Explore the vast range of titles available.

ObjectiveTo determine the prevalence of undiagnosed diabetes and identify associated factors using a two-step diagnostic method combining fasting blood sugar with confirmatory glycated haemoglobin A1c (HbA1c) testing among adults 45 years and above in rural Sidama, Ethiopia.DesignA community-based cross-sectional design was conducted from 1 April to 31 July 2024. Data were collected through a census of adults aged 45 years and above using a pretested WHO-STEPwise questionnaire. Physical and biochemical tests were performed following standard protocols. Data were analysed using Stata V.17.SettingSelected rural kebeles of Shebedino district, Sidama, Ethiopia.Participants2875 adults aged 45 years and above.Primary outcome measuresUndiagnosed diabetes confirmed by HbA1c levels (≥48 mmol/mol or ≥6.5%).ResultsThe prevalence of undiagnosed diabetes confirmed by HbA1c was 1.2% (35 of 2871; 95% CI: 0.9% to 1.7%). Previously diagnosed diabetes was found in 0.5% (14 of 2875; 95% CI: 0.3% to 0.8%). The total diabetes prevalence, confirmed by HbA1c or prior diagnosis, was 1.7% (49 of 2871; 95% CI: 1.3% to 2.3%). A total of 1327 out of 2875 (46%) participants were undernourished. Advanced age (β=0.21; 95% CI: 0.08 to 0.32, p=0.001), and estimated annual income (β=0.15; 95% CI: 0.02 to 0.28; p=0.029) were significantly associated with elevated fasting blood sugar levels.ConclusionThe prevalence of undiagnosed diabetes among rural adult population was low. Older age and higher income were significantly associated with elevated fasting blood sugar. Routine community-based diabetes screening among older population, health education and nutrition-focused interventions are recommended to sustain the low burden and address undernutrition.

Background The first 28 days of aliveness are the biggest challenge mentioned for the continuity of life for children. In Ethiopia, despite a significant reduction in under-five mortality during the last 15 years, neonatal mortality remains a public health problem accounting for 47% of under-five mortality. Understanding neonatal survival and risk factors for neonatal mortality could help devising tailored interventions. The aim of this study was to determine the neonatal survival and risk factors for neonatal mortality in Aroresa district, Southern Ethiopia. Methods A community based prospective follow up study was conducted among a cohort of term pregnant mothers and neonates delivered from January 1/2018 to March 30/2018. A total of 586 term pregnant mothers were selected with a multistage sampling technique and 584 neonates were followed-up for a total of 28 days, with 12 twin pairs. Data were coded, entered cleaned and analyzed using SPSS version 22. Kaplan–Meier survival curve was used to show pattern of neonatal death in 28 days. Independent and adjusted relationships of different predictors with neonates’ survival were assessed with Cox regression model. The risk of mortality was explored and presented with hazard ratio and 95% confidence interval and P -value less than 0.05 were considered as significant. Result The overall neonatal mortality was 41 per 1000 live births. Hazards of neonatal mortality was high for neonates with complications (AHR = 3.643; 95% CI, 1.36–9.77), male neonates (AHR = 2.71; 95% CI, 1.03–7.09), neonates that mothers perceived to be small (AHR = 3.46; 95% CI, 1.119–10.704), neonates who had initiated exclusive breast feeding (EBF) after 1 h (AHR = 3.572; 95% CI, 1.255–10.165) and mothers who had no postnatal care (AHR = 3.07; 95% CI, 1.16–8.12). Conclusion Neonatal mortality in the study area was 4.1% which was high and immediate action should be taken towards achieving the Sustainable Development Goals. To improve neonatal survival, high impact interventions such as promotion of maternal service utilization, essential newborn care and early initiation of exclusive breast feeding were recommended.

