Individual and community level factors associated with anemia among children 6-59 months of age in Ethiopia: A further analysis of 2016 Ethiopia demographic and health survey.

BACKGROUND: Anemia is a global public health problem; but its burden is disproportionately borne among children in the African Regions. The 2016 Ethiopia Demographic and Health Survey report showed that the prevalence of anemia among children 6-59 months of age was 57%; far exceeding the national target of 25% set for 2015. Although studies have been conducted in Ethiopia, multilevel analysis has rarely been used to identify factors associated with anemia among children. Therefore, this study aimed to identify individual and community-level factors associated with anemia among children 6-59 months of age by fitting a multilevel logistic regression model. METHODS: The data was obtained from the 2016 Ethiopia Demographic and Health Survey, conducted from January to June 2016, and downloaded from the website http://www.DHSprogram.com. The sample was taken using two-stage stratified sampling. In stage one, 645 Enumeration Areas and in stage two 28 households per Enumeration Area were selected. A sample of 7790 children 6-59 months of age was included. Data were analyzed using STATA version 14. A multilevel logistic regression model was fitted and an adjusted odds ratio with a 95% confidence interval was obtained. RESULT: From the individual-level factors, anemia was associated most strongly with child age, wealth index, maternal anemia and child stunting followed by child underweight, child fever and birth order whereas from the community-level, the strongest odds of anemia occurred among children from Somali, Harari, Dire Dawa and Afar region followed by Oromia and Addis Ababa. Low community-poverty is a protective factor for anemia. The odds of anemia were 0.81 (95% CI: 0.66, 0.99) times lower for children who were living in communities of lower poverty status than children who were living in communities of higher poverty status. Children from Somali and Dire Dawa had 3.38 (95% CI: 3.25, 5.07) and 2.22 (95% CI: 1.42, 3.48) times higher odds of anemia, respectively than children from the Tigray region. CONCLUSIONS: This study shows that anemia among children 6-59 months of age is affected both by the individual and community level factors. It is better to strengthen the strategies of early detection and management of stunted and underweight children. At the same time, interventions should be strengthened to address maternal anemia, child fever and poverty, specifically targeting regions identified to have a high risk of anemia.

Knowledge, Attitudes, and Practices Towards COVID-19 Pandemic Among Quarantined Adults in Tigrai Region, Ethiopia.

BACKGROUND: With the onset of any novel condition, it is the "first" case identified that brings attention and sets into motion the machinery to respond - so it began with a first novel pneumonia case of unknown origin in Wuhan, China. Currently, the World Health Organization has declared SARS-CoV-2 (more commonly known as COVID-19) a public health emergency of international concern. It is projected that the path of COVID-19 could kill 50-80 million people and impacts the world's economy in its devastating global sweep. The surge is increasing on global and national levels, causing rapid loss of life, joblessness, deterioration of the healthcare systems, and both national and global economies. In Ethiopia, the first COVID-19 case was reported in March. Since then, the government has been taking different measures to prevent its spread. Locking down all schools, declared social distancing and hand hygiene, and restricting large gatherings were some of the Ethiopian government's actions. OBJECTIVE: To determine knowledge, attitudes, and practices towards COVID-19 pandemic among quarantined adults in Tigrai region, Ethiopia. METHODS: A total of 331 participants selected using a systematic random sampling method were included in the study. We used an interviewer-administered questionnaire. After describing the variables using frequencies, means, and standard deviations, multivariable logistic regression determined factors associated with knowledge and chi-squared tests for attitudes and practices towards COVID-19. RESULTS: The study participants were primarily males (70%) and mean age 30.5 (SD=11) years. The mean knowledge score was 8.73 (SD=2.64), with less than half 42.9% (95% CI: 37.5-48%) of the study participants were knowledgeable. Regarding the attitude questions, three-fourths of the participants believed that Ethiopia will control and win the battle against the COVID-19 pandemic. Nearly one-third of the participants replied that the Ethiopian government is handling this pandemic health crisis well. About half of the study participants reported that they had gone to crowded places in recent days, did not wear face mask when leaving home, and practiced preventive measures given by local health authorities. Knowledge score was statistically significantly associated with gender, age, and educational status of the study participants, whereas attitude and practices were significantly associated with educational status and knowledge of participants.

Exploring knowledge on danger signs of common childhood illnesses and associated factors among mothers of under-five children in Central Tigrai, Ethiopia: a cross-sectional study.

INTRODUCTION: Globally, a large number of under-five deaths have occurred from preventable and treatable common childhood illnesses. Therefore, early identification of general danger signs of common childhood illnesses and adhering to appropriate treatment helps to reduce morbidity and mortality. This study aimed to assess the knowledge of mothers and associated factors on general danger signs of common childhood illnesses of under-five children in Central Tigrai, Ethiopia. METHODS: A community-based cross-sectional study design was employed from February to March 2017. A total of 416 study participants were finally enrolled in the study using simple random sampling technique. A pretested and structured interviewer-based questionnaire was used. Data were entered, coded and analysed using SPSS 22.0. Multivariable logistic regression was used to control the effect of confounders. RESULTS: In this study, 44.7% of the mothers had good knowledge of the general danger signs of common childhood illnesses. Mothers' educational status (AOR=1.93, 95%CI=1.09-3.44, p=0.025), occupation of mothers (AOR=5.94, 95%CI=3.17-11.12, p≤0.001), childbirth order (AOR=1.85, 95%CI=1.00-3.40, p=0.005) and source of information (AOR=2.19, 95%CI=1.23-3.87, p=0.007) were significantly associated with knowledge of mothers on general danger signs of common childhood illnesses. CONCLUSIONS: Maternal knowledge of general danger signs of common childhood illnesses was low. Therefore, intervention modalities focusing on improving the educational level, behavioural change communication activities, and access of mothers to health visits are needed.

