Severe disability and its prevalence and causes in northwestern Ethiopia: evidence from Dabat district of Amhara National Regional State. A community based cross-sectional study

Abstract

Background: Disability is the social outcome of unfavorable interactions between individuals’ impairments, on the one hand, and inaccessible physical spaces, disenabling cultural environment and negative attitudes towards disability and persons with disabilities, on the other. Despite the fact that it directly affects 15% of Ethiopians as well as families and communities, policy-relevant studies on disability and the conditions of persons with disabilities are lacking. The Dabat Demographic Health Surveillance System (DHSS) was established to collect vital statistics in Dabat district, Amhara region. But it did not collect data on disability types, causes and community responses. With this drawback in DHSS, this study aimed at assessing the prevalence, types and major causes of severe disability in Dabat district. Method: A community-based cross-sectional study design was employed and covered 17,000 households residing in 13 Kebeles of Dabat district. The study was conducted in 2018 utilizing the modified 12-item World Health Organization’s Disability Assessment Schedule (WHODAS 2.0) and 7-item WHO Minimal Generic Set of Domains of Functioning and Health to collect data on disability in the district. The data were organized and presented as frequencies and percentages in table and figures. Relevant variables were used to construct a logit model that predicts the likelihood of disability whereby P-value < 0.05 was considered as statistically significant. Results: This study found that the overall prevalence of disability in Dabat district was 2.14% [95% CI: 2.03, 2.24]. About 8.3% of households reported at least one member with disability. Visual impairment was the most commonly reported impairment (51%) while 8.19% had multiple impairments. Eighty-three percent of immediate the causes of disability were modifiable – specifically, illness (36.93%), injury (17.81%), and congenital (10.86%). The aged [AOR=1.0; 95% CI: 1.03, 1.04], those unable to read or write illiterate [AOR=1.57; 1.15, 2.14], the unmarried/single [AOR=1.39; 95% CI: 185,2.47] and the separated [AOR=2.78; 95% CI: 4.14,6.19] were more likely to risk disability in the population.Conclusion: This study reported an increased likelihood of impairment among those with advanced ages. The proportion of households with PwDs was also high. While most disabilities were visual, there were significant numbers with mobility impairments and hard of hearing. Most school-age PwDs did not complete secondary education, while employment was significantly limited. The findings indicated that most causes of disability were reversible if impairments were screened or identified early and preventive or medical treatments were sought. Without undermining the role of specialized medical treatments, this study underlines the significance of early screening and preventive community interventions through CBR programs and rehabilitation workers in lowering disability rates in the district.

The burden of disabilities in Sidama National Regional State, Ethiopia: A cross-sectional, descriptive study

“…Regarding types of disability, extremity paralysis (35.4%), vision disability (20.13%), hearing disability (19.7%), walking disability (14.7%), and cognitive disabilities (7.7%) were the identified types of disabilities, (2.4%) of people with disabilities had more than one type of disability. This finding is different from the studies conducted in the Dabat district, Ethiopia and North Ethiopia [ 9 , 10 , 12 ]. In the Dabat study, the leading causes were 51% vision disability, 22.3% walking disability, and 22.3% hearing disability [ 12 ].…”

“…In this study, 61% of the disabilities are due to illness, injury, and accidents, which are preventable. As evidenced by different findings [ 12 , 21 ] the majority of the disabilities in Africa are due to the above three preventable causes. In low and middle-income countries, including Ethiopia, the majority of the disabilities are caused by different infections like meningitis, measles, maternal rubella and poliomyelitis [ 10 , 22 ] which are avoidable and preventable by early detection and treatment [ 12 ].…”

“…As evidenced by different findings [ 12 , 21 ] the majority of the disabilities in Africa are due to the above three preventable causes. In low and middle-income countries, including Ethiopia, the majority of the disabilities are caused by different infections like meningitis, measles, maternal rubella and poliomyelitis [ 10 , 22 ] which are avoidable and preventable by early detection and treatment [ 12 ]. But due to poor health-seeking behaviour and access, many people are the victims of disabilities in low and middle-income countries, including Ethiopia.…”

“…The causes of disability are multifactorial. Of the causes of disability, 37% are due to illness [ 12 ] and 17.8% to 35.9% are due to injury [ 9 , 10 , 12 ], and infections like meningitis, measles, maternal rubella, and poliomyelitis [ 10 , 12 ] were some of the causes of disability. On the other hand, different studies revealed different types of disabilities in Ethiopia, including 34% to 51% vision disability [ 9 , 10 , 12 ], 11.7% to 22.3% walking disability [ 9 , 10 , 12 ], 6.8% to 22.3% hearing disability [ 9 , 10 , 12 ] and 15% cognitive disability [ 9 , 12 ].…”

“…There is also a significant disparity between World Health Organization estimates of disabled people and the actual number of disabled people. Likewise, there is a disagreement between the findings regarding the causes and types of disability in Ethiopia, evidenced by a 17.8% to 35.9% [ 9 , 10 , 12 ] difference in the magnitude of disability due to injury and a 34% to 51% [ 9 , 10 , 12 ] difference in the types of vision disability.…”