Introduction Folic acid deficiency is the most common pregnancy-related micronutrient deficiency, leading to fetal neural tube defects (NTDs). Periconceptional folic acid supplementation is highly effective in reducing NTDs by 72%-86%. However, awareness of this essential prevention method remains limited in lower-income countries, contributing to a high rate of preventable birth defects. Therefore, this study aims to evaluate the knowledge and factors associated with periconceptional folic acid supplementation among pregnant women attending the Antenatal care clinic at Dilla University Teaching Hospital in 2024. Method This institution-based cross-sectional study was conducted at Dilla University Teaching Hospital from January to December 2024. A systematic random sampling technique was used to enroll 337 eligible pregnant mothers attending Antenatal Care. Bivariate and multiple logistic regression analyses were performed to identify associated factors. The strength of association was reported using the Adjusted Odds Ratio (AOR) with a Confidence Interval (CI), with p-values considered statistically significant. Result Only 8.9% (95% CI: 5.85%-11.96%) of pregnant mothers demonstrated good knowledge of periconceptional folic acid supplementation. Factors significantly associated with improved knowledge included higher education (AOR 5.13), current family planning use (AOR 4.06), having a planned pregnancy (AOR 3.59), being in the 26–30 age group (AOR 2.33), and employment status (AOR 1.63). Conclusion Knowledge of periconceptional folic acid supplementation is extremely poor (8.9%) among pregnant women in the study area. Factors like higher education, family planning use, and planned pregnancy are strong determinants of awareness. There is an urgent need to implement targeted health education programs integrated within Antenatal Care and Family Planning services to improve knowledge and reduce the incidence of preventable NTDs.

Background Ethiopia is the second populous country in Africa with a total fertility rate of 4.6 and contraceptive prevalence of 35%, where implant and intrauterine contraceptive devices account for 8 and 2% respectively. The aim of this study was to determine the magnitude of long acting reversible contraceptives utilization and its associated factors among women of reproductive age in Arsi Negele town, Southeastern Ethiopia. Methods Facility-based cross-sectional study was conducted from April 01–May 30, 2017. A total of 361 women using modern contraceptives were selected by a systematic random sampling technique. Pre-tested and interviewer administered structured questionnaire was used to collect quantitative data. Bivariate and multivariate logistic regressions were performed using SPSS version 20.0 software. Result The magnitude of long acting reversible contraceptives (LARCs) utilization was 33.5% [95% CI, 28.5–38.8]. Husband with no formal education [AOR = 0.41, CI: 0.16, 0.78] and unemployed women [AOR = 0.35, CI: 0.42, 0.65] were negative predictors while having media exposure [AOR = 7.14, CI: 3.85, 13.25], women who desired only one child [AOR = 3.28, CI; 1.28, 8.39] and husband support [AOR = 7.33, CI: 3.48, 15.43] were positive predictors of LARCs utilization. Conclusion The overall utilization of LARCs is 33.5%. Creating employment opportunities, male involvement, advertisement and advocacy activities through mass media need to be considered to improve utilization of LARCs.

Background Obstetric danger signs are not the literal obstetric complications, merely symptoms that are well named by non-clinical personnel. The identification of these danger signs and its relation with complications during pregnancy would increase the capacity of women, their partners and families to seek for timely health care, following the appropriate steps to insure a safe birth and post-partum. The aim of this study was to assess the knowledge of obstetric danger signs and associated factors among pregnant women attending antenatal care in Yirgacheffe town, Gedeo zone, Southern Ethiopia. Method Institutional-based cross-sectional study was conducted from March 15–April 15, 2016. Data on pregnant women were collected using a pre-tested and interviewer administered structured questionnaire from 342 women using systematic random sampling technique. Bivariate and multivariate logistic regression was performed using SPSS version 20.0 software. Result A total of 342 (90%) pregnant women were included in the study. The level of obstetric knowledge of danger signs was 21.9% (95% CI: 20.2–55.65%). Maternal education (AOR = 0.26, CI: 0.08, 0.88), paternal education (AOR = 0.13, CI; 0.04, 04) and time taken to reach health facilities on foot (AOR = 0.06, CI: 0.02, 0.17) were negatively associated factors while maternal age (AOR = 3.68, CI: 1.30, 10.46), paternal occupation (AOR = 4.65, CI: 1.82, 11.87), place of residence (AOR = 2.61, CI: 1.35, 5.04) were positively associated factors with knowledge of obstetric danger signs. Conclusion Maternal and paternal education, maternal age, paternal occupation, place of residence and time taken to reach health facility on foot were the main factors for knowledge of obstetric danger signs. Increasing knowledge of key danger signs, creating and promoting income generating mechanisms need to be continuously done at the health facility and the community as it makes ready women and their families for prompt and appropriate decisions and measures in case of obstetric danger signs.

