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"Shifa, Jemal"
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Spatiotemporal patterns and factors contributing to neonatal mortality in Ethiopia: Data from EDHS 2000 to 2019
by
Bizuayehu, Habtamu Mellie
,
Shifa, Jemal E.
,
Alebel, Animut
in
Adolescent
,
Adult
,
Biology and Life Sciences
2024
Although Ethiopia has substantial improvements in various health indicators such as maternal and child mortality, the burden of neonatal mortality remains high. Between 2016 and 2019, neonatal mortality increased from 29 deaths per 1,000 live births to 33 deaths per 1,000 live births. This study aimed to explore the spatial patterns and factors contributing to neonatal mortality in Ethiopia.
Data from the Ethiopian Demographic and Health Surveys (EDHS) for the years 2000, 2005, 2011, 2016, and 2019 were analyzed. The EDHS sampling design uses a two-stage cluster sampling technique, considering census enumeration areas as primary sampling units and households as secondary sampling units. We used the Spatial Scan analysis in SaTScan and Getis-Ord Gi* statistic in Geographic Information System (GIS), to analyse the spatiotemporal patterns of neonatal mortality. Maternal, newborn and health service-related factors contributing to neonatal mortality were also analyzed using a multilevel logistic regression model. Adjusted Odds Rios (AOR) with corresponding 95% CI were presented as a measure of association and a P-value of 0.05 was used to declare statistical significance.
During the initial three consecutive surveys, there was a consistent pattern of hot spot clusters in the Amhara and Benshangul Gumuz regions, along with certain parts of the Oromia region. However, in later surveys, these clusters shifted to the eastern parts of the country, notably including the Somali region. Early initiation of breast feeding was associated with reduced chances of neonatal death (Adjusted Odds Ratio [AOR]) = 0.27; 95% Confidence Interval [CI]: 0.23, 0.32). Neonates born at home (AOR = 1.46; 95% CI: 1.16, 1.82) and male babies had a higher likelihood of mortality during the neonatal period compared to their counterparts (AOR = 1.36; 95% CI: 1.24, 1.51). The odds of neonatal mortality increased with the number of children a mother had ever given birth to (AOR = 1.36; 95% CI: 1.24, 1.51). In contrast, longer birth intervals were associated with a reduced risk of neonatal mortality (AOR = 0.76; 95% CI: 0.68, 0.83).
The central southern, central-western, north-western, and northern parts of Ethiopia had most of the neonatal death clusters in the first three rounds of DHS while eastern Ethiopia had the highest neonatal mortality clusters in the latest two surveys. Our results underscore the importance for policymakers and health administrators to reassess intervention approaches and reallocate resources to regions identified as hot spots for neonatal mortality. Enhancing the initiation of breastfeeding within the first hour of birth would improve newborn survival rates. Special attention and care need to be given to babies born of smaller sizes.
Journal Article
Substance use among young people in the West Arsi Zone, Ethiopia: A cross-sectional study
2025
Substance use is a pressing public health concern in young Ethiopians, impacting their physical, psychosocial, and emotional well-being and productivity. However, there is a limited understanding of the prevalence and factors associated with substance use in this population both across Ethiopia and in the West Arsi zone specifically. This study investigates the prevalence of substance use and associated factors among young people in the West Arsi Zone, Ethiopia.
A community-based cross-sectional survey was conducted among 427 randomly selected young people aged 14-29 in the West Arsi zone of the Oromia region, Ethiopia. Data were collected using structured interviewer-administered questionnaires. Logistic regression analysis was performed to determine the association between the outcome and independent variables. Ethical approval was obtained from the University of Technology Sydney, Australia, and Madda Walabu University, Ethiopia.
A total of 424 participants were included in the analysis, giving a response rate of 99.3%. The overall lifetime prevalence of any substance use among the study participants was 48.1% (95% CI: 43.3%, 53.0%) and the prevalence of current substance use was 72.5% (95% CI: 65.9, 78.5). Among lifetime users, 76.5% reported chewing khat, 49.0% drinking alcohol, 33.3% using various forms of tobacco, and 23.0% using cannabis. Being male, having a single marital status, a family history of substance use, low perceived social support, and the presence of mental health conditions were associated with an increased likelihood of substance use.
About half of the study participants reported a history of use of at least one substance from alcohol, khat, tobacco, or cannabis in their lifetime, highlighting the need for appropriate focused interventions to help address the growing challenges of substance use amongst young people in Ethiopia.
