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Background: Nowadays, the burden of non-communicable diseases including obesity has been an increasing public health concern. This menace can be monitored using indexing method like body mass index. Studies indicate that socioeconomic indicators such as income, biology, behavior, and demographic factors associated with body mass index. In Ethiopia, few studies associate wealth index with body mass index in people of ages between 15 and 49. This study was aimed to assess the association of body mass index with wealth index, and behavioral and sociodemographic population characteristics. Methods: A cross-sectional population-based study was conducted using the 2016 Ethiopian Demographic and Health Survey population of ages 15–49. A total of 10,245 individuals were considered to detect the effect of socioeconomic, biological, behavioral, and demographic factors on body mass index using logistic regression. Results: The prevalence of underweight, overweight, and obesity among men are 23.8%, 6.6%, and 2.0%, respectively, which is lower than that of women (underweight 25.3%, overweight 9.1%, and obesity 2.9%). The poorest men had higher odds of being underweight (adjusted odds ratio = 2.395%; 95% confidence interval = 2.020–3.544) as compared to the richest men. Merchants and government employees have lower odds (adjusted odds ratio = 0.744; 95% confidence interval = 0.588–0.899) compared to men whose occupation is farming and labor, indicating that merchants and government employees are more likely to become overweight and obese compared to men who are farmers and laborers. Conclusion: It is concluded that wealth index is an important socioeconomic determinant of body mass index among men and women of age 15–49 in Ethiopia. A high prevalence of underweight, and overweight, and obesity is observed, which increases instances of non-communicable diseases. Effects of socioeconomic, biological, behavioral, and demographic indicators on body mass index differed according to sex.

BackgroundAcute lower respiratory infections (ALRI) are a major cause of mortality among children under five. This study aimed to investigate the spatiotemporal pattern of ALRI in Ethiopian administrative zones.MethodsIn this study, a total of 29,599 under-five children from 2299 geographical units in 2000, 2005, 2011, and 2016 Ethiopian Demographic and Health Surveys (EDHSs) were involved. The generalized multilevel mixed model to analyze the effect of child-household level characteristics on ALRI was adopted.ResultsOverall prevalence of ALRI among Ethiopian under-five children is found to be 15%, with 2000, recording the highest prevalence of 24.44% while 2016 had the lowest prevalence of 11.07%. Being in the higher age group of children and having no experience of undernutrition status showed significantly lower ALRI prevalence than their counterparts. Among the household characteristics children from uneducated parents, unimproved household sanitation, lower wealth index, and rural residents were more likely to have ALRI than their counterparts. Based on the best linear unbiased prediction (BLUP) for the zonal-level random effect, the performance of Zones was ranked.ConclusionsBetween and within the Ethiopian administrative Zones disparities in ALRI were observed. The ranking of the performance of the Zones may help to target the worst performing Zones for immediate intervention strategy and the best performing Zones as a role model to adopt their best practice in the Ethiopian strategy to achieve the Sustainable Development Goal by the year 2030.

Background: Cancer is the second leading cause of death globally. Despite developing countries including Ethiopia continuing to shoulder the greatest burden, insufficient research has been conducted to determine geographical and other characteristic effects. The main objective of this study was to assess the distribution and risk of cancer and determine the effects of some common clinical patient characteristics on current patient status by taking into account the spatial effect. Methods: The data for this study were obtained from the oncology ward of Felege Hiwot Referral Hospital, Bahir Dar, Ethiopia. About 415 cancer patients were included in the study. Spatial mixed ordinal logistic regression model was used to explore the geographical patterns of the incidence of cancer and identify the risk factors. Results: The findings of this study show that only 1.45% of patients were cured and 46.02% improved, whereas the rest have shown no change and even worse status after treatment. The estimated odds of patients who received chemotherapy was 4.284 times the estimated odds of patients who received palliative care. Prognostic factor (stage of cancer tumor), complication of cancer such as anemia during diagnosis, and treatment of patients given in the hospital had significant effect on the patient status. Conclusion: Patients without anemia were more likely to be cured and improved than patients with anemia during diagnosis. Most of the patients had advanced stage (IV) of cancer tumor, which dismantles the capability of the treatment to be less effective. There was negative spatial effect on the incidence of cancer, indicating that districts with higher cancer incidence were usually surrounded by districts with lower incidence.