Family planning is known not only as a fundamental intervention for improving the health of women but also as a human right. The aim of this study was to assess the current knowledge, attitude and practice of contraceptive use among female students in Dilla secondary and preparatory school, Dilla, South Ethiopia, 2014. A cross sectional study was conducted among 288 female students in Dilla secondary and preparatory school, south Ethiopia, June 19- 29/2014. A simple random sampling technique was used to select the study subjects. The data was collected using a self-administered structured questionnaire. The data was analyzed by SPSS 20. Chi-square test was used to identify associated factors. A total of 263 female students were involved in this study, of which 249 (94.7%) had good knowledge about contraception. The three most frequently identified methods were injectable form (83.9%), oral contraceptive pills (72.7%) and condom (48.6%). A total of 15.7% respondents ever used contraceptive. Among the users, 56.4% used oral contraceptive pills, and 23.1 and 10.2% used injectable form and condom, respectively. In spite of the fact that most respondents had good knowledge of contraception, their attitude and practice was low. Emphasis needs to be given on disseminating health information concerning the attitude and practice of contraceptive method.

Lower respiratory infections are a leading cause of morbidity and mortality around the world. The Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study 2016, provides an up-to-date analysis of the burden of lower respiratory infections in 195 countries. This study assesses cases, deaths, and aetiologies spanning the past 26 years and shows how the burden of lower respiratory infection has changed in people of all ages. We used three separate modelling strategies for lower respiratory infections in GBD 2016: a Bayesian hierarchical ensemble modelling platform (Cause of Death Ensemble model), which uses vital registration, verbal autopsy data, and surveillance system data to predict mortality due to lower respiratory infections; a compartmental meta-regression tool (DisMod-MR), which uses scientific literature, population representative surveys, and health-care data to predict incidence, prevalence, and mortality; and modelling of counterfactual estimates of the population attributable fraction of lower respiratory infection episodes due to Streptococcus pneumoniae, Haemophilus influenzae type b, influenza, and respiratory syncytial virus. We calculated each modelled estimate for each age, sex, year, and location. We modelled the exposure level in a population for a given risk factor using DisMod-MR and a spatio-temporal Gaussian process regression, and assessed the effectiveness of targeted interventions for each risk factor in children younger than 5 years. We also did a decomposition analysis of the change in LRI deaths from 2000–16 using the risk factors associated with LRI in GBD 2016. In 2016, lower respiratory infections caused 652 572 deaths (95% uncertainty interval [UI] 586 475–720 612) in children younger than 5 years (under-5s), 1 080 958 deaths (943 749–1 170 638) in adults older than 70 years, and 2 377 697 deaths (2 145 584–2 512 809) in people of all ages, worldwide. Streptococcus pneumoniae was the leading cause of lower respiratory infection morbidity and mortality globally, contributing to more deaths than all other aetiologies combined in 2016 (1 189 937 deaths, 95% UI 690 445–1 770 660). Childhood wasting remains the leading risk factor for lower respiratory infection mortality among children younger than 5 years, responsible for 61·4% of lower respiratory infection deaths in 2016 (95% UI 45·7–69·6). Interventions to improve wasting, household air pollution, ambient particulate matter pollution, and expanded antibiotic use could avert one under-5 death due to lower respiratory infection for every 4000 children treated in the countries with the highest lower respiratory infection burden. Our findings show substantial progress in the reduction of lower respiratory infection burden, but this progress has not been equal across locations, has been driven by decreases in several primary risk factors, and might require more effort among elderly adults. By highlighting regions and populations with the highest burden, and the risk factors that could have the greatest effect, funders, policy makers, and programme implementers can more effectively reduce lower respiratory infections among the world's most susceptible populations. Bill & Melinda Gates Foundation.

