Background: Dietary diversity is a proxy indicator of maternal nutrient adequacy. However, little is documented on dietary diversity among lactating mothers. Therefore, this study assessed diet diversity and associated factors among lactating mothers visiting public health facilities in Aksum town, Tigray, Northern Ethiopia. Methods: An institution based cross-sectional study was conducted on 346 randomly selected lactating women visiting public health facilities of Aksum town in June 2015. Dietary diversity was assessed using 24 h dietary recall method. A mean dietary diversity score (DDS) was computed of nine food groups. Food insecurity access was measured using 9 items Household Food Insecurity Access Scale (HFIAS). Data were entered and analyzed using SPSS version 20. Results: More than a quarter (27.2 %) of the lactating mothers was from food insecure households. The mean DDS was 3.4 and a total of 56.4 % lactating mothers had low dietary diversity (less than mean DDS). Average monthly income, home gardening and source of drinking water were associated with low dietary diversity. Lactating mothers who had monthly income of less than 501 ETB [AOR = 2.3, 95 % CI (1.2, 4.6)] and 501 to 1500 ETB [AOR = 3.0, 95 % CI (1.4, 6.3)] were more likely to have low dietary diversity than those who had monthly income above 1500 ETB. And those who did not practice home gardening were more likely to have low dietary diversity than their counterparts [AOR = 2.1, 95 % CI (1.01, 4.2)]. Regarding source of drinking water, mothers who reported protected well as a main source were more likely to have low dietary diversity compared to those who reported tap water as main source [AOR = 4.5, 95 % CI (1.1,18.2)]. Conclusions: Dietary diversity among lactating mothers was low. Factors like monthly income less than 501 ETB and 501 to 1500 ETB, not having home gardening, and source of drinking water from protected well were significantly associated with low dietary diversity. Attention should be paid to dietary diversity of lactating mothers to improve their nutritional status, and that of their children and their family.

BackgroundGlobally, childhood diarrhea is amongst the most prevalent health problems and accounts for 9% of all deaths in children under-five. In Ethiopia, childhood diarrhea is a major public health problem in which the prevalence ranges from 13.5 to 30.5% and experienced by multiple factors. Although health extension program has been implementing for couples of years; diarrheal disease remains the second cause of morbidity and continues an important public health problem in the study district. Thus, this study assessed determinants of diarrheal disease among under-five children in the Medebay Zana district, northwest Tigray, Ethiopia, 2015.MethodA community based case-control study was used. A multistage sampling procedure was employed to enroll the study participants. Data were collected using face to face administered questionnaire. The collected data were entered into Epi Info version 3.5.4 and exported to SPSS Version 21 for analysis. Frequencies with percentages were computed using univariate analysis. Finally, logistic regression model was fitted to identify factors associated with childhood diarrhea where P-values of less than 0.05 were considered statistically significant.ResultsSocio-demographic factors such as low maternal educational level [AOR = 2.88, 95% CI (1.70, 4.88)], being index child of older age, households with ≥3 number of children under-five [AOR = 4.05, 95% CI (1.91, 8.60)] and maternal history of diarrhea [AOR = 2.10, 95% CI (1.09, 4.05)] were statistically associated with childhood diarrhea. This study also revealed that child feeding practice; not exclusively breastfed [AOR = 4.84, 95% CI (2.21, 10.60)] and initiation of complementary feeding above 6 months [AOR = 1.78, 95% CI (1.09, 2.92)] were statistically associated with outcome variable. Environmental and behavioral practices such as unavailability toilet facility [AOR = 2.10, 95% CI (1.34, 3.30)], improper solid waste disposal [AOR = 2.29, 95% CI (1.53, 3.44)] and unprotected drinking water [AOR = 1.83, 95% CI (1.12, 2.98)] were also found significant factors of childhood diarrhea.ConclusionMaternal educational status, age of index child, number of < 5 children, child feeding practices, maternal history of diarrhea, toilet facility, solid waste disposal and household drinking water were found determinants of childhood diarrhea. These findings have policy implications and insight the strengthening for health intervention programs.