Background Child malnutrition is a huge health problem having multifaceted consequences for child survival and long-term well-being. Although, several studies investigated stunting, underweight, and wasting in low- and middle-income countries, in Nigeria, the link between them received little attention. The aim of this study is, therefore, to assess the association between anthropometric indicators of under-five children such as stunting, underweight and wasting given that of other characteristics of children and households. Methods The data for this study was obtained from Nigerian Demographic and health survey (NDHS) in 2018. A total of 11,314 under-five children were involved. Multivariate logistic regression model was used to determine the association between stunting, underweight and wasting given that of the estimated effect of other determinants. Results From 11,314 under-five children the study considered 36.2, 21.4 and 6.7% of them suffered from stunting, underweight and wasting, respectively. About half (50.7%) of the children were male, 24.1% was obtained from North West region of Nigeria, and 37.8% of them were from households having unimproved drinking water. The pairwise dependency between stunting and underweight; underweight and wasting was measured using odds ratio (OR) of 15.796, and 16.750 respectively. The estimated odds of children from richest household to become stunted, underweight, and wasted was respectively 0.392, 0.540, 0.786 times that of the estimated odds of children from poorest households. Conclusion The prevalence of under-five children with stunting, underweight and/or wasting in Nigeria was very high. The important determinants of stunting, underweight, and wasting for under five children were household wealth index, women body mass index, sex of the child, anemia, mothers’ age at first birth, and a diarrhea two weeks prior to the survey. Whereas, region, religion, multiple birth, women’s educational level significantly associated with both stunting and underweight. Both stunting and wasting significantly associated with underweight.

Background Malnutrition is the most common cause of mortality and morbidity of children in low and middle income countries including Ethiopia and household wealth index shares the highest contribution. Thus, in this study it is aimed to conduct bivariate binary logistic regression analysis by accounting the possible dependency of child composite index anthropometric failure and household wealth index. Methods In this study the data from Ethiopian Demographic and Health Survey (EDHS) 2016 involved 9411 under five children was considered. Child Composite Index Anthropometric Failure (CIAF) measures the aggregate child undernourished derived from the conventional anthropometric indices (stunting, underweight and wasting). The correlation between CIAF and wealth index was checked and significant correlation found. To address the dependency between the two outcome variables bivariate binary logistic regression was used to analyze the determinants of child CAIF and household wealth index jointly. Results Study results show that region, place of residence, religion, education level of women and husband/partner, sex of child, source of drinking water, household size and number of under five children in the household, mothers body mass index, multiple birth and anemia level of child had significant association with child CIAF. Female children were 0.82 times less likely to be CIAF compared to male and multiple birth children were more likely to be CIAF compared to single birth. Children from Oromia, Somalie, Gambela, SNNPR, Harari and Addis Ababa region were 0.6, 0.56, 0.67, 0.52, 0.6 and 0.44 times less likely to be CIAF compared to Tigray. A household from rural area were 15.49 times more likely poor compared to a household. The estimated odds of children whose mothers attended primary, and secondary and higher education was 0.82, and 0.52 times respectively the estimated odds of children from mothers who had never attended formal education. Conclusion The prevalence of children with composite index anthropometric failure was high and closely tied with the household wealth index. Among the determinants, region, religion, family education level, and anemia level of child were statistically significant determinants of both CIAF and household wealth index. Thus, the authors recommend to concerned bodies and policymakers work on household wealth index to reduce the prevalence of child composite anthropometric failure.

Background Undernutrition is the main cause of morbidity and mortality of children aged under five and it is an important indicator of countries’ economic and health status. Limited attention is given to research papers conducted in Ethiopia that identified and estimates the determinants of under-five anthropometric indicators by considering their association and clustering effect. Therefore, this study aimed to identify and estimate the effects of important determinants of anthropometric indicators by taking into account their association and cluster effects. Methods In this study, a cross-sectional study design was implemented based on the data obtained from the 2019 Ethiopia Mini Demographic and Health Survey (EMDHS) consists a total of 5027 under-five children. A multilevel multivariate logistic regression model was employed to estimate the effect of the determinants given their association of anthropometric indicators and clustering effect. Results Among 5027 children considered in the study 36.0, 23.3, and 9.1% of them were stunted, underweight, and wasted, respectively. Whereas the total number of undernourished (stunting, underweight and/or wasting) children was 42.9%. More than half of the children (51.2%) were males and 77.0% lived in rural area. The estimated odds of children from households with secondary and above education levels being stunted was 0.496 (OR = 0.496) times the estimated odds of children from households with no education. Whereas children from the richest households were less likely to be stunted as compared to children from the poorest households (OR = 0.485). The estimated odds of children from urban areas being underweight and wasting were lower by 24.9 and 33.7% of estimated odds of children from rural areas respectively. Conclusion The prevalence of anthropometric indicators of stunting, underweight, and wasting in Ethiopia was increased. The children underweight has significant dependency with both stunting and wasting. The sex of the child, wealth index, and education level of a household are the common important determinants of stunting, underweight and wasting. The undernourished status of children was more alike within the region and differences between regions.