Knowledge of and Utilization of Emergency Contraceptive and Its Associated Factors among Women Seeking Induced Abortion in Public Hospitals, Eastern Tigray, Ethiopia, 2017: A Cross-Sectional Study.

BACKGROUND: In developing countries, most maternal deaths are related to the lack of accessibility and availability of reproductive health services. In those nations, emergency contraceptive pills are the most commonly used family planning methods to prevent unintended pregnancy. However, women do not use this family planning method for different reasons. Consequently, women expose to unsafe abortion which results in maternal morbidity and mortality. OBJECTIVE: To assess the knowledge of and utilization of emergency contraceptive and its associated factors among women seeking induced abortion in public hospitals, Eastern Tigray, Ethiopia, 2017. METHODS: Hospital-based cross-sectional study was conducted on 380 women, who came for safe termination of pregnancy from April to July 2017. Systematic random sampling technique was used. Pretested structured questionnaire was used to collect data through interview. Data were entered using Epi Info version 7 and exported to SPSS version 20 for analysis. Data were presented using descriptive statistics. Bivariate and multivariate logistic regression was carried out to see if there was significant association between variables at P < 0.05 and 95% confidence interval (CI). RESULT: Out of the total 369 respondents, 149 (40.4%) had the knowledge about emergency contraceptive pills. The magnitude of utilization of emergency contraceptive among respondents was found to be 45 (12.2%). Protestant in religion (AOR = 60.85, CI (5.34-693.29)), previous utilization of any contraceptive method (AOR = 0.13, CI (0.05-0.36)), and women who were not knowledgeable about emergency contraceptive (AOR = 0.030, CI (0.006-0.14)) were significantly associated with the utilization of emergency contraceptive. CONCLUSION: Most of the women were not knowledgeable about emergency contraceptive and utilization of emergency contraceptive was also very low. In conclusion, religion, knowledge, and previous utilization of emergency contraceptive were associated with the utilization of emergency contraceptive.

Risk factors of anemia among pregnant women attending antenatal care in health facilities of Eastern Zone of Tigray, Ethiopia, case-control study, 2017/18.

INTRODUCTION: Worldwide the average prevalence of anemia among pregnant women is 38.2% and in Ethiopia, the average prevalence of anemia among pregnant women is 22%. The aim of this research was to identify risk factors of anemia among pregnant women in Eastern Zone of Tigray, Ethiopia. METHODS: A case-control study was conducted among 600 (150 cases and 450 controls) pregnant women in 2017/18. Pregnant women with a hemoglobin level below 11 g/dl were cases (anemic) and those with hemoglobin >11 g/dl were controls (non-anemic). Data were collected using structured questionnaire and SPSS version 20 was used for analysis. Bivariate and multivariate logistic regression model was used to identify the risk factors for anemia among pregnant women. P-value <0.05 and adjusted odds ratio with a 95% confidence interval were used to assess the association. RESULTS: Intestinal parasites (adjusted odds ratio (AOR)=3.4; 95% confidence interval (CI): 1.2, 17.9), farmer occupation (AOR=3, 95% CI: 1.4, 10.8), unprotected sources of drinking water (AOR=3; 95% CI: 1.7, 16.9), drinking coffee/tea with or immediately after meal daily (AOR=1.9; 95%CI: 1.04, 8.7) and diet diversity score (DDS) of less than 3 (AOR=3; 95% CI: 1.5, 5.5) were statistically significant for anemia among pregnant women. CONCLUSION: In this study, the risk factors for anemia among pregnant women were intestinal parasites, mother farmer occupation, unprotected source of drinking water, drinking coffee or tea with a meal or immediately after meal and low diet diversification score. Therefore, nutritional intervention should consider the above-identified risk factors.

Prevalence and Associated Factors of Perinatal Asphyxia among Neonates in General Hospitals of Tigray, Ethiopia, 2018.

Perinatal asphyxia is one of the most important causes of morbidity and mortality in neonates. Perinatal asphyxia occurs in association with maternal, fetal, and maternofetal factors. However, the magnitude and associated factors of perinatal asphyxia are not well studied in Tigray, Ethiopia. Therefore, our study is conducted to determine the prevalence and factors associated with perinatal asphyxia among neonates in general hospitals of Tigray. An observational hospital-based cross-sectional study was conducted in randomly selected general hospitals. A semistructured questionnaire was used to collect data from 421 randomly selected neonates with their mothers and medical records. The data was entered into epidata version 3.5 and exported to Statistical Package for Social Sciences (SPSS) version 20 for analysis. Finally, the presence of an association between a dependent variable and an independent variables has been declared at P-value ≤0.05, or adjusted odds ratio (AOR), 95% confidence interval (CI). Accordingly, the result of this study showed that the prevalence of perinatal asphyxia among the selected general hospitals was 22.1%. Neonates born with cesarean section are seven times more likely to have perinatal asphyxia than those who are born spontaneously through the vagina (AOR, 6.97; CI (2.87-16.93)). In addition, neonates who are born meconium stained are 8.55 times more likely to have perinatal asphyxia than those who had not stained with meconium (AOR, 8.55; CI (4.20-17.39)). Neonates who are weighed less than 2.5 kg are 12.75 times more likely to have perinatal asphyxia than those who are weighed 2.5-4 kg (AOR, 12.75; CI (4.05-40.08)). Prolonged duration of labour was also associated statistically with perinatal asphyxia (AOR, 3.33, CI (1.32-8.38)). In conclusion, the magnitude of perinatal asphyxia in general hospitals of Tigray remains high. Low birth weight, meconium-stained amniotic fluid, cesarean section, and prolonged maternal labour have been associated with perinatal asphyxia.