Does Moringa stenopetala based diet consumption decrease burden of under nutrition in under-five children, Southern Ethiopia?

Background: Moringa stenopetala is used for medicinal and nutritional purposes. This study was, therefore, conducted to assess the contribution of Moringa stenopetala based diet in reducing under nutrition in under-five children in four districts of Southern Ethiopia. Method: A community-based comparative cross-sectional study design was employed from August to September 2016 in randomly selected comparative sites among 732 under five children. Anthropometric measurements of weight and height of children were measured based on the standard measurement protocol. Regarding moringa stenopetala diet, the consumption habit was collected by using a seven days food frequency questionnaire. Amount of moringa stenopetala leaf biomass portion size consumption was measured with local measurement and converted to kilograms. Anthropometric data were analyzed using WHO Anthro software to determine the nutritional status of the child. An independent t-test was conducted to compare the mean difference of WHO-Z score of child nutritional index. Statistical mean significance difference was measured based on p-value less than 0.05 with 95% confidence level. In addition chi-square test with a p-value, less than 0.05 with a 95% confidence level was used to compare the prevalence of stunting, wasting, and underweight in moringa stenopetala based diet and non-moringa stenopetala based diet consuming area. Result: The prevalence of stunting was 19% vs. 28.8%, wasting 4.7% vs. 9.6%, and underweight 12.19% vs 13.71% in moringa stenopetala based diet consuming and non-consuming participants respectively. There was a significant difference in stunting and wasting (p < 0.05) among moringa stenopetala based diet-consuming and non-consuming participants. Conclusion: The present study showed that moringa stenopetala based diet consumption had a significant contribution in reducing under-nutrition in under-five children.

Spatial distribution and determinants of HIV prevalence among adults in urban Ethiopia: Findings from the Ethiopia Population-based HIV Impact Assessment Survey (2017-2018).

The design and evaluation of national HIV programs often rely on aggregated national data, which may obscure localized HIV epidemics. In Ethiopia, even though the national adult HIV prevalence has decreased, little information is available about local areas and subpopulations. To inform HIV prevention efforts for specific populations, we identified geographic locations and drivers of HIV transmission. We used data from adults aged 15-64 years who participated in the Ethiopian Population-based HIV Impact Assessment survey (October 2017-April 2018). Location-related information for the survey clusters was obtained from the 2007 Ethiopia population census. Spatial autocorrelation of HIV prevalence data were analyzed via a Global Moran's I test. Geographically weighted regression analysis was used to show the relationship of covariates. The finding indicated that uncircumcised men in certain hotspot towns and divorced or widowed individuals in hotspot woredas/towns might have contributed to the average increase in HIV prevalence in the hotspot areas. Hotspot analysis findings indicated that, localized, context-specific intervention efforts tailored to at-risk populations, such as divorced or widowed women or uncircumcised men, could decrease HIV transmission and prevalence in urban Ethiopia.

Progress towards controlling the HIV epidemic in urban Ethiopia: Findings from the 2017-2018 Ethiopia population-based HIV impact assessment survey.

INTRODUCTION: In 2014, the Joint United Nations Programme on HIV/AIDS set an 'ambitious' 90-90-90 target for 2020. By 2016, there were disparities observed among countries in their progress towards the targets and some believed the targets were not achievable. In this report, we present the results of data from the Ethiopia Population-based HIV Impact Assessment survey analyzed to assess progress with the targets and associated factors. METHODS: We conducted a nationally representative survey in urban areas of Ethiopia. Socio-demographic and behavioural data were collected from consenting participants using a structured interview. HIV testing was done following the national HIV rapid testing algorithm and seropositivity confirmed using a supplemental laboratory assay. HIV viral suppression was considered if the viral load was <1,000 RNA copies/ml. Screening antiretroviral drugs was done for efavirenz, lopinavir, and tenofovir, which were in use during the survey period. In this analysis, we generated weighted descriptive statistics and used bivariate and logistic regression analysis to examine for associations. The 95% confidence interval was used to measure the precision of estimates and the significance level set at p<0.05. RESULTS: Of 19,136 eligible participants aged 15-64 years, 614 (3% [95% CI: 0.8-3.3]) were HIV-positive, of which 79.0% (95% CI: 4.7-82.7) were aware of their HIV status, and 97.1% (95% CI: 95.0-98.3 were on antiretroviral therapy, of which 87.6% (95% CI: 83.9-90.5) achieved viral load suppression. Awareness about HIV-positive status was significantly higher among females (aOR = 2.8 [95% CI: 1.38-5.51]), significantly increased with age, the odds being highest for those aged 55-64 years (aOR = 11.4 [95% CI: 2.52-51.79]) compared to those 15-24 years, and was significantly higher among those who used condom at last sex in the past 12 months (aOR = 5.1 [95% CI: 1.68-15.25]). Individuals with secondary education and above were more likely to have achieved viral suppression (aOR = 8.2 [95% CI: 1.82-37.07]) compared with those with no education. CONCLUSION: Ethiopia made encouraging progress towards the UNAIDS 90-90-90 targets. The country needs to intensify its efforts to achieve the targets. A particular focus is required to fill the gaps in knowledge of HIV-positive status to increase case identification among population groups such as males, the youth, and those with low education.

