Explore the vast range of titles available.

Background In Ethiopia, despite considerable improvement of measles vaccination, measles outbreaks is occurring in most parts of the country. Understanding the neighborhood variation in childhood measles vaccination is crucial for evidence-based decision-making. However, the spatial pattern of measles-containing vaccine (MCV1) and its predictors are poorly understood. Hence, this study aimed to explore the spatial pattern and associated factors of childhood MCV1 coverage. Methods An in-depth analysis of the 2016 Ethiopia demographic and health survey data was conducted, and a total of 3722 children nested in 611 enumeration areas were included in the analysis. Global Moran’s I statistic and Poisson-based purely spatial scan statistics were employed to explore spatial patterns and detect spatial clusters of childhood MCV1, respectively. Multilevel logistic regression models were fitted to identify factors associated with childhood MCV1. Results Spatial hetrogeniety of childhood MCV1 was observed (Global Moran’s I = 0.13, p -value < 0.0001), and seven significant SaTScan clusters of areas with low MCV1 coverage were detected. The most likely primary SaTScan cluster was detected in the Afar Region, secondary cluster in Somali Region, and tertiary cluster in Gambella Region. In the final model of the multilevel analysis, individual and community level factors accounted for 82% of the variance in the odds of MCV1 vaccination. Child age (AOR = 1.53; 95%CI: 1.25–1.88), pentavalent vaccination first dose (AOR = 9.09; 95%CI: 6.86–12.03) and third dose (AOR = 7.12; 95%CI: 5.51–9.18, secondary and above maternal education (AOR = 1.62; 95%CI: 1.03–2.55) and media exposure were the factors that increased the odds of MCV1 vaccination at the individual level. Children with older maternal age had lower odds of receiving MCV1. Living in Afar, Oromia, Somali, Gambella and Harari regions were factors associated with lower odds of MCV1 from the community-level factors. Children far from health facilities had higher odds of receiving MCV1 (AOR = 1.31, 95%CI = 1.12–1.61). Conclusion A clustered pattern of areas with low childhood MCV1 coverage was observed in Ethiopia. Both individual and community level factors were significant predictors of childhood MCV1. Hence, it is good to give priority for the areas with low childhood MCV1 coverage, and to consider the identified factors for vaccination interventions.

Background Female genital mutilation/cutting (FGM/C) is a harmful traditional practice that violates the human rights of girls and women. It is widely practiced mainly in Africa including Ethiopia. There are a number of studies on the prevalence of FGM/C in Ethiopia. However, little has been devoted to its spatial epidemiology and associated factors. Hence, this study aimed to explore the spatial pattern and factors affecting FGM/C among girls in Ethiopia. Methods A further analysis of the 2016 Ethiopia Demographic and Health Survey data was conducted, and a total of 6985 girls nested in 603 enumeration areas were included in this analysis. Global Moran’s I statistic was employed to test the spatial autocorrelation, and Getis-Ord Gi* as well as Kulldorff’s spatial scan statistics were used to detect spatial clusters of FGM/C. Multilevel logistic regression models were fitted to identify individual and community level factors affecting FGM/C. Results Spatial clustering of FGM/C was observed (Moran’s I = 0.31, p -value < 0.01), and eight significant clusters of FGM/C (hotspots) were detected. The most likely primary SaTScan cluster was detected in the neighborhood areas of Amhara, Afar, Tigray and Oromia regions (LLR = 279.0, p  < 0.01), the secondary cluster in Tigray region (LLR = 67.3, p < 0.01), and the third cluster in Somali region (LLR = 55.5, P  < 0.01). In the final best fit model, about 83% variation in the odds of FGM/C was attributed to both individual and community level factors. At individual level, older maternal age, higher number of living children, maternal circumcision, perceived beliefs as FGM/C are required by religion, and supporting the continuation of FGM/C practice were factors to increase the odds of FGM/C, whereas, secondary or higher maternal education, better household wealth, and regular media exposure were factors decreasing the odds of FGM/C. Place of residency, Region and Ethnicity were also among the community level factors associated with FGM/C. Conclusions In this study, spatial clustering of FGM/C among girls was observed in Ethiopia, and FGM/C hotspots were detected in Afar, Amhara, Tigray, Benishangul Gumuz, Oromia, SNNPR and Somali regions including Dire Dawa Town. Both individual and community level factors play a significant role in the practice of FGM/C. Hence, FGM/C hotspots require priority interventions, and it is also better if the targeted interventions consider both individual and community level factors.

