Background In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries.Methods GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw values of the posterior distribution.Findings Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates. After taking into account population growth and ageing, the absolute number of DALYs has remained stable. Since 2010, the pace of decline in global age-standardised DALY rates has accelerated in age groups younger than 50 years compared with the 1990-2010 time period, with the greatest annualised rate of decline occurring in the 0-9-year age group. Six infectious diseases were among the top ten causes of DALYs in children younger than 10 years in 2019: lower respiratory infections (ranked second), diarrhoeal diseases (third), malaria (fifth), meningitis (sixth), whooping cough (ninth), and sexually transmitted infections (which, in this age group, is fully accounted for by congenital syphilis; ranked tenth). In adolescents aged 10-24 years, three injury causes were among the top causes of DALYs: road injuries (ranked first), self-harm (third), and interpersonal violence (fifth). Five of the causes that were in the...

BackgroundCOVID-19 infection is a global pandemic threatening the public health. Due to the development and initiation of vaccination, currently significant difference upon vaccine acceptance is seen between developed and developing countries. However, there are no data on the level of COVID-19 vaccine hesitancy and its associated factors in Addis Ababa, Ethiopia.MethodsAn embedded mixed method study [QUAN(quali)] was conducted among residents of Akaki Kality sub-city in Addis Ababa, Ethiopia. For the quantitative part, a multi-stage sampling technique was used to recruit the study participants (n = 422). Twenty four adults were included purposively for the qualitative in-depth interview. Data was collected by face-to-face interview by using a semi-structured questionnaire. Factors associated with COVID-19 vaccine hesitancy were identified by multivariable binary logistic regression model.ResultThe mean age of the participants was 34.1 years (±12.9). Nearly half (46.7%) of the participants exhibited poor level of knowledge and 51.8% had negative attitude towards COVID-19 and its preventive measures. One out five (19.1%) participants were not willing to get vaccinated when it becomes available. In the multivariable analysis, vaccine hesitancy was significantly associated with being female (aOR=1.97; 95% CI: 1.10 - 3.89, p=0.03), negative attitude towards COVID-19 and its preventive measures (aOR=1.75; 95% CI: 1.08 - 3.02, p=0.04), and information source being social media (internet) (aOR=3.59; 95% CI: 1.75 - 7.37, P <0.0001).ConclusionA considerable proportion of the people in Addis Ababa have concerns on COVID-19 vaccine and unwilling to accept once it is available. Several conspiracy theories were put forth to justify their stance and this was mainly due to the misconceptions distributed from the use of social media as source of information. Overall, providing the community with health education and consistent government efforts in uphold the prevention measures are of paramount importance to tackle this pandemic.

Background: Severe acute malnutrition is one of the major killers of under five children in developing countries including Ethiopia. However, little information is known about the determinant factors of severe acute malnutrition. Hence this study identified the determinants of severe acute malnutrition in Shashogo woreda, Southern Ethiopia. Methods: An age matched community based case control study was conducted from February 20 to march 30, 2014 in 12 randomly selected rural kebeles of the Shashogo district, southern Ethiopia. The cases were 108 severely malnourished children under the age of five and the controls (n=108) were children without malnutrition recruited concurrently from under five children of the same kebele. Data was collected by face to face interview using structured questionnaire and the anthropometric measurements of the children was taken using standard procedures. Descriptive and summary statistics was done. Bivariate and multivariate analysis was done using conditional logistic regression on SPSS version 20.0 and Epi info version 7 software in order to determine factors associated with severe acute malnutrition. Result: Multivariate analysis with conditional logistic regression revealed that severe acute malnutrition was associated with maternal illiteracy (AOR=8.683, 95% CI 2.668-28.26), lack of maternal autonomy in decision making (AOR = 3.46, 95% CI 1.272-9.414), diarrhea 2 weeks preceding the survey (AOR = 4.13, 95% CI 1.34-11.47), sub optimal frequency of complementary feeding (AOR = 3.21, 95% CI 1.63-9.33) and visit to health institution after 24 hours of the onset of symptoms for sick child (AOR=3.95, 95% CI 1.465-10.647) after the effects of other significant variables were controlled. Conclusion and recommendation: The findings of this study have confirmed the association of severe acute malnutrition with maternal education, maternal autonomy in decision making and inappropriate infant and young child caring practices. To reduce childhood malnutrition due emphasis should be given in empowering women and improving the knowledge and practice of parents on appropriate infant and young child caring practices.