Factors associated with unawareness of HIV-positive status in urban Ethiopia: Evidence from the Ethiopia population-based HIV impact assessment 2017-2018.

BACKGROUND: The HIV epidemic in Ethiopia is concentrated in urban areas. Ethiopia conducted a Population-based HIV Impact Assessment (EPHIA) in urban areas between October 2017 and April 2018 to measure the status of the country's response to the epidemic. METHODS: We conducted field data collection and HIV testing in randomly selected households using the national, rapid testing algorithm with laboratory confirmation of seropositive samples using a supplemental assay. In addition to self-report on HIV diagnosis and treatment, all HIV-positive participants were screened for a set of HIV antiretroviral (ARV) drugs indicative of the first- and second-line regimens. We calculated weighted frequencies and 95% confidence intervals to assess regional variation in participants' level of unawareness of their HIV-positive status (adjusted for ARV status). RESULTS: We interviewed 20,170 survey participants 15-64 years of age, of which 19,136 (95%) were tested for HIV, 614 (3.2%) tested positive, and 119 (21%) of HIV-positive persons were unaware of their HIV status. Progress towards the UNAIDS first 90 target (90% of people living with HIV would be aware of their HIV status by 2020) substantially differed by administrative region of the country. In the bivariate analysis using log binomial regression, three regions (Oromia, Addis Ababa, and Harari), male gender, and young age (15-24 years) were significantly associated with awareness of HIV positive status. In multivariate analysis, the same variables were associated with awareness of HIV-positive status. CONCLUSION: One-fifth of the HIV-positive urban population were unaware of their HIV-positive status. The number of unaware HIV-positive individuals has a different distribution than the HIV prevalence. National and regional planning and monitoring activities could address this potentially substantial source of undetected HIV infection by increasing HIV testing among young people, men and individuals who do not use condoms.

Distribution and determinants of serum high-sensitivity C-reactive protein in Ethiopian population.

BACKGROUND: C-reactive protein (CRP) is an important inflammatory marker associated with different disease conditions, and its concentration differs among ethnicity. This study aimed to determine the distribution and determinants of serum high-sensitive method CRP (hsCRP) that can measure the typically low concentrations, among the Ethiopian population, for which there is no data. METHODS: A cross-sectional community-based study was conducted in April-June 2015. A total of 5162 individuals aged 15-69 were included. Behavioral, physical, and biochemical measurements were taken using the WHO STEPS non-communicable diseases (NCDs) risk factors assessment tool. Serum hsCRP was determined using Cobas Integra 400 Plus (Roche). Factors associated with hsCRP levels were also considered. RESULTS: median hsCRP was 0.80 mg/L (Interquartile range, 0.19-2.12) (males: 0.91 mg/L, females: 0.74 mg/L). More than 18% of the study participants had hsCRP greater than 3 mg/L according to the American Heart Association and Centers for Diseases Control and Preventions cut off value. Higher BMI, living in Somali and in Dire Dawa region, and not consuming of fruit or vegetables were independent risk factors for high hsCRP levels. CONCLUSION: Serum hsCRP levels distribution is comparable to other studies. Until now, no data have been reported in the literature about the Ethiopian population.

Prevalence of Hyperhomocysteinaemia and Associated Factors among Ethiopian Adult Population in a 2015 National Survey.

Hyperhomocysteinaemia (HHcy) is an independent risk factor for major cardiovascular diseases, but data on the prevalence and predictors of HHcy in low- and middle-income countries like Ethiopia are scant. The aim of this study was to estimate the prevalence of HHcy and associated risk factors in the Ethiopian adult population. A cross-sectional survey on risks of noncommunicable diseases (NCDs) using the STEPwise approach to surveillance (STEPS) survey was conducted between April and June 2015. A total of 4,175 study participants were surveyed. Serum homocysteine (Hcy) and metabolic profile were determined using Cobas Integra 400 Plus and CardioChek PA analyzer, respectively. Factors associated with HHcy were determined using logistic regression. The mean serum tHcy concentration was 14.6 µmol/L, with 16.4 µmol/L in males and 13.4 µmol/L in females. Overall, 38% had HHcy, with figures in males (49%) higher than females (30%). Increased age, being male, and high blood pressure and/or taking blood pressure medication, as well as low consumption of fruit and/or vegetables, were independent risk factors for HHcy. In conclusion, the prevalence of HHcy among the adult Ethiopian population is alarmingly high. Improving diets through the promotion of fruit and vegetable consumption is needed to reduce the risk of NCDs.

