Ethiopian Journal of Health Sciences最新文献

Background: Neonatal circumcision is the oldest and most common surgical procedure The safety, ease, and outcomes of various methods of surgical procedures for neonatal circumcision have become increasingly the focus in the reviews of this procedure. This study aimed to identify the easy, safe and acceptable method for neonatal circumcision.

Methods: This prospective study involved 357 male neonates, divided into three groups based on the methods used for neonatal circumcision: artery-forceps, bone-cutter, and Gomco methods. Clamps were uniformly applied for 7 minutes (420 seconds). The study assessed procedure time, primary and reactionary bleeding, and outcomes using the adapted Paediatric Penile Perception (PPP) score. Data were analyzed using SPSS version 23, with a p-value set at <0.05.

Results: Each group consisted of 119 neonates. The bone-cutter method was the fastest (590.2 ± 60.14 seconds), while the Gomco method was the slowest (624.2 ± 55.16 seconds, p<0.001). Primary bleeding occurred most frequently with the artery-forceps method (37 out of 119), and least with the bone-cutter (p<0.001). Only the artery-forceps group had reactionary bleeding (p=0.018). The bone-cutter and Gomco methods had the highest PPP mean scores: 11.91 ± 0.390 and 11.87 ± 0.566, respectively (p<0.001).

Conclusion: The bone-cutter method is the fastest, safest, and produces the best cosmetic outcomes of the three methods studied.

Background: Chronic non-communicable diseases (NCDs) are a global health challenge, causing millions of deaths annually and contributing significantly to the global disease burden. Despite their prevalence in low- and middle-income countries (LMICs), NCDs receive limited global health financing. Ethiopia, like other LMICs, is experiencing a rising burden of NCDs. This study aimed to assess the self-reported prevalence of chronic NCDs and identify associated sociodemographic factors.

Methods: A population-based cross-sectional study was conducted at the Addis Health Demographic Surveillance System (Addis-HDSS) site in Addis Ababa, Ethiopia. All adults (≥18 years) living in the Addis-HDSS sites were included. Data were collected using a structured electronic questionnaire on self-reported NCDs and sociodemographic variables. Binomial regression model was used to identify sociodemographic factors associated with self-reported NCDs.

Results: Overall, 11.5% (95% CI: 11.3%-11.7%) of adults reported at least one NCD. The most prevalent conditions were hypertension (5.9%; 95% CI: 5.7%-6.1%) and diabetes mellitus (3.4%; 95% CI: 3.3%-3.5%). Older age (Adjusted Incidence Rate Ratio (AIRR): 5.47; 95% CI: 5.17-5.79), no formal education (AIRR: 1.58; 95% CI: 1.45-1.72), being formerly married (AIRR: 2.68; 95% CI: 2.47-2.91), and higher wealth quintiles (AOR: 1.16; 95% CI: 1.07-1.26) were statistically significant risk factors associated with NCDs.

Conclusion: This study highlights the high burden of chronic NCDs among adults in Addis Ababa. The findings highlight the importance of addressing NCDs as a significant public health challenge. Expanding access to early prevention, diagnosis, and care is critical in urban settings.

Background: Understanding healthcare facility preferences-public versus private-is essential for formulating policies that promote universal health coverage (UHC). Various sociodemographic factors influence these preferences. This study examines healthcare facility preferences within the ADDIS-HDSS population in Addis Ababa, Ethiopia.

Methods: This analysis is based on the ADDIS-HDSS baseline census conducted in Yeka sub-city, Addis Ababa. We focused on respondents' preferred healthcare facility when household members are ill, and the reasons behind their choice. Multivariable logistic regression was used to analyze the factors influencing preferences.

Results: Most households (82.81%) preferred public healthcare facilities, citing affordability as the primary reason (59.31%). The remaining 17.19% preferred private healthcare, mainly due to perceived quality of care (43.06%) and timeliness (37.04%). Larger family size was associated with a reduced likelihood of preferring private facilities (AOR = 0.579, 95% CI: 0.522-0.642), while higher education (AOR = 2.573, 95% CI: 2.194-3.017) and wealthier households (AOR = 16.925, 95% CI: 14.705-19.481) were more likely to prefer private care.

Conclusion: The majority of households prefer public healthcare facilities, with affordability, quality, and timeliness as key factors. To achieve UHC in low-income countries, improving service quality and timeliness in public healthcare is critical.

Background: Access to sanitation and healthy housing conditions are essential for public health, reducing the spread of diseases and improving overall well-being. However, millions of people, particularly in low-income countries, still lack access to basic sanitation and housing facilities. This study assessed household sanitation and crowding status in a rapidly developing urban area of Addis Ababa.

Methods: Data were extracted from the household census conducted from December 2022 to January 2023 at the Addis-HDSS site. Availability of basic sanitation facilities was defined as the presence of privately owned sanitation facilities within the household. Household crowding was measured by the number of occupants per bedroom. Multivariable logistic regression was used to identify factors associated with access to sanitation facilities (STATA/SE 14.2). A p-value of <0.05 was considered statistically significant.

Results: The study included 30,533 households. Overall, 76.37% (95% CI: 74.86-77.2) lacked access to basic sanitation facilities. Most households (67.42%) lived in overcrowded housing. Educational status of the household head and household size were significantly associated with sanitation access. Households with college-educated heads were more likely to have access to basic sanitation (AOR 2.52, 95% CI: 2.27-2.79), while overcrowded households were less likely to have such access (AOR 0.06, 95% CI: 0.040-0.063).

Conclusions: A large proportion of households lacked basic sanitation facilities and lived in overcrowded housing, which increases the risk of infectious disease transmission. Improving sanitation and housing conditions is crucial for reducing health risks and improving public health outcomes.