Background Trachoma is the world’s major infectious cause of blindness, responsible for blinding 1.9 million people, including 1.2 million irreversibly. It is still endemic predominantly in sub-Saharan Africa, including Ethiopia. Five or more follicles in the upper tarsal conjunctiva measuring at least 0.5 mm indicate trachomatous inflammation-follicular (TF) disease. No previous study determined the prevalence of TF, and it had not been determined for the study area to satisfy adequate geospatial representation/spatial distribution of TF among children 1–9 years old. These study findings can help programmers understand the prevalence of TF and identify the villages in the study area where TF will be clustered to implement appropriate intervention strategies to support the current trachoma control and elimination program and to help achieve SDG Goal 3 target 3.3 and Goal 6. Therefore, this study addressed those gaps by identifying TF’s prevalence and spatial distribution using spatial analytical techniques and models in Yilmana Densa and Gonji Kolela Districts. Methods The study utilizes spatial autocorrelation methodologies, including Global Moran’s I and Local Getis-Ord statistics, to describe and map spatial clusters. The global Moran’s I statistic was used to evaluate the global spatial autocorrelation of TF prevalence. The Gi_Bin field was computed in hot spot spatial analysis, independent of the False Discovery Rate correction (FDR), to detect important hot spots and cold spots. Bins of +/-3, +/-2, and +/-1 indicated statistically significant clustering of the TF distribution with 99%, 95%, and 90% confidence levels, respectively. However, non-significant TF clusters were identified with a 0 bin. Results This study found that the prevalence of TF was 17.8% (95% CI: 15.3–20.2%). From spatial analytical techniques and models, the global spatial autocorrelation analysis based on feature locations and attribute values revealed a clustering of TF among children aged 1–9 years across the study area (Global Moran’s I = 0.849, p-value < 0.0001). In hot spot spatial analysis, fourteen hot spot clusters were detected. Eight clusters were detected as significantly clustered from those fourteen hot spot areas at the 99% confidence level. The study also found that the distribution of TF was not spatially random. It was clustered at the village levels and showed strong spatial patterns. It was affected by different locations based on sociodemographic, environmental, and behavioral factors. It was more clustered in Gonji Kolela District compared to Yilmana Densa District. This study showed that trachoma is a family-based disease. Conclusion TF was found to be higher than the WHO recommended threshold of 10% to say that trachoma is a severe public health problem to conduct MDA and eliminate trachoma as a Public Health problem in a community when the prevalence of TF is less than 5%. The results of the study may be used to support the current trachoma control and elimination program, and to help achieve SDG Goal 3 target 3.3 and Goal 6. Intervention against TF may also have an impact on poverty (SDG1) and hunger (SDG2), may improve education (SDG4), work, and economic growth (SDG8). These will be helpful to decide whether the Yilmana Densa and Gonji Kolela Districts meet VISION 2020, “The Right to Sight” (elimination of the major causes of avoidable blindness), an initiative launched in Ethiopia in September 2002. It is recommended that coordinated work on implementing the WHO endorsed SAFE strategy in particular, and enhancing the overall living conditions of the community be given a high priority.

Background Ethiopia signed both for Millennium Development Goals (MDGs) previously and Sustainable Development Goals (SDGs) currently to improve food security through gender equality and empowerment of women by positioning them as household leader. However, there is no concrete evidence about the impact of being of the female gender for household head on the prevalence of food insecurity at the national level, the authors’ intention being to fill this gap. Methods Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol (PRISMA-P) guideline was followed. All major databases such as PubMed/MEDLINE, WHOLIS, Cochrane Library, Embase, PsycINFO, ScienceDirect, Web of science, and reference lists were used to identify published articles, whereas shelves, author contact, Google, and Google Scholar were also searched to identify unpublished studies. Joanna Briggs Institute Meta-Analysis of Statistical Assessment and Review Instrument (JBI-MAStARI) was used for critical appraisal of studies. Meta-analysis was conducted using the STATA software version 14. The random effect model was used to estimate the pooled prevalence of food insecurity at 95% confidence level, while subgroup analysis and meta-regression were employed to identify the possible source of heterogeneity and the associated factors respectively. Moreover, Begg’s test was used to check publication bias. Results A total of 143 articles were identified, of which 15 studies were included in the final model with a total sample size of 2084 female-headed households. The pooled estimate of food insecurity among female-headed households was 66.11% (95% confidence level (CL) 54.61, 77.60). Female-headed households had 1.94 (95% CL 1.26, 3.01) times the odds of developing food insecurity as compared with male-headed households in Ethiopia. However, considerable heterogeneity across studies was also exhibited (I2 = 92.5%, p value < 0.001). Conclusion This review found that severity of food insecurity among female-headed households in Ethiopia was a more pronounced issue as compared with the general national estimate of food insecurity. Food insecurity among them was two-fold increased as compared with their men counterparts. So that, the government of Ethiopia needs to outlook how cultural and social restriction of women’s involvement in every aspect of activity affects their level of household food security. Beyond this, previous success and current gap of food insecurity among female-headed households should be explored in future research to run in accordance with Sustainable Development Goals (SDGs) specially with goals 2 and 5.