IntroductionHypertension is a major risk factor of cardiovascular diseases which are the leading causes of deaths from chronic non-communicable diseases in Ethiopia. However, little is documented in the issue. Therefore, this study aimed to assess the prevalence, associated factors, awareness, treatment and control of hypertension among adults 18 years old or above in Aksum town, Tigray region, North Ethiopia.MethodsA sequential quantitative-qualitative study was conducted among adults aged 18 years and above in Aksum town. A multi stage sampling procedure was used to select the study participants for the quantitative study whilst convenience sampling technique was used for the qualitative part. A pre-tested and structured questionnaire was used to collect quantitative data, and an interview guide was used to collect the qualitative data. The logistic regression model was fitted to identify factors independently associated with hypertension using SPSS Version 20. P-values of < 0.05 were considered statistically significant. For the qualitative data, iterative hearing of the discussions verbatim interpretation was followed by categorizing similar ideas into themes and finally triangulated with the quantitative results.ResultsThe overall prevalence of hypertension was 16.5% (95% CI: 13.4, 20.0). Awareness, treatment and control of hypertension were 43%, 2.1% and 18.2%, respectively. Being unable to read and write [AOR = 4.73, 95% CI:1.11, 20.23], not consuming fruit [AOR = 4.31, 95% CI:1.74, 10.66], being physically inactive [AOR = 20.11, 95% CI:8.75, 6.20], not knowing physical inactivity is a risk factor of hypertension [AOR = 3.57, 95% CI: 1.69, 7.69] and being overweight/obese [AOR = 9.2, 95% CI:4.54, 18.67] were significantly associated with hypertension. Remarkably, all identified hypertensive cases were linked to the nearby hospital for confirmation of diagnosis, care and follow-up and all of them were found to be hypertensive. This suggests that implementing primary health care approach integrated with the urban health extension package may be effective in the prevention and control of hypertension in poor settings.Conclusion and recommendationPrevalence of hypertension among adults was very high, but awareness, treatment and control of hypertension was very low. Being unable to read and write, not consuming fruit, being physically inactive, overweight/obesity and not knowing physical inactivity is a risk factor for hypertension were independently associated with hypertension. Policy makers need to consider integrating prevention and control of hypertension with health extension package. Appropriate information, education and communication strategies should also be designed and implemented to avoid unhealthy lifestyles and promote healthy practices.

BackgroundMalnutrition hastens progression to Acquired Human Immunodeficiency Syndromes (AIDS) related illnesses; undermines adherence and response to antiretroviral therapy (ART) in resource-poor settings. However, nutritional status of people living with HIV (PLHIV) can be affected by various psychosocial factors which have not been well explored in Ethiopia. Therefore, the objective of this study was to determine psychosocial correlates of nutritional status among people living with HIV (PLHIV) on ART in Central zone of Tigray, Northern Ethiopia.MethodsA matched case-control study design was conducted to assess psychosocial correlates of nutritional status among PLHIV on ART. Data were collected by an interviewer-administered technique using structured pre-tested questionnaire, record review using a checklist and anthropometric measurements. Cases were selected by simple random sampling and controls purposively to match the selected cases. Conditional logistic regression was used to compute relevant associations by STATA version 12.ResultsThe psychosocial factors independently associated with malnutrition were ever consuming alcohol after starting ART [AOR = 4.7, 95% CI: 1.8–12.3], ever smoking cigarette after starting ART [AOR = 7.6, 95% CI: 2.3–25.5], depression [AOR = 2.8, 95% CI: 1.3, 6.1], not adhering to ART [AOR = 6.8,95% CI: 2.0–23.0] and being in the second lowest wealth quintile [AOR = 4.3,95% CI: 1.1–17.7].ConclusionEver consuming alcohol and ever smoking cigarette after starting ART, depression, not adhering to ART and being in the second lowest wealth quintile were significantly associated with malnutrition. Therefore; policies, strategies, and programs targeting people living with HIV should consider psychosocial factors that can impact nutritional status of people living with HIV enrolled on ART.

BackgroundNon-prescribed antimicrobial use and their resistance are among the main public health problems, worldwide. In Ethiopia, particularly in the northern part, the magnitude of non-prescribed antimicrobial use and its major determinants is not yet well known. Thus, this study was done to assess the magnitude of non-prescribed anti-microbial use and associated factors among customers in drug retail outlet in Central Zone, Tigray, Ethiopia.MethodsA drug retail outlet based cross-sectional study was conducted among adults aged 18 years and above. A multistage sampling procedure was used to select study participants. Data were collected using a structured questionnaire by druggists under the supervision of pharmacists. Data were entered into EpiInfo software version 3.5.4. Binary logistic regression was used to identify independently associated variables in bivariate and multivariable analyses using SPSS version 21. Odds Ratios with 95% confidence intervals were estimated.ResultsFrom 829 study samples, a total of 780 respondents participated in this study with a response rate of 94.1%. Of 367 respondents who received non-prescribed antimicrobial, 249 (67.8%), 121 (33%), and 94 (25.6%) of them were males, secondary school and paid employed respectively. The magnitude of non-prescribed antimicrobial use was 47.1% (95% CI: 43.8, 50.5). The factors which were independently associated with non-prescribed antimicrobial use were male sex [AOR = 1.72, 95% CI = 1.21, 2.44], seeking modern health care in private/Non-Governmental Organization (NGO) [AOR =0.47, 95% CI; 0.23, 0.98], moderate waiting time in health care facilities [AOR = 1.92, 95% CI; 1.20, 3.09], delayed waiting time in health care facilities [AOR = 1.56, 95% CI; 1.03, 2.38], ever received antimicrobial [AOR = 3.51, 95% CI; 2.45, 5.02], and frequency of purchasing non-prescribed antimicrobial (1–3 times and 4 times, [AOR = 2.04, 95% CI; 1.36, 3.06] and [AOR = 2.66, 95% CI; 1.24, 5.68] respectively).ConclusionThe magnitude of non-prescribed antimicrobial use was high. Familiarizing with health care utilization and delayed waiting time in health care facilities were the very important factors independently associated with non-prescribed antimicrobial use. Emphasis should be given to community education through involvement of the private health sector and health care providers. Regulation and policy enforcement are also necessary to promote the rational use of antimicrobial.