Journal Article
Anxiety symptoms during pregnancy and risk of adverse birth outcomes in Gondar Town Ethiopia
2025
Anxiety is the most common complication of pregnancy and childbirth and is reported to have a plethora of adverse maternal, birth, and childhood outcomes. There is a lack of studies that looked at the association between pregnancy-related anxiety and the risk of adverse birth outcomes in Ethiopia. We conducted a community-based prospective cohort study in Gondar Town to explore the link between anxiety symptoms during pregnancy and the risk of adverse birth outcomes (low birth weight (LBW), preterm, and stillbirth). We used the three questions listed in the Edinburgh Postnatal Depression Scale (EPDS-3 A) to assess the presence of anxiety symptoms during pregnancy. We explored both association and causal effects using modified Poisson regression and the Targeted Maximum Likelihood Estimation (TMLE), respectively. We also calculated the population impacts of risk factors significantly associated with adverse birth outcomes. Of 916 mothers who made up a cohort, 895 completed follow-ups and were included in the final analysis. No evidence of an association was found between anxiety symptoms during pregnancy and: LBW (Adjusted incidence rate ratio (aIRR) = 1.20; 95%CI: 0.49, 2.94), preterm birth (aIRR = 0.77; 95%CI: 0.36, 1.64), and stillbirth (aIRR = 3.29; 95%CI: 0.96, 11.29,
p
= 0.058). However, other psychosocial factors such as maternal fearful thoughts about delivery and poor stress-coping ability contributed to 34.9% (95% CI: 10.3, 52.7) and 38.3% (95% CI: 12.6, 56.5) of preterm births, respectively. Supportive husbands, on the other hand, averted about 14.7% (95% CI: 5.1, 27.1) of premature births. About 90.0% (95%CI: 82.2, 94.4) and 54.1% (95%CI: 15.0, 75.2) of the risk of LBW was attributed to preterm birth and smoking in pregnancy. There was no evidence of an association between anxiety symptoms during pregnancy and adverse birth outcomes. Other psychosocial factors contributed to or averted adverse birth outcomes. Early screening followed by providing proven psychological interventions is key for reducing individual and population-level impacts of psychosocial risk factors associated with adverse birth outcomes.
Journal Article
Perceived stigma among patient with pulmonary tuberculosis at public health facilities in southwest Ethiopia: A cross-sectional study
by
Hajure, Mohammedamin
,
Mohammedhussein, Mustefa
,
Shifa, Jemal Ebrahim
in
Adult
,
Antitubercular Agents - therapeutic use
,
Biology and Life Sciences
2020
Although tuberculosis (TB) related stigma has a significant impact on the diagnosis, patient adherence with treatment, and recovery from the disease, there is limited evidence from Ethiopia regarding perceived stigma among patient with pulmonary tuberculosis (PTB).The purpose of this study was to assess perceived stigma and associated factors among patient with PTB on treatment in southwest Ethiopia.
Institution-based cross-sectional study was conducted from April to May 2019 among 410 patient with PTB. Data were collected by using the perceived tuberculosis stigma scale. Epi data v3.1 and SPSSv23 were used for data entry and analysis. Multivariable logistic regression models were fitted to identify factors associated with perceived stigma. Results are presented as adjusted odds ratios (AORs) with 95% confidence intervals (CIs).
Prevalence of perceived stigma among patient with Pulmonary tuberculosis was 57.1% (95% CI: 52.2, 61.7). Poor social support (AOR = 2.41; 95% CI: 1.06, 5.48), above a month duration of illness (AOR = 2.48; 95% CI: 1.33, 4.64), high perceived stress (AOR = 1.95; 95% CI:1.09, 3.49), current khat use (AOR = 1.88; 95% CI:1.05, 3.37), and presence of depression (AOR = 8.18; 95% CI:4.40, 15.22) were significantly associated with perceived stigma. Patient with HIV co-infection were 5.67 times (AOR = 5.67; 95% CI: 2.32, 13.87) more likely to have Perceived stigma than their counterparts.
TB related stigma was reported by more than half of the study participant. Stigma reduction measures are needed to lower TB related stigma perceived by the patient, the level of distress associated with it, and to promote the psychological wellbeing of patient with TB.
Journal Article
Person-centred maternity care during childbirth: a systematic review in low and middle-income countries
by
Bizuayehu, Habtamu Mellie
,
Bedaso, Asres
,
Shifa, Jemal E.
in
Births
,
Childbirth
,
Childbirth & labor
2025
Background
Improving the quality of intrapartum and immediate postnatal care is critical for reducing maternal and neonatal mortality in low- and middle-income countries (LMICs). This review aimed to assess the extent of Person-Centred Maternity Care (PCMC) practices during childbirth in LMICs.
Methods
We retrieved studies from four databases, including PubMed/Medline, Embase, CINAHL, and Maternal and Infant Care, up to 30 May 2023 and updated 26 April 2024. Additionally, manual searching was performed to identify additional studies. Our study included studies that examined PCMC using PCMC scale. The included studies were assessed using the Joanna Briggs Institute (JBI) checklist for quality appraisal.