Background Globally, the estimated recurrent childbirth of one forth of women happens every two years or fewer. Next to Nigeria, Ethiopia is the second populist country in Africa and the first populist country in sub-Saharan Africa which consists of over 114 million population. There are prevalent short successive birth intervals problems in underdeveloped nations such as Ethiopia that contributes to adverse effects on mother and child health. However, studies that explore recurrent birth events and associated factors are very limited. Thus, this study aimed to explore and model the recurrent birth event by considering its subsequent within a mother and identifying its important determinants. As a result, the research findings of this study will be one of the preliminary research papers on the recurrent birth events that take into account the subsequent event and enable to be input for the policymakers, health institutions, and future researchers. Methods A total of 4676 mothers with their 16833 corresponding children were involved in this study. The data was obtained from the 2019 Ethiopian Mini Demographic and Health Survey (EMDHS). In this study, extended cox regression models such as Andersen-Gill (AG), Prentice, Williams, and Peterson total time (PWP-TT) model, PWP-gap time (PWP-GT) model, and Frailty model were employed. These all models are used to consider recurrent events within mothers and determine the potential determinants. AG, PWP-TT, and PWP-GT estimate the effect of covariates by considering the correlation between event times for a person can be explained by past events given the covariates, k th event since the entry time, k th event since the time from the previous event, respectively. Results Among mothers who have first and ninth recurrent birth events, 75.5% and 80.1% of them respectively were rural residents while 57.6% and 70.6% of them respectively were a place of delivery in the health sector. The highest prevalence of first recurrent births (44.3%) was obtained from Muslim mothers. Mothers' education level (HR: 1.210; 95%CI: 1.010, 1.460), mothers' age at first birth (HR: 0.713; 95% CI: 0.614, 0.828), household wealth index (HR: 0.776; 95% CI: 0.625, 0.965), child mortality (HR: 0.673; 95%CI: 0.514, 0.881), household size (HR: 1.914; 95%CI:1.539,2.381) and sex of child (HR:0.836; 95%CI = 0.755,0.926) were important determinants of recurrent birth event. This indicates mothers’ education level and household size were positively associated with recurrent birth events. Whereas mothers’ age at first birth, household wealth index, child mortality, and sex of the child was negatively associated with recurrent birth events. Conclusion The WHO recommends a minimum of 33 months between two consecutive births, which is longer than the Ethiopian recurrent birth intervals observed in this study. The highest recurrent birth occurred during the age of fewer than twenty years old of mothers at first birth as compared to mothers whose age was older at first birth. Mothers, children, and household characteristics had significant effects on recurrent birth events. We authors would like to recommend communities, governmental and non-governmental stakeholders consider the associated factors of frequent recurrence of birth noticed in this study. Besides, we would also like to recommend women start birth while they got mature in age to reduce frequent recurrent birth and its corresponding adverse effects.

Hypertension is a widespread condition when the blood's force on the artery walls is extremely high to develop adverse health effects. This paper aimed to jointly model the longitudinal change of blood pressures (systolic and diastolic) and time to the first remission of hypertensive outpatients receiving treatment. A retrospective study design was used to collect appropriate data on longitudinal changes in blood pressure and time-to-event from the medical charts of 301 hypertensive outpatients under follow-up at Felege Hiwot referral hospital, Ethiopia. The data exploration was done using summary statistics measures, individual profile plots, Kaplan-Meier plots, and log-rank tests. To get wide-ranging information about the progression, joint multivariate models were employed. A total of 301 hypertensive patients who take treatment was taken from Felege Hiwot referral hospital recorded between Sep. 2018 to Feb. 2021. Of this 153 (50.8%) were male, and 124 (49.2%) were residents from rural areas. About 83(27.6%), 58 (19.3%), 82 (27.2%), and 25 (8.3%) have a history of diabetes mellitus, cardiovascular disease, stroke, and HIV respectively. The median time of hypertensive patients to have first remission time was 11 months. The hazard of the patient's first remission time for males was 0.63 times less likely than the hazard for females. The time to attain the first remission for patients who had a history of diabetes mellitus was 46% lower than for those who had no history of diabetes mellitus. Blood pressure dynamics significantly affect the time to the first remission of hypertensive outpatients receiving treatment. The patients who had a good follow-up, lower BUN, lower serum calcium, lower serum sodium, lower hemoglobin, and take the treatment enalapril showed an opportunity in decreasing their blood pressure. This compels patients to experience the first remission early. Besides, age, patient's history of diabetes, patient's history of cardiovascular disease, and treatment type were the joint determinant factors for the longitudinal change of BP and the first remission time. The Bayesian joint model approach provides specific dynamic predictions, wide-ranging information about the disease transitions, and better knowledge of disease etiology.