Background/Objectives: Diabetes is a global public health problem, and its burden is rising, particularly in developing countries. However, limited data is available from sub-Sahara African communities to assess and monitor the disease burden. The study aimed to determine the prevalence and associated factors of diabetes in Hosanna, Ethiopia. Methods: A community-based cross-sectional study was conducted among 634 randomly selected adults in Hosanna. The study participants were recruited by multi-stage stratified sampling. A face-to-face interview using a structured questionnaire was administered by trained nurses. Anthropometry, blood pressure and fasting blood glucose levels were measured. Diabetes mellitus was considered when the fasting blood glucose level was ≥126 mg/dl on two separate measurements or when the participant self-reported a previous diagnosis of diabetes by healthcare providers or when the participant was currently receiving treatment for diabetes. Multi-variable binary logistic regression was used to identify factors associated with diabetes mellitus. Findings: The overall prevalence of diabetes was found to be 5.7% (95% CI; 4.0-7.7), out of which more than one third (36%) were not aware of it prior to the survey. Nearly two thirds (61.1%) of the diabetic participants were also found to be hypertensive. In the multi-variable analysis, diabetes was associated with current alcohol use, sitting on average of more than 8 hours/day, abnormal BMI and being hypertensive. Conclusion: The prevalence of diabetes among the adult population in the town is alarming. If appropriate measures to address the burden are not emplaced, it might result in serious complications to the patients and unnecessarily high costs to the health system of the country. Active screening for raised blood glucose level should be given due consideration, particularly in the community setting. Designing health education programs on the importance of physical activity and the risks of alcohol use should also be considered.

ObjectiveData on COVID-19 vaccine hesitancy is limited in Ethiopia and other parts of Africa. Therefore, the aim of this study was to determine the level of COVID-19 vaccine hesitancy and its associated factors in Addis Ababa, Ethiopia.DesignA community-based concurrent mixed-method study.SettingIn a community setting.ParticipantsAdult residents (n=422) of Akaki Kality subcity who were recruited by a two stage sampling technique and 24 adults who were selected purposively were included for the quantitative and qualitative part of the study respectively.Outcome measuresData were collected by face-to-face interview using a semistructured questionnaire. Factors associated with COVID-19 vaccine hesitancy were identified by multivariable binary logistic regression model.ResultsOne out five (19.1%, 95% CI 15.3% to 24.6%) participants were not willing to get vaccinated. In the multivariable analysis, vaccine hesitancy was significantly associated with being female (aOR=1.97; 95% CI 1.10 to 3.89), having negative attitude towards COVID-19 and its preventive measures (aOR=1.75; 95% CI 1.08 to 3.02), and primary information source being social media (internet) (aOR=3.59; 95% CI 1.75 to 7.37). Study participants have predominantly stated that they did not have enough information about the vaccine, feared it would not be effective or have too many side effects, and reflected their uncertainty towards the quality of the vaccine.ConclusionsA considerable proportion of the people in Addis Ababa have concerns on COVID-19 vaccines and unwilling to accept them. This was due to the misconceptions, negative attitudes and use of social media as their primary source of information. Providing the community with health education and consistent efforts to enhance the prevention measures are important, particularly using different medias including social media.

BackgroundIntrauterine Contraceptive Device (IUCD) is a highly effective and reversible modern contraceptive, which is still significantly underutilized in Ethiopia. The aim of this study was to identify factors affecting the use of IUCDs among women of reproductive age group in Addis Ababa. OPEN ACCESSCitation: Dereje N, Engida B, Holland RP (2020) Factors associated with intrauterine contraceptive device use among women of reproductive age group in Addis Ababa, Ethiopia: A case control study. PLoS ONE 15(2): e0229071. https://doi.org/ 10.The findings of the study reinforce the need of husbands/partners involvement in the interventions to enhance utilization of IUCD. Moreover, due attention should also be provided for delivering IUCD-related messages in the public mass-media.Factors associated with intrauterine contraceptive device use PLOS ONE | https://doi.