Findings
Twelve articles out of 888 were retained in the review. Among these, nine studies specifically examined various elements of PCMC, such as dignity and respect, communication and autonomy, and supportive care. The lowest and highest levels of the mean (± SD-standard deviation) PCMC were 46.5 (6.9) and 60.2 (12.3) out of 90 total scores in Ghana and urban Kenya, respectively. The lowest score was reported in the communication and autonomy subscale domain of PCMC at a mean (± SD) score of 8.3 (3.3). Women who were wealthier and educated, and those who received ANC and birthing care by the same health care providers were found to have a higher level of PCMC during childbirth. Whereas those women who did not have ANC follow-up, visited health facilities for ANC in the second or third trimester, stayed at health facilities after birth for 2–7 days, had complications, and received care from auxiliary midwives, nurses, or assisted by unskillled attendants were associated with a lower level of PCMC during childbirth.
Conclusions
Our findings indicated that the communication and autonomy components of PCMC are notably low, affecting the rapport between healthcare providers and women, as well as decision-making and the execution of procedures. To enhance PCMC, continuity of care through antenatal and intrapartum care provided by the same healthcare providers, along with fostering a supportive environment for both women and healthcare providers during childbirth is imperative.
PROSPERO ID
CRD42023426638.
Journal Article
Mental health conditions of young Ethiopians who use substances: a cross-sectional study in West Arsi zone
2025
Background
Mental health conditions among young Ethiopians present a pressing public health concern, posing risks to their well-being and productivity. However, there is a limited understanding of the prevalence and associated factors among young people who use substances in the West Arsi Zone, Ethiopia. This study investigated the prevalence of mental health conditions and associated factors among young people who use substances in the West Arsi Zone, Ethiopia.
Methods
A community-based cross-sectional survey was conducted among 427 randomly selected young people aged 14–29 years in the West Arsi Zone of the Oromia region, Ethiopia from May 18, 2023, to September 22, 2023. Data were collected through structured interviewer-administered questionnaires. Logistic regression analysis was performed to determine the associations between the outcome and independent variables. Ethical approval was obtained from the University of Technology Sydney, Australia, and Madda Walabu University, Ethiopia.
Results
A total of 424 participants were included in the analysis, giving a response rate of 99.3%. The prevalence of mental health conditions was 47% (95% CI: 40.1%, 54.2%) among substance users and 26% (95% CI: 20.3%, 32.2%) among nonusers. In the final model, among substance users, participant sex, education level, family history of substance use, and family history of mental illness remained significantly associated with mental health conditions. Among nonusers, participant sex, perceived social support, and family history of mental illness remained significant predictors of mental health conditions.
Conclusions
Approximately half of the participants who used substances reported experiencing mental health conditions. This result highlights the need for appropriately focused interventions to address the growing challenges of mental health conditions and substance use among young people in Ethiopia.
Journal Article
Hydranencephaly in a Neonate: A Literature Review
by
Kgwarae, Chada
,
Siamisang, Aobakwe
,
Shifa, Jemal
in
Antiretroviral agents
,
Antiretroviral drugs
,
Apgar score
2020
The mother was tested positive for HIV before pregnancy and had been on highly active antiretroviral therapy (HAART) using Atripla with good viral suppression and CD4+ count. The pathogenesis of HE is still unknown, however most researchers support the hypothesis that the brain damage in HE is related to early internal carotid artery involvement, as demonstrated by angiographic and autopsy observation, in which internal carotid artery anomalies, both aplastic and hypoplastic, are reported and by the anatomic distribution of the anomaly in HE, which follows the internal carotid artery supply. [4],[5] Moreover, HE was associated with bilateral internal carotid artery occlusion, congenital infection such as TORCH syndrome, Treponema palladium, equine virus, and extensive hemorrhagic infarction following either germinal matrix hemorrhage or intraventricular hemorrhage which cannot be overlooked.
Journal Article
Bell's palsy in pregnancy as a prodromal sign of preeclampsia: A report of three cases, pregnancy outcome, and literature review
2021
Bell's palsy is a less common neurological disorder in the
general population. Its occurrence during pregnancy can be used as a
predictor of adverse obstetric outcomes including preeclampsia and its
complications. We report cases of three pregnant women from Botswana
who presented with Bell's palsy in the third trimester coexisting
with preeclampsia and multiple complications. One of the patient was a
case of maternal near-miss with multiple life threating complications
including stage 3 acute kidney injury (AKI) and required hemodialysis.