The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 provides an up-to-date analysis of the burden of diarrhoea in 195 countries. This study assesses cases, deaths, and aetiologies in 1990–2016 and assesses how the burden of diarrhoea has changed in people of all ages. We modelled diarrhoea mortality with a Bayesian hierarchical modelling platform that evaluates a wide range of covariates and model types on the basis of vital registration and verbal autopsy data. We modelled diarrhoea incidence with a compartmental meta-regression tool that enforces an association between incidence and prevalence, and relies on scientific literature, population representative surveys, and health-care data. Diarrhoea deaths and episodes were attributed to 13 pathogens by use of a counterfactual population attributable fraction approach. Diarrhoea risk factors are also based on counterfactual estimates of risk exposure and the association between the risk and diarrhoea. Each modelled estimate accounted for uncertainty. In 2016, diarrhoea was the eighth leading cause of death among all ages (1 655 944 deaths, 95% uncertainty interval [UI] 1 244 073–2 366 552) and the fifth leading cause of death among children younger than 5 years (446 000 deaths, 390 894–504 613). Rotavirus was the leading aetiology for diarrhoea mortality among children younger than 5 years (128 515 deaths, 105 138–155 133) and among all ages (228 047 deaths, 183 526–292 737). Childhood wasting (low weight-for-height score), unsafe water, and unsafe sanitation were the leading risk factors for diarrhoea, responsible for 80·4% (95% UI 68·2–85·0), 72·1% (34·0–91·4), and 56·4% (49·3–62·7) of diarrhoea deaths in children younger than 5 years, respectively. Prevention of wasting in 1762 children (95% UI 1521–2170) could avert one death from diarrhoea. Substantial progress has been made globally in reducing the burden of diarrhoeal diseases, driven by decreases in several primary risk factors. However, this reduction has not been equal across locations, and burden among adults older than 70 years requires attention. Bill & Melinda Gates Foundation.

In 2016, the estimated lifetime risk of stroke from the age of 25 years onward (as calculated from the results of the GBD Study) was 24.9%. This estimate varies according to country, region, and national level of social development. The risk increased by 8.9% from 1990 to 2016.

Efforts to quantify the global burden of enteric fever are valuable for understanding the health lost and the large-scale spatial distribution of the disease. We present the estimates of typhoid and paratyphoid fever burden from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017, and the approach taken to produce them. For this systematic analysis we broke down the relative contributions of typhoid and paratyphoid fevers by country, year, and age, and analysed trends in incidence and mortality. We modelled the combined incidence of typhoid and paratyphoid fevers and split these total cases proportionally between typhoid and paratyphoid fevers using aetiological proportion models. We estimated deaths using vital registration data for countries with sufficiently high data completeness and using a natural history approach for other locations. We also estimated disability-adjusted life-years (DALYs) for typhoid and paratyphoid fevers. Globally, 14·3 million (95% uncertainty interval [UI] 12·5–16·3) cases of typhoid and paratyphoid fevers occurred in 2017, a 44·6% (42·2–47·0) decline from 25·9 million (22·0–29·9) in 1990. Age-standardised incidence rates declined by 54·9% (53·4–56·5), from 439·2 (376·7–507·7) per 100 000 person-years in 1990, to 197·8 (172·0–226·2) per 100 000 person-years in 2017. In 2017, Salmonella enterica serotype Typhi caused 76·3% (71·8–80·5) of cases of enteric fever. We estimated a global case fatality of 0·95% (0·54–1·53) in 2017, with higher case fatality estimates among children and older adults, and among those living in lower-income countries. We therefore estimated 135·9 thousand (76·9–218·9) deaths from typhoid and paratyphoid fever globally in 2017, a 41·0% (33·6–48·3) decline from 230·5 thousand (131·2–372·6) in 1990. Overall, typhoid and paratyphoid fevers were responsible for 9·8 million (5·6–15·8) DALYs in 2017, down 43·0% (35·5–50·6) from 17·2 million (9·9–27·8) DALYs in 1990. Despite notable progress, typhoid and paratyphoid fevers remain major causes of disability and death, with billions of people likely to be exposed to the pathogens. Although improvements in water and sanitation remain essential, increased vaccine use (including with typhoid conjugate vaccines that are effective in infants and young children and protective for longer periods) and improved data and surveillance to inform vaccine rollout are likely to drive the greatest improvements in the global burden of the disease. Bill & Melinda Gates Foundation.