Predictors of skilled assistance seeking behavior to pregnancy complications among women at southwest Ethiopia: a cross-sectional community based study.

BACKGROUND: In Ethiopia, about 20,000 women die each year from complications of pregnancy and child birth with many more maternal morbidities occurring for each maternal deaths. This makes Ethiopia one of the highest countries for maternal deaths in the developing world. This study attempted to assess women's skilled assistance seeking behaviour for pregnancy complications among those who gave birth. METHOD: A cross-sectional community based study was conducted among women who gave birth within one year regardless of their delivery place. The study was carried out in fifteen randomly selected villages at Arba Minch Zuria district, south west Ethiopia. Data was collected house-to-house using a pretested Amharic questionnaire. During the survey, 798 women were interviewed. Logistic regression model was applied to control confounders. RESULTS: Out of the total sample, 344 (43.1 %) respondents reported at least any one of the pregnancy complications faced in the recent pregnancy. The most common complications reported were malaria (57 %), nausea/vomiting (47.1 %) and severe head ache (29.1 %). of those women who faced complications, around 254 (73.8 %) sought assistance from a skilled provider. Ninety (26.2 %) of the respondents sought assistance either from unskilled provider or home based self-care. Unable to understand the seriousness of the complications, thought as unnecessary, and family disapproval were the major reasons for not seeking care from skilled providers. Belonging to monthly household income $US25- 100 (AOR = 3.4, 95 % CI; 1.04, 11.4), getting antenatal care from a skilled provider (AOR = 10.6, 95 % CI; 3.3, 34.5), Women in the age 20-34 years old (AOR = 3.8; 95 % CI, 1.2, 12.3), Availability of transport access (AOR = 72.2; 95 % CI; 17.2, 303.5) were significantly associated with seeking assistance from a skilled provider. CONCLUSIONS: Nearly half (43.1 %) of the women had faced pregnancy complications to the recent birth of last one year. Majority (2/3(rd)) of the women who reported complications sought skilled assistance. Family, income, transport issue and antenatal care use were independent predictors for skilled assistance from skilled provider.

Predictors of sexual abstinence among Wolaita Sodo University Students, South Ethiopia.

BACKGROUND: It is over 30 years since the first case of AIDS [Acquired Immune Deficiency Syndrome] was identified. Attention has been focused recently on the promotion of the "ABCs" of HIV prevention (being abstinent or delaying sex, remaining faithful to one sexual partner, and using condoms consistently during sexual intercourse). As programs that focus on ABCs to prevent heterosexual transmission HIV are rolled out, questions of how well university students who come from varied cultural contexts actually understand the terms and address challenges to adopt behaviors is unanswered. In Ethiopia, despite the mushrooming number of students in the higher learning institutions with the current figure being 210,000 students accommodated in 33 public and 72 private higher learning institutions, sexual and reproductive health services, are not delivered in an organized way. The objective of this study is to identify factors associated with Sexual abstinence among Wolaita Sodo University students to provide evidence for designing appropriate interventions. METHODS: A Cross-Sectional study was conducted among 750 undergraduate students selected from Wolaita Sodo University using a stratified simple random sampling technique during the academic year. Data were collected using structured self administered questionnaire, focus group discussion and in depth interview guides as tools for data collection. Ethical clearance was obtained from Jimma University and informed consent was obtained from the participants after explaining purpose of study. Statistical tests were employed wherever necessary at the significance level of 0.05. RESULTS: All of the participants had heard about HIV/AIDS of which 97.3% had good knowledge. Higher proportions of male students were sexually active than their counter parts. Students with better knowledge on HIV AIDS were 6.6 (95%CI=1.6, 12.9) times more likely to abstain from sexual intercourse than their counter parts. CONCLUSIONS: Knowledge of students about risk of HIV infection is strong predictors of sexual abstinence of students which were less observed among students who came from rural areas. The university needs to intensify strong behavior change communication using multiple strategies through the active involvement of students themselves within the university's premises and in the surrounding community in collaboration with stakeholders to promote Sexual abstinence.