ObjectivePostnatal care (PNC) is essential for preventing maternal and newborn deaths; however, it still remains less well recognised in low-income and middle-income countries. This study was aimed to explore geographical patterns and identify the determinants of PNC usage among women aged 15–49 years in Ethiopia.MethodsA secondary data analysis was conducted using the 2016 Ethiopian demographic and health survey data. A total of 7193 women were included in this analysis. We employed spatial scan statistics to detect spatial inequalities of PNC usage among women. A multilevel binary logistic regression model was fitted to identify factors associated with women’s PNC.ResultsThe prevalence of PNC usage among women was 6.9% (95% CI 6.3% to 7.5%). The SaTScan spatial analysis identified three most likely clusters with low rates of PNC use namely southwestern Ethiopia (log likelihood ratio (LLR)=18.07, p<0.0001), southeast Ethiopia (LLR=14.29, p<0.001) and eastern Ethiopia (LLR=10.18, p=0.024). Women with no education (Adjusted Odd Ratio (AOR)=0.55, 95% CI 0.37 to 0.84) and in the poorest wealth quantile (AOR=0.55, 95% CI 0.39 to 0.78) were less likely to use PNC, while women aged 35–49 years (AOR: 1.75, 95% CI 1.01 to 3.04) and with at least four antenatal care (ANC) visits (AOR=2.37, 95% CI 1.71 to 3.29) were more likely to use PNC.ConclusionPNC usage remains a public health problem and has spatial variations at regional levels in the country. Low prevalence of PNC was detected in the Somali, Oromia, Gambella and Southern Nations, Nationalities, and People’s Region (SNNPR) regions. Women with low educational status, old age, being in poorest wealth quantile and history of ANC visits were significantly associated with PNC usage. Hence, it is better to strengthen maternal health programmes that give special emphasis on health promotion with a continuum of care during pregnancy.

ObjectivesTo determine uptake of the COVID-19 vaccine and identify the associated factors among health professionals in major cities of the Amhara region in Ethiopia.DesignInstitution-based, cross-sectional study.SettingThe study was conducted from July to September 2022 across 40 health centres and 13 hospitals, representing 10 major cities within the Amhara region.Participants1251 participants, all of whom were vaccine-eligible health professionals, were selected using a systematic random sampling procedure.Outcome measuresThe level of vaccine uptake in the study was determined by the proportion of health professionals who had received at least one dose of a COVID-19 vaccine.Results1251 health professionals participated, with 848 (67.8%) reporting that they had received at least one dose of a COVID-19 vaccine. Key findings from the multivariable logistic regression analysis revealed that health professionals aged 46 years and older were four times more likely to be vaccinated (95% CI, 1.656 to 9.510), married participants were 1.4 times more likely to take the vaccine (95% CI, 1.010 to 1.933) and those with good knowledge of COVID-19 vaccines were 1.75 times more likely to get vaccinated (95% CI, 1.307 to 2.331). Additionally, participants with a positive attitude towards vaccination were 3.65 times more likely to have received a vaccine (95% CI, 2.753 to 4.732).ConclusionsThe study reveals a commendable level of COVID-19 vaccine uptake among health professionals, emphasising their critical role in public health initiatives. However, the observed disparities in vaccination rates indicate the need for targeted interventions to improve vaccine coverage, particularly among younger professionals and those with limited knowledge of the vaccine. Addressing these gaps requires the implementation of tailored educational programmes that enhance understanding of COVID-19 vaccines. Furthermore, fostering positive attitudes through targeted campaigns, workplace-based initiatives and peer influence, particularly among younger and unmarried professionals, will be crucial. Encouraging vaccinated professionals to share their experiences and establishing regular follow-ups will also be essential strategies to improve vaccine acceptance and coverage in the region.

