Diarrhea remains a major cause of mortality in children under 5 years of age in Sub-Saharan countries in Africa. Risk factors for diarrhea vary by context and have important implications for developing appropriate strategies to reduce the burden of the disease. The objective of this study was to assess the prevalence of diarrhea and associated risk factors among children under 5 years of age in Kersa district, located in Eastern Ethiopia. A community-based crosssectional study was conducted among 1456 randomly selected households with at least one child under 5 years of age. A questionnaire and an observational check list were used for collecting information on socio-economic characteristics, environmental hygiene and behavioral practices, and occurrence of diarrhea among children under 5 years of age. Logistic regression was used to calculate the adjusted odds ratio of 95% confidence interval. The two-week prevalence of diarrhea among children under 5 years of age was 22.5% (95% CI: 20.3 -24.6). Improper refuse disposal practices (OR = 2.22, 95% CI: 1.20 -4.03), lack of hand washing facilities (OR = 1.92, 95%CI: 1.29 -2.86), living in rural area (OR = 1.81, 95% CI: 1.12 -3.31), the presence of two or more siblings in a household (OR = 1.74, 95% CI: 1.33 -2.28), and age of the child (OR= 2.25, 95% CI; 1.5-3.36) were the major risk factors for diarrhea. This study demonstrated that diarrhea morbidity was relatively high among children under 5 years of age residing in Eastern Ethiopia. Efforts to reduce childhood diarrhea should focus on improving household sanitation, personal hygiene, and child birth spacing.

Background: For behavioral as well as physiological reasons, early sexual debut increases young peoples' risk for infection with HIV and other STIs. Youths who begin sexual activity early are more likely to have high-risk sex or multiple sexual partners and are less likely to use condoms. It is crucial to understand the factors associated with early sexual initiation in a broader context for designing and implementing effective interventions targeting youth. Objective: The objective of the study was to determine the median age at first sexual intercourse and the associated factors of sexual initiation among rural and urban youths (age 15-24 years). Methods: A comparative cross sectional study was conducted between, March 1 -15, 2008, in Dessie town and Dessie Zuria Woreda. To draw a total sample of size 1294 (647 urban and 647 rural), a multistage cluster sampling was used. Bivariate and multivariate analyses were employed. Moreover, Kaplan Meier survival analysis was used to estimate the probability of sexual initiation at various age stratified by residence and sex. Result: About half, 51.3% of the youths have ever had sex. Rural youths initiate sexual intercourse at lower age than their urban counterparts with mean (±SD) (16.49+2.11) for rural and (17.18+2.32) for urban youths. The median age at sexual debut was 16 years for rural and 17 years for urban. IntroductionMeeting the needs of youth today is critical for a wide range of policies and programs, because the actions of young people will shape the size, health, and prosperity of the world's future population. More than 1 billion people in the world are between the ages of 15 and 24, and most live in developing countries (1-3).

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Background. Study of meningococcal carriage is essential to understanding the epidemiology of Neisseria meningitidis infection.Methods. Twenty cross-sectional carriage surveys were conducted in 7 countries in the African meningitis belt; 5 surveys were conducted after introduction of a new serogroup A meningococcal conjugate vaccine (MenAfriVac). Pharyngeal swab specimens were collected, and Neisseria species were identified by microbiological and molecular techniques.Results. A total of 1687 of 48 490 participants (3.4%; 95% confidence interval [CI], 3.2%–3.6%) carried meningococci. Carriage was more frequent in individuals aged 5–14 years, relative to those aged 15–29 years (adjusted odds ratio [OR], 1.41; 95% CI, 1.25–1.60); in males, relative to females (adjusted OR, 1.17; 95% CI, 1.10–1.24); in individuals in rural areas, relative to those in urban areas (adjusted OR, 1.44; 95% CI, 1.28–1.63); and in the dry season, relative to the rainy season (adjusted OR, 1.54; 95% CI, 1.37–1.75). Forty-eight percent of isolates had genes encoding disease-associated polysaccharide capsules; genogroup W predominated, and genogroup A was rare. Strain diversity was lower in countries in the center of the meningitis belt than in Senegal or Ethiopia. The prevalence of genogroup A fell from 0.7% to 0.02% in Chad following mass vaccination with MenAfriVac.Conclusions. The prevalence of meningococcal carriage in the African meningitis belt is lower than in industrialized countries and is very diverse and dynamic, even in the absence of vaccination.

ObjectiveTo investigate the clinical characteristics of children who died from diarrhoea in low- and middle-income countries, such as the duration of diarrhoea, comorbid conditions, care-seeking behaviour and oral rehydration therapy use.MethodsThe study included verbal autopsy data on children who died from diarrhoea between 2000 and 2012 at seven sites in Bangladesh, Ethiopia, Ghana, India, Pakistan, Uganda and the United Republic of Tanzania, respectively. Data came from demographic surveillance sites, randomized trials and an extended Demographic and Health Survey. The type of diarrhoea was classified as acute watery, acute bloody or persistent and risk factors were identified. Deaths in children aged 1 to 11 months and 1 to 4 years were analysed separately.FindingsThe proportion of childhood deaths due to diarrhoea varied considerably across the seven sites from less than 3% to 30%. Among children aged 1–4 years, acute watery diarrhoea accounted for 31–69% of diarrhoeal deaths, acute bloody diarrhoea for 12–28%, and persistent diarrhoea for 12–56%. Among infants aged 1–11 months, persistent diarrhoea accounted for over 30% of diarrhoeal deaths in Ethiopia, India, Pakistan, Uganda and the United Republic of Tanzania. At most sites, more than 40% of children who died from persistent diarrhoea were malnourished.ConclusionPersistent diarrhoea remains an important cause of diarrhoeal death in young children in low- and middle-income countries. Research is needed on the public health burden of persistent diarrhoea and current treatment practices to understand why children are still dying from the condition.