CI 1.20-1.36) times more likely than non-media-exposed women to delivery in health institutions. CONCLUSIONS: Women over 24, primary education at least, urban residents, fewer children, never married (living alone), higher number of prenatal care visits, higher economic level, have a possibility of mass-media exposure and live with educated husbands are more likely to provide health care in institutions. Additionally, the distance from home to a health facility is not observed widely as a problem in the preference of place of child delivery. Therefore, due attention needs to be given to address the challenges related to narrowing the gap of urban-rural health facilities, educational level of women improvement, increasing the number of health facilities, and create awareness on the advantage of visiting and giving birth in health facilities.

Determinants of full childhood immunization among children aged 12-23 months in sub-Saharan Africa: a multilevel analysis using Demographic and Health Survey Data.

BACKGROUND: Sub-Saharan Africa is one of the highest under-five mortality and low childhood immunization region in the world. Children in Sub-Saharan Africa are 15 times more likely to die than children from high-income countries. In sub-Saharan Africa, more than half of under-five deaths are preventable through immunization. Therefore, this study aimed to identify the determinant factors of full childhood immunization among children aged 12-23 months in sub-Saharan Africa. METHODS: Data for the study was drawn from the Demographic and Health Survey of nine sub-Saharan African countries. A total of 21,448 children were included. The two-level mixed-effects logistic regression model was used to identify the individual and community-level factors associated with full childhood immunization RESULT: The prevalence of full childhood immunization coverage in sub-Saharan Africa countries was 59.40% (95% CI: 58.70, 60.02). The multilevel logistic regression model revealed that secondary and above maternal education (AOR = 1.38; 95% CI: 1.25, 1.53), health facility delivery (AOR = 1.51; 95% CI: 1.41, 1.63), fathers secondary education and above (AOR = 1.28, 95% CI: 1.11, 1.48), four and above ANC visits (AOR = 2.01; 95% CI: 1.17, 2.30), PNC visit(AOR = 1.55; 95% CI: 1.46, 1.65), rich wealth index (AOR = 1.26; 95% CI: 1.18, 1.40), media exposure (AOR = 1.11; 95% CI: 1.04, 1.18), and distance to health facility is not a big problem (AOR = 1.42; 95% CI: 1.28, 1.47) were significantly associated with full childhood immunization. CONCLUSION: The full childhood immunization coverage in sub-Saharan Africa was poor with high inequalities. There is a significant variation between SSA countries in full childhood immunization. Therefore, public health programs targeting uneducated mothers and fathers, rural mothers, poor households, and those who have not used maternal health care services to promote full childhood immunization to improve child health. By enhancing institutional delivery, antenatal care visits and maternal tetanus immunization, the government and other stakeholders should work properly to increase child immunization coverage. Furthermore, policies and programs aimed at addressing cluster variations in childhood immunization need to be formulated and their implementation must be strongly pursued.

Determinants of water source use, quality of water, sanitation and hygiene perceptions among urban households in North-West Ethiopia: A cross-sectional study.

BACKGROUND: Clean water is an essential part of human healthy life and wellbeing. More recently, rapid population growth, high illiteracy rate, lack of sustainable development, and climate change; faces a global challenge in developing countries. The discontinuity of drinking water supply forces households either to use unsafe water storage materials or to use water from unsafe sources. The present study aimed to identify the determinants of water source types, use, quality of water, and sanitation perception of physical parameters among urban households in North-West Ethiopia. METHODS: A community-based cross-sectional study was conducted among households from February to March 2019. An interview-based a pre-tested and structured questionnaire was used to collect the data. Data collection samples were selected randomly and proportional to each of the kebeles' households. MS Excel and R Version 3.6.2 were used to enter and analyze the data; respectively. Descriptive statistics using frequencies and percentages were used to explain the sample data concerning the predictor variable. Both bivariate and multivariate logistic regressions were used to assess the association between independent and response variables. RESULTS: Four hundred eighteen (418) households have participated. Based on the study undertaken,78.95% of households used improved and 21.05% of households used unimproved drinking water sources. Households drinking water sources were significantly associated with the age of the participant (x2 = 20.392, df = 3), educational status (x2 = 19.358, df = 4), source of income (x2 = 21.777, df = 3), monthly income (x2 = 13.322, df = 3), availability of additional facilities (x2 = 98.144, df = 7), cleanness status (x2 = 42.979, df = 4), scarcity of water (x2 = 5.1388, df = 1) and family size (x2 = 9.934, df = 2). The logistic regression analysis also indicated that those factors are significantly determining the water source types used by the households. Factors such as availability of toilet facility, household member type, and sex of the head of the household were not significantly associated with drinking water sources. CONCLUSION: The uses of drinking water from improved sources were determined by different demographic, socio-economic, sanitation, and hygiene-related factors. Therefore; the local, regional, and national governments and other supporting organizations shall improve the accessibility and adequacy of drinking water from improved sources in the area.