Background The prevention of unplanned pregnancy among women infected with human immunodeficiency virus (HIV) is critical for the prevention of mother-to-child transmission (PMTCT) of HIV. Of the prevention strategies, deployment of modern contraceptives is principal one. However, there were limited facts on utilization of modern contraceptives and associated factors among HIV infected women, in particular of resource-limited settings in Ethiopia. Hence, we aimed to quantify the proportion of modern contraceptive utilization and the possible related factors among women infected HIV. Methods A facility-based cross-sectional study was conducted on randomly selected 632 women infected with HIV from 05 February to 25 March 2018. Data on their treatment, socio-economic, and demographic background were collected through a structured interviewer administered questionnaire. Binary logistic regression model was fitted to identify the associated factors of modern contraceptive use among women infected with HIV. Result We found 61.4% (95% CI, 57.6–65.2) were using modern contraceptives. Greater than four family size (AOR:2.17; 95%CI: 1.31–3.59), family planning counseling service (AOR: 2.37; 95% CI: 1.44–3.91), discussing contraceptive issues with sexual partner (AOR: 1.76; 95% CI: 1.12–2.77), history of giving birth (s) (AOR:2.21; 95%CI:1.20–4.05) and World Health Organization (WHO) clinical stage III or IV (AOR: 3.59; 95%CI: 1.37, 9.44) were positively associated with modern contraceptives use, whereas, older age (AOR: 0.45; 95% CI: 0.24–0.81) and being widowed (AOR: 0.34; 95% CI: 0.14–0.83), abridged the chances of modern contraceptives use. Conclusion The prevalence of modern contraceptive use among women infected with HIV is low. Higher family size, counseling on contraceptives, discussing contraceptives issues with partner, history of giving births and WHO clinical stage III/IV were positively related with contraceptives use, whereas, older age and being widowed abridged the chances of contraceptives use among HIV infected women. Therefore, our findings support calls for the district health office and the antiretroviral treatment clinics of the resource-limited settings to work more on family planning counseling services and promoting more dialogues with sexual partners on modern contraceptives use.

The coronavirus disease-2019 (COVID-19) pandemic has posed a significant multifaceted threat to the global community. Ethiopia, as a Sub-Saharan African country, is suffering from chronic food insecurity, and the emergence of such a pandemic will exacerbate the situation. As a result, this study investigated the spatial variation of non-resilience to food insecurity, its relationship with COVID-19, and household coping strategies to become resilient in the long run among households in the East Gojjam Zone of Northwest Ethiopia. From September 22 to December 24, 2020, an agro-ecological-based cross-sectional study of 3532 households was conducted to assess the spatial distribution and associated factors of non-resilience to household food insecurity. The enumeration areas (EAs) and households were chosen using a multistage sampling technique. Data were gathered using a semi-structured questionnaire and checklist using an Android device loaded with an Open Data Kit (ODK) template. Binary logistic regression was used to identify the specific factors associated with household non-resilience to food insecurity. A thematic analysis was conducted to investigate the opportunities and challenges of resilience for household food insecurity. Nearly two-thirds (62.5%) of the households were farmers, 67.9% lived in rural areas, and nearly three-quarters (73.8%) earned less than or equal to ETB 2100 per month. Males headed more than four-fifths of the households (81.7%). We found that nearly two-thirds of the households (60.02%), 95% CI 58.40, 61.64) were food insecure. After bivariate logistic regression, we found that households who were divorced (AOR = 2.54 (1.65, 3.87)), daily laborers (AOR = 2.37 (1.15, 4.87)), government employees (AOR = 2.06 (1.05, 4.05)), residents of highland and hot areas (AOR = 11.5 (5.37, 16.77)) and lowland areas (AOR = 1.35 (1.02, 3.15)) were frustrated by COVID-19 (AOR = 1.23 (1.02, 1.50)) and price inflation (1.89 (AOR = 1.42, 2.56))) were at higher odds of being non-resilient to household food insecurity at a 95% confidence level. Geospatial hot spot analysis revealed that Kurar kebele (the lowest government administrative unit) in Dejen District and Debre Markos town were the red-hotspot areas of household non-resilience to food insecurity. Less than a quarter of the households attempted to cope with food insecurity by adjusting their food consumption, while more than 60% of the households chose none of the coping strategies tested. According to the thematic analysis, the degree of poverty (lack of asset ownership), the COVID-19 pandemic, farm decreased variety, and low crop productivity were identified as challenges to coping with the hardship of resilience to food insecurity. During the COVID-19 pandemic and public emergency, the proportion of households that were unprepared for food insecurity reached its peak. It was recognized that a segment of the population with low economic capacity was more vulnerable to food insecurity and less resilient. Tough developmental gains will be undermined in this case. As a result, each responsible body and stakeholder should develop and implement solid corrective plans for the local context.