The second and third patients developed Bell`s palsy and preeclampsia
at term, management of preeclampsia commenced with immediate delivery
resulting in good maternal and neonatal outcome. In all the three
patients preeclampsia and Bell's palsy completely resolved
post-delivery. Therefore, new onset Bell's palsy in pregnancy may
be used as a prodromal sign of preeclampsia. Such patients deserve
close follow up for preeclampsia or gestational hypertension for a
better obstetric outcome.
La paralysie de Bell est un trouble neurologique moins fréquent
dans la population générale. Son apparition pendant la
grossesse peut être utilisée comme un prédicteur
d'issues obstétricales défavorables, y compris la
prééclampsie et ses complications. Nous rapportons les cas de
trois femmes enceintes du Botswana qui ont présenté une
paralysie de Bell au troisième trimestre coexistant avec une
prééclampsie et de multiples complications. L'un des patients
était un cas de quasi-accident maternel avec de multiples
complications potentiellement mortelles, notamment une insuffisance
rénale aiguë (IRA) de stade 3 et une hémodialyse
nécessaire. Les deuxième et troisième patientes ont
développé une paralysie de Bell et une prééclampsie
à terme, la prise en charge de la prééclampsie a
commencé avec l'accouchement immédiat, ce qui a donné de
bons résultats maternels et néonatals. Chez les trois
patientes, la prééclampsie et la paralysie de Bell ont
complètement disparu après l'accouchement. Par
conséquent, une nouvelle paralysie de Bell pendant la grossesse
peut être utilisée comme signe prodromique de
prééclampsie. Ces patientes méritent un suivi
rapproché de la prééclampsie ou de l'hypertension
gestationnelle pour un meilleur résultat obstétrical.
Journal Article
Bell's palsy in pregnancy as a prodromal sign of preeclampsia: A report of three cases, pregnancy outcome, and literature review
2021
La paralysie de Bell est un trouble neurologique moins frequent dans la population genérale. Son apparition pendant la grossesse peut étre utilisée comme un prédicteur d'issues obstetricales défavorables, y compris la prééclampsie et ses complications. Nous rapportons les cas de trois femmes enceintes du Botswana qui ont présenté une paralysie de Bell au troisiéme trimestre coexistant avec une prééclampsie et de multiples complications. L'un des patients était un cas de quasi-accident maternel avec de multiples complications potentiellement mortelles, notamment une insuffisance rénale aiguē (IRA) de stade 3 et une hémodialyse nécessaire. Les deuxiéme et troisiéme patientes ont développé une paralysie de Bell et une prééclampsie å terme, la prise en charge de la prééclampsie a commencé avec l'accouchement immédiat, ce qui a donné de bons résultats maternels et néonatals. Chez les trois patientes, la prééclampsie et la paralysie de Bell ont complétement disparu aprés l'accouchement. Par conséquent, une nouvelle paralysie de Bell pendant la grossesse peut étre utilisée comme signe prodromique de prééclampsie. Ces patientes méritent un suivi rapproché de la prééclampsie ou de l'hypertension gestationnelle pour un meilleur résultat obstétrical. (Afr J Reprod Health 2021; 25[3]: 135-141).
Journal Article
Compliance level and associated factors of iron folic acid supplementation among pregnant women in North Shoa Zone, Ethiopia
2024
Iron deficiency is a widespread micronutrient deficiency, impacting over 30% of the global population. Iron Folic Acid supplement is recommended for pregnant women to counter iron deficiency anemia and neural tube anomalies. Although Iron Folic Acid supplementation is integral to Ethiopian antenatal care, one in four women in Ethiopia experiences anemia during pregnancy suggesting poor compliance. This study aimed to investigate compliance level and associated factors of Iron Folic Acid supplementation among pregnant women attending antenatal care in Wuchale Woreda of North Shoa Zone, Ethiopia. An institutional-based cross-sectional study was conducted among 302 pregnant women from March 20 to April 5, 2021, who were selected using a systematic random sampling technique. Data were collected through face-to-face interview, entered epi-data, and exported to Statistical Package for the Social Sciences for analysis. A multivariable logistic regression was used to identify factors associated with compliance level. All the results were presented with 95% confidence intervals. The compliance with Iron Folic Acid supplementation was 47.0%. Residing nearest to the health facility (AOR = 2.46; 95% CI 1.32, 4.57), initiating antenatal care at health center (AOR = 2.23; 95% CI 1.17, 4.51), having a family size of 4 and above (AOR = 4.99; 95% CI 2.43, 10.24), and receiving information from health extension workers (AOR = 5.52; 95% CI 1.30, 23.54) increased compliance with Iron Folic Acid supplementation. Less than half of the pregnant women were compliant with Iron Folic Acid utilization. There is a need to prioritize promoting the importance of Iron Folic Acid supplementation through health education particularly by targeting pregnant women with identified factors.
Journal Article