Background: Stunting is a result of chronic under nutrition and a major public health issue in Ethiopia. This study aimed to calculate the prevalence of stunting, and associated factors among children younger than five years. Methods: A total of 9588 children in Ethiopia were included. Proportional Odds Model was used to identify determinants of stunting. The score test and plots were used to see the proportional odds model assumptions. Results: The prevalence of stunting was 38% (21% moderately, 17% severely). Children with illiterate mothers were 2 times more likely to be moderately and severely stunted compared with their counterparts with secondary education. The odds of being stunted for children whose age group 24-35 months respectively as compared to children 0-5 months of age were 4.71 times higher. Being female children were 9.66 times more likely to be in normal nutrition status as compared to male. Children of families in the highest wealth quintile were 7.92 times more likely to have normal stature compared with children from poorest ones. Conclusions: Child age, child sex, birth interval, mother's educational status, wealth index, were the important determinants of stunting. Addressing these factors will help to prevent future injury of physical and mental development in children and will assist in alleviating malnutrition and refining their quality of life. Moreover, in a DHS data set, complex sampling design should be incorporated in order to make a valid statistical inference.
Background: Ethiopia is one of the developing countries where child under-nutrition is prevalent. Prior studies employed three anthropometric indicators for identifying factors of children's under-nutrition. This study aimed at identifying the factors of child under-nutrition using a single composite index of anthropometric indicators. Methods: Data from Ethiopia's Demographic and Health Survey 2016 was the base for studying under-nutrition in a sample of 9494 children below 59 months. A single composite index of under-nutrition was created from three anthropometric indices through principal component analysis recoded into an ordinal outcome. In line with World Health Organization 2006 Child Growth Standards, the three anthropometric indices involve z-score of height-forage (stunting), weight-for-height (wasting) and weight-for-age (underweight). Partial proportional odds model was fitted and its relative performance compared with some other ordinal regression models to identify significant determinants of under-nutrition. Results: The single composite index of anthropometric indicators showed that 49.0% (19.8% moderately and 29.2% severely) of sampled children were undernourished. In the Brant-test of proportional odds model, the null hypothesis that the model parameters equal across categories was rejected. Compared to ordinal regression models, partial proportional odds model showed an improved fit. A child with mother's body mass index less than 18.5 kg, from poorest family and a husband without education, and male to be in a severe under-nutrition status was 1.4, 1.8 1.2 and 1.2 times more likely to be in worse under-nutrition status compared to its reference group respectively. Conclusion: Authors conclude that the fitted partial proportional odds model indicated that age and sex of the child, maternal education, region, source of drinking water, number of under five children, mother's body mass index and wealth index, anemic status of child, multiple births, fever of child before 2 months of the survey, mother's age at first birth, and husband's education were significantly associated with child under-nutrition. Thus, it is argued that interventions focus on improving household wealth index, food security, educating mothers and their spouses, improving maternal nutritional status, and increasing mothers' health care access.
Background: Tuberculosis is one of the world's most common causes of death in the era of Human immunodeficiency virus. The purpose of this study was to determine the prevalence and associated factors of TB/HIV co-infection. Methods: Hospital based retrospective studies were conducted among adult HIV-positive patients. Logistic regression method and Chi square test were applied. Results: A total of 571 HIV positive study participants were enrolled. Of these, 158 (27.7%) were found to have pulmonary tuberculosis. Lower baseline CD4 count<200cell/μl, patients who drunk alcohol, patients who were ambulatory at the initiation of ART, patients whose marital status was single were significant predictors for increased risk of tuberculosis in PLWHIV (P <0.05). Non smoker patients, patients in WHO clinical stage I, patients in WHO clinical stage II and ownership of the house had significant protective benefit against risk of TB (P <0.05). Conclusion:The prevalence of TB/HIV co-infection in adults on ART in our study was moderately high. Having advanced clinical status and presence of risk factors were found to be the predicting factors for co-infection. The health office should open TB/HIV co-infection units in the hospitals and health workers should be cautious when a patient has an advanced disease.
Background Child undernutrition is a global health concern. Many studies have focused on the association of childhood undernutrition indicators with their predictors. A few studies have looked at relationship between the undernutrition indicators. This study aimed at investigating the possible association structures of childhood undernutrition indicators. Methods A log-linear model of cell counts of a three way table of stunting, wasting, and underweight was fitted based on the 2016 Ethiopia demographic health survey data. The variables of interest were generated based on the 2006 WHO Child Growth Standards as: stunted, wasted and underweight if z-scores of height-for-age, weight-for-height and weight-for age are below-2, respectively; otherwise not stunted, wasted and underweight. Results This study showed that 36.34, 12.09 and 24.87% were stunted, wasted and underweight out of sampled children respectively and the prevalence of total undernutrition in children was about 45.96%.The fitted log-linear model showed that underweight was associated with both stunting ( P -value< 0.001), and wasting ( P -value< 0.001). There was no association between stunting and wasting ( P -value = 0.999). Furthermore, the model showed that there is no a three way interaction among stunting, wasting, and underweight ( P -value = 1.000). Conclusion The authors conclude that there is lack of three way association of stunting, wasting, and underweight. This confirms that the three anthropometric indicators of children have multi-dimensional nature. Thus, the concerned body should consider the three undernutrition indicators simultaneously to estimate the actual burden of childhood undernourishment as they are not redundant of each other.
BackgroundMultidrug-resistant tuberculosis (MDR-TB) is caused by bacteria that are resistant to the most effective anti-tuberculosis drug. The MDR-TB is an increasing global problem and the spread of MDR-TB has different recovery time for different patients. Therefore, this study aimed to investigate the recovery time of MDR-TB patients in Amhara region, Ethiopia.MethodA retrospective study was carried out in seven hospitals having MDR-TB treatment center of Amhara region, Ethiopia from September 2015 to February 2018. An accelerated failure time and parametric shared frailty models were employed.ResultsThe study revealed that the recovery time of MDR-TB patients in Amhara region was 21 months. Out of the total MDR-TB patients, 110 (35.4%) censored and 201 (64.6%) cured of MDR-TB. The clustering effect of frailty model was hospitals and the Weibull-gamma shared frailty model was selected among all and hence used for this study. The study showed that extra pulmonary MDR-TB patients had longer recovery time than that of seamier pulmonary MDR-TB patients in Amhara region, Ethiopia. According to this study, male MDR-TB patients, MDR-TB patients with co-morbidity and clinical complication were experiencing longer recovery time than that of the counter groups. This study also showed that MDR-TB patients with poor adherence had longer recovery time than those with good adherence MDR-TB patients.ConclusionAmong different factors considered in this study, MDR-TB type, clinical complication, adherence, co-morbidities, sex, and smoking status had a significant effect on recovery time of MDR-TB patients in Amhara region, Ethiopia.In conclusion, the Regional and Federal Government of Ethiopia should take immediate steps to address causes of recovery time of MDR-TB patients in Amhara region through encouraging adherence, early case detection, and proper handling of drug-susceptibility according to WHO guidelines.
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