Background Cervical cancer is one of the most diagnosed and deadly cancers in women globally. Though vaccination is an effective way to reduce cervical cancer, people’s knowledge and acceptance of the vaccination remains a challenge in low and middle-income countries. Therefore, the aim of this study was to assess the level of knowledge and acceptance of Human Papilloma Virus (HPV) vaccination and its associated factors among parents of daughters in Addis Ababa, Ethiopia. Methods A community-based cross-sectional study was conducted among parents or guardians whose daughters are in the age group of 9–17 years and residing in Akaki-Kalty sub-city in Addis Ababa. A multistage sampling technique was used to select the study participants (n = 430). Face-to-face interview was conducted by using a structured questionnaire. Factors associated with the acceptance of HPV vaccination was identified by multivariable binary logistic regression and expressed by adjusted odds ratio (aOR), and respective 95% confidence interval. Results Complete response was obtained from 422 (98.1%) of the participants and their mean age was 39.0 years (SD ± 9.9). Out of the study participants, 41.7% and 72.0% had poor knowledge on cervical cancer and HPV, respectively. More than a quarter (27.0%) of the participants has never heard about HPV vaccine. One-third (36.5%) of the participants had negative attitude towards the HPV vaccine. Overall, 94.3% of the study participants were willing to vaccinate their daughters for HPV. Vaccine acceptability was associated with higher monthly income (aOR = 2.48, 95% CI 1.08–6.34), good knowledge on HPV (aOR = 2.32, 95% CI 1.56–4.87) and the vaccine (aOR = 2.24, 95% CI 1.12–8.60), and positive attitude towards the vaccine (aOR = 5.03, 95% CI 1.63—9.56). Conclusions The overall HPV vaccine acceptance was high. However, two out of five and one-thirds of the parents had poor knowledge on cervical cancer and negative attitude towards the HPV vaccine, respectively. Higher monthly income, good knowledge on HPV and the vaccine, and positive attitude towards the vaccine were associated with acceptance of HPV vaccination. To ensure sustainable acceptance of HPV vaccination, it is crucial to increase the community awareness in a sustainable manner.

PurposeData comparing the burden of the opportunistic infections among the Pre-ART and On-ART HIV-infected patients in Ethiopia are scarce. Therefore, this study aimed to compare the prevalence and predictors of opportunistic infections in Pre-ART and On-ART HIV-infected patients.MethodsA comparative cross-sectional study was conducted among adult patients infected with HIV and who were on Pre-ART or On-ART and followed up from 2012 to 2016 in Zewditu Memorial Hospital, Addis Ababa. Those patients who were infected with HIV, but not eligible for ART were categorized under Pre-ART follow-up (n=192) and those patients who started taking ART were categorized under the On-ART follow-up group (n=192). Patients were included in the study by using simple random sampling technique from the list of the patients registered in the ART follow-up database. The presence of opportunistic infections along with clinical findings and baseline laboratory data was extracted from the ART follow-up database and the medical records of the patients using a standardized checklist. Factors associated with the development of opportunistic infections were analyzed using multi-variable binary logistic regression analysis.ResultsThe overall prevalence of opportunistic infections was found to be 33.6% (95% CI; 28.9–38.5). The prevalence of opportunistic infections among the Pre-ART group (38%) was higher than On-ART group (29.2%) (P-value = 0.04). Pulmonary tuberculosis was the most common opportunistic infection observed in both Pre-ART and On-ART groups. Being in the WHO clinical Stage III (AOR = 2.1; 95% CI 1.1–3.9) or Stage IV (AOR = 3.6; 95% CI 1.7–7.7) were independent predictors for the development of opportunistic infections.ConclusionThe prevalence of opportunistic infections among the HIV-infected patients who were in Pre-ART was higher than On-ART group. This finding reinforces the need for early initiation of ART for HIV-infected patients irrespective of their CD4 counts.