Background Anemia is a common hematologic disorder among human Immunodeficiency virus (HIV) infected adult Individuals. However, there is no concrete scientific evidence established at national level in Ethiopia. Hence, this review gave special emphasis on Ethiopian HIV infected adult individuals to estimate pooled prevalence of anemia and its associated factors at national level. Methods Studies were retrieved through search engines in PUBMED/Medline, Cochrane Library, and the web of science, Google and Google scholar following the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). Joanna Briggs Institute Meta-Analysis of Statistical Assessment and Review Instrument (JBI-MAStARI) was used for critical appraisal of the included studies. Random effects meta-analysis was used to estimate the pooled prevalence of anemia and associated factors at 95% Confidence interval with its respective odds ratio (OR). Meta regression was also carried out to identify the factors. Moreover, Sub-group analysis, begs and egger test followed by trim-and-fill analysis were employed to assess heterogeneity and publication bias respectively. Result A total of 532 articles were identified through searching of which 20 studies were included in the final review with a total sample size of 8079 HIV infected adult individuals. The pooled prevalence of anemia was 31.00% (95% CI: 23.94, 38.02). Cluster of Differentiation 4 (CD4) count <= 200 cells/μl with OR = 3.01 (95% CI: 1.87, 4.84), World Health Organization (WHO) clinical stage III&IV with OR = 2.5 (95% CI: 1.29, 4.84), opportunistic infections (OIs) with OR = 1.76 (95% CI: 1.07, 2.89) and body mass index (BMI) < 18.5 kg/M 2 with OR = 1.55 ((95% CI: 1. 28, 1.88) were the associated factors. Conclusion This review demonstrates high prevalence of anemia among HIV infected adults. Low CD4 count, WHO clinical stage III&IV, OIs and low level of BMI were found to have significant association with the occurrence of anemia. Therefore, the responsible stockholders including anti retro viral treatment (ART) clinics should strengthen the system and procedures for the early diagnosis of opportunistic infection and screening of underlying problems. There should be also early screening for OIs and under nutrition with strict and frequent monitoring of HIV infected individuals CD4 count.

Background: Female genital mutilation/cutting (FGM/C) is a harmful traditional practice that violates the human rights of girls and women. It is widely practiced mainly in Africa including Ethiopia. There are a number of studies on the prevalence of FGM/C in Ethiopia. However, little has been devoted to its spatial epidemiology and associated factors. Hence, this study aimed to explore the spatial pattern and factors affecting FGM/C among girls in Ethiopia. Methods: A further analysis of the 2016 Ethiopia Demographic and Health Survey data was conducted, and a total of 6,985 girls nested in 603 enumeration areas were included. Moran's I statistic was employed to test the spatial autocorrelation, and Getis-Ord Gi* as well as Kulldorff’s spatial scan statistics were used to detect spatial clusters of FGM/C. Multilevel logistic regression models were fitted to identify individual and community level factors affecting FGM/C. Results: Spatial clustering of FGM/C was observed (Moran’s I=0.31, p-value < 0.01), and eight significant clusters of FGM/C were detected. The most likely primary cluster was detected in the neighborhood areas of Amhara, Afar, Tigray and Oromia regions (LLR = 279.0, p< 0.01), the secondary cluster in Tigray region (LLR=67.3, p<0.01), and the third cluster in Somali region (LLR=55.5, P<0.01). In About 83% variation in the odds of FGM/C was attributed to both individual and community level factors. At individual level, older maternal age, higher number of living children, maternal circumcision, perceived believes as FGM/C is required by religion, and supporting the continuation of FGM/C practice were factors to increase the odds of FGM/C, whereas, secondary/higher maternal education, better household wealth, and media exposure were factors decreasing the odds of FGM/C. Place of residency, Region and Ethnicity were the community level factors associated with FGM/C. Conclusions: Spatial clustering of FGM/C among girls was observed, and FGM/C hotspots were detected in Afar, Amhara, Tigray, BenishangulGumuz, Oromia, SNNPR and Somali regions including Dire Dawa Town. Both individual and community level factors play a significant role in the practice of FGM/C. Hence, FGM/C hotspots require priority interventions, and it is also better to consider both individual and community level factors.