Background: Contraceptives are essential for protecting women's sexual and reproductive health, as well as for reducing maternal and infant morbidity and mortality. This study aimed to identify socioeconomic factors associated with contraceptive use among married women of childbearing age in Ethiopia.

Methods: We analysed cross-sectional data from 15,499 married women aged 18-49 years, collected as part of the Urban Health and Demographic Surveillance System (HDSS) in Addis Ababa. Trained interviewers conducted face-to-face interviews using structured, pre-tested questionnaires. Bivariable and multivariable logistic regression models were used to calculate adjusted odds ratios (AOR) with 95% confidence intervals (CIs) to assess associations between socioeconomic factors and contraceptive use.

Results: The overall prevalence of contraceptive use among married women was 53.5% (95% CI: 52.7-54.4%). Women with larger family sizes (>6) (AOR: 2.1; 95% CI: 1.5-2.8), excellent self-reported health (AOR: 1.6; 95% CI: 1.3-1.9), and those in households with adequate income to meet basic needs (AOR: 1.29; 95% CI: 1.11-1.48) were more likely to use contraceptives. Women over 40 years old (AOR: 0.21; 95% CI: 0.18-0.25) and those living in female-headed households (AOR: 0.68; 95% CI: 0.61-0.76) had lower odds of using contraception.

Conclusion: About half of urban married women of reproductive age reported using contraceptives. Factors associated with higher contraceptive use included better self-reported health and larger family sizes. Further research is needed to understand the complex dynamics of contraceptive use in low-income urban settings.

Background: Accurate population-based data is essential for evidence-based public health decision-making. Monitoring health events and evaluating interventions through a population-based platform enables timely decisions in rapidly growing urban areas. Such platforms are rare in African countries. This paper outlines the procedures for establishing the Addis Health and Demographic Surveillance System (Addis-HDSS).

Methods: The Addis-HDSS, located in Yeka sub-city of Addis Ababa, Ethiopia, conducted its first census from December 3, 2022, to January 18, 2023. Each enumeration area was identified and mapped digitally. All households in the study area were visited and geocoded. The baseline census gathered data on sociodemographic status, housing conditions, economic status, and selected health-related factors.

Results: A total of 30,533 households and a population of 107,494 were recorded. The response rate was 99.1%, reflecting high community engagement The average household size was 3.5, and the sex ratio was 81 males to 100 females. The population structure resembled a typical low-income country profile.

Conclusion: Establishing an urban HDSS was feasible with reasonable effort due to the presence of a digital map and the willingness of the urban population. This surveillance system will be an asset to generate reliable urban health and demographic information by providing an unbiased sampling frame for health-related studies. The HDSS will also be used to test the effectiveness of population-based public health interventions.

Background: Measuring household economic status is crucial, as it is a key determinant of health. In low-income settings, no single measure of economic status is universally accepted. This study aims to assess the agreement between a single-item tool for measuring socioeconomic status (SES) and the wealth index.

Methods: The Addis Health and Demographic Surveillance System (Addis-HDSS), based in Addis Ababa, Ethiopia, collects data on various socioeconomic indicators, including income, expenditure, and asset ownership. In this study, a single question, "Does your family's income cover basic needs?" was used as a proxy for SES. The percent agreement with the wealth index was calculated, and significance was assessed using the Pearson chi-square test. Scale reliability was evaluated using Cronbach's alpha (α).

Results: Data from 30,533 households showed strong agreement (α = 0.925) between self-reported income adequacy and wealth for both lower and higher wealth groups. The highest agreement was found between the lowest wealth index and "very low" income adequacy (93.84%) and between the highest wealth index and "high" income adequacy (89.47%) (p < 0.001).

Conclusion: The single-item SES measure showed good agreement with the wealth index in an urban setting. This simple tool can effectively identify vulnerable populations for targeted health interventions. Further research is needed to assess its applicability in other contexts.

Background: Low-and middle-income countries face a double burden of malnutrition. However, comprehensive, population-based nutritional assessments are rare, particularly across all age groups. This study aimed to assess the prevalence of malnutrition across different age groups in Addis Ababa Health and Demographic Surveillance Site (Addis-HDSS), Addis Ababa, Ethiopia.

Methods: A community-based cross-sectional survey was conducted from December 2022 to January 2023 in Addis Ababa, involving residents of the Addis-HDSS sites. Mid-upper arm circumference (MUAC) was used to assess nutritional status for individuals aged 6 months to 64 years. Descriptive statistics were analyzed using STATA version 14, employing previously published age-specific cutoff points to define underweight, overweight, and obesity.

Results: A total of 37,364 individuals aged 6 months to 64 years participated. Among children aged 6-59 months, 4.2% had moderate acute malnutrition (95% CI: 3.7-4.9), and 3.0% had severe acute malnutrition (95% CI: 2.5-3.6). Overweight prevalence was 22.3% (95% CI: 20.3-24.3) in children aged 5-9 years, 25.9% (95% CI: 23.4-28.5) in adolescents aged 10-14 years, and 12.7% (95% CI: 11.5-14.0) in late adolescents aged 15-19 years. Among adults aged 20-64 years, 6.3% were underweight (95% CI: 6.0-6.6), 19.3% overweight (95% CI: 18.8-19.7%), and 21.5% obese (95% CI: 21.0-22.0).

Conclusions: This study highlights a double burden of malnutrition in Addis Ababa, with overweight and obesity more prevalent than underweight, especially in adolescents and adults. It underscores the need for interventions targeting both undernutrition and overnutrition, emphasizing better diets and physical activity to curb nutrition-related diseases.