Background Antenatal care (ANC) is a maternal health care service given by skilled health professionals to pregnant women. Women may give birth at home or in health institutions. Home delivery care (DC) increases the likelihood of mortality of the mother and the newborn. Globally, each year nearly 303,000 maternal deaths occurred from complications of pregnancy and childbirth. Ethiopia alone accounted for 13,000 deaths, which disproportionately affects women living in different places of the country. Thus, this study aimed to assess the spatiotemporal patterns and associated factors of antenatal and delivery care utilization in Ethiopia. Method This study used the 2000 to 2016 EDHS (Ethiopian and Demographic Health Survey) data as a source. A total weighted sample of 30,762 women (7966 in 2000, 7297 in 2005, 7908 in 2011, and 7591 in 2016) was used. The separate and bivariate logistic regression analyses with and without the spatial effect were modeled using SAS version 9.4 and ArcGIS version 10.8. Results The spatial distribution of ANC and DC was non-random in Ethiopia. The overall odds ratio of ANC and DC was 2.09. In 2016, 31.8% and 33.2% of women had ANC and DC respectively. The estimated odds of following ANC among mothers from middle and rich households were 1.346 and 1.679 times the estimated odds of following ANC among mothers from poor households respectively. Women who had attained higher education were 1.56 and 2.03 times more likely to have ANC and DC respectively compared to women who had no formal education. Conclusions Despite the government's report that women now have better access to maternal health care, a sizable proportion of women continue to give birth at home without going to the advised antenatal care appointment. Women and husbands with low education, having non-working partners, religion, regions of dwelling, residing in rural, lower birth order, low birth interval, unable to access mass media, low wealth status, and earlier EDHS survey years were significant predictors that hinder antenatal and delivery care utilization simultaneously in Ethiopia. Whereas the spatial variable significantly affects antenatal care and being unable to access mobile phones lead to low utilization of delivery care. We recommend that policymakers, planners, and researchers consider these variables and the spatiotemporal distribution of ANC and DC to reduce maternal mortality in Ethiopia. Besides, it is recommended that further studies use the latest EDHS survey data.

Background Several studies were carried out on prevalence and associated factors of physical, emotional, and sexual violence against women. However, little attention was given to a comprehensive study that assesses the association between physical, emotional, and sexual violence against women. Thus, this study aimed to assess the association between physical, emotional, and sexual violence against women and their prevalence. Methods A retrospective cross-sectional design was implemented based on the 2018 Nigeria Demographic and Health Survey involving 8061 married women aged 15–49. A log-linear statistical model for the three-way table was used to assess the association between emotional, physical, and sexual violence. SAS statistical software was used for data management and parameter estimation. Results Among a total of 8061 women considered in the study 3022 (37.49%), 4216 (52.3%) and 1186 (14.71%) women have experienced physical, emotional, and sexual violence, respectively. The estimated odds of the interaction between emotional and physical violence (e 1.9281  = 6.876); physical and sexual violence (e −2.0529  = 0.128) were significantly differ from 1.0 with p-values < 0:0001 and 0.0201, respectively. Conclusion Over 33 percent of women experienced at least one incident of physical, emotional, or sexual violence in their lifetime. Physical violence against women has a significant association with emotional and sexual violence. However, it does not imply physical violence causes the other violence since cross-sectional data used for the analysis and other factors were not taken into consideration. The lack of a three-way association between emotional, physical, and sexual violence was also perceived. Therefore, as the prevalence of intimate partner violence against women s high, Nigeria as a country needs to strive to reduce it with the collaboration of other nations in the world to achieve Sustainable Development Goal (SDG). Design and apply guidelines to aware of the community about intimate partner violence against women and besides, take appropriate sentencing on those who commit the violence are the better approaches to prevent violence. Traditional habits that might be the cause of violence should be avoided to reduce or prevent the burden of women due to violence. Plain language summary Even though studies were carried out on physical, emotional, and sexual violence against women, and prevalence and associated factors, little attention was given to a comprehensive study that assesses the association between physical, emotional, and sexual violence against women. As a result, this study aimed to assess the association between physical, emotional, and sexual acts of violence against women in Nigeria. The data was obtained from the 2018 Nigeria Demographic and Health Survey (NDHS). A total of 8061 ever married/cohabited women aged 15–49 years who were residents of the study community for at least 6 months were considered. The log-linear statistical model was used to assess the association between physical, emotional, and sexual violence against women. Of the 8061 women considered in this study, 516(6.40%) have ever been physically forced into unwanted sex by a husband/partner. About 1346 (16.70%) and 1467(18.20%) women have ever been slapped and humiliated by their husbands/partners, respectively. Whereas 3022 (37.49%), 4216 (52.3%), and 1186 (14.71%) women have experienced physical, emotional, and sexual violence, respectively. Four hundred sixty-six women were victims of physical, emotional, and sexual violence. Besides, 40, 755, and 144 women have experienced both physical and sexual violence; emotional and physical violence; and emotional and sexual violence respectively. Physical violence against women has a significant association with emotional and sexual violence. However, it does not imply physical violence causes the other violence since cross-sectional data used for the analysis and other factors were not taken into consideration.