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Malnutrition is the leading cause of poor child health in Ethiopia, and progress to avert it is unacceptably slow. In addition, little is known about the magnitude and factors associated with concurrent wasting and stunting (WaSt). Therefore, this study aimed to assess the prevalence and factors associated with WaSt, wasting, stunting and underweight among children 6–59 months in Kersa Health and Demographic Surveillance System, Ethiopia. Data from a total of 1091 children and their parents' were analysed from a cross‐sectional study. Household questionnaires and anthropometric measurements were used for data collection. Height‐for‐age, weight‐for‐height and weight‐for‐age indices are expressed as standard deviation units from the mean for the reference group. Multivariate analyses were conducted to identify factors associated with WaSt, wasting, stunting and underweight. Statistical significance was declared at p < 0.05. The prevalence of indicators of malnutrition was WaSt (5.8%), wasting (16.8%), stunting (53.9%) and underweight (36.9%). Children aged 6–17 months had a higher odds of wasting (adjusted odds ratio [aOR] 1.8, 95% confidence interval [CI] 1.12–2.75) compared with those aged 36–59 months, whereas children aged 18–35 months (aOR 2.4, 95% CI 1.65–3.47) and 36–59 months (aOR 1.6, 95% CI 1.07–2.37) had higher odds of stunting compared with those aged 6–17 months. Similarly, children aged 18–35 months (aOR 1.6, 95% CI 1.07–2.37) and 36–59 months (aOR 2.2, 95% CI 1.52–3.10) had higher odds of underweight compared with children aged 6–17 months. Households that did not treat drinking water at point of use were at higher odds of WaSt (aOR 3.3, 95% CI 1.16–9.27) and stunting (aOR 1.9, 95% CI 1.31–2.85) compared with those who did treat drinking water. Boys were more likely to be WaSt, wasted, stunted and underweight. Cough was associated with WaSt, wasting and underweight. Furthermore, maternal education, maternal occupation and maternal age were significantly associated with wasting. Maternal body mass index (BMI) of less than 18.5 kg/m2 and maternal BMI between 18.5 and 25 kg/m2 were associated with child stunting. In Kersa, the prevalence of WaSt, wasting, stunting and underweight is very high and requires urgent public health intervention. This study highlights point‐of‐use water treatment, maternal education, hygiene and sanitation, child health service utilization and maternal BMI as important areas to improve to target child malnutrition. Furthermore, a community‐based programmatic and policy direction for early identification and management of WaSt in addition to other indicators of malnutrition is recommended.

Background In the context of WHO’s “task shifting” project and growing global consensus on primary HPV-based cervical cancer screening, self-sampling is a promising new tool to expand screening access, uptake and coverage for women worldwide. We aimed to explore perceptions and acceptability of HPV self-sampling-based cervical cancer screening among community members and health professionals in rural northwest Ethiopia and to identify preferences and socio-cultural barriers regarding self-sampling in order to design a suitable high-coverage screening intervention for a rural African setting. Methods Four community-based focus group discussions (FGD) were conducted in the rural district of Dabat, Northwest Ethiopia, each comprising 8 to 14 female participants, counting a total of 41 participants. The groups were homogenously composed in terms of their socio-economic status in the community. They included health centre attendees, community members, nurses and health development army leaders (HDAL). Two qualitative data collection experts conducted the interviews in the local language, using a FGD guide with several thematic areas. All participants granted written informed consent prior to the conduct of the interviews. As a concrete example of an existing self-sampling approach for cervical cancer screening we used the Evalyn® Brush. Results Emerging themes included (i) misconceptions and low awareness about cervical cancer among community residents and primary health care providers in rural northwest Ethiopia, (ii) stigmatization and social exclusion of affected women, (iii) delay in seeking of health care due to poor access and availability of services, and lacking of a concept of early cancer prevention, (iv) need of spousal permission, (v) fear of financial burden and (vi) fear of social marginalization. The self-sampling device was regarded to be acceptable and was judged to be easy to use for most women. The existing Ethiopian health care structure could facilitate a community approach. Conclusion Home-based self-sampling for cervical cancer screening is a socially acceptable and feasible “task shifting” method that will increase cervical cancer screening access and coverage in the Ethiopian study community. Education, awareness creation, community mobilization and family inclusion are identified as key activities to promote, implement and facilitate “task shifting” approaches like self-sampling.

Skipping breakfast during pregnancy presents several challenges and potential health risks for both the mother and her baby. Breakfast plays a crucial role in providing essential nutrients and energy after an overnight fast. Skipping breakfast during pregnancy creates an unhealthy environment for the fetus. Thus, this study aimed to identify the determinants of breakfast skipping among pregnant women. An unmatched, community-based case-control study was conducted among 116 randomly selected cases (breakfast skippers) and 232 neighboring controls (regular breakfast consumers). Data was collected using pre-tested interviewer-administered structured questionnaire. Binary logistic regression analysis was employed to determine predictors of breakfast skipping using STATA version 16. The odds of non-formal education (AOR = 3.92; 95% CI: 1.75, 8.78), low socioeconomic status (AOR = 2.93; 95% CI: 1.12, 7.68), poor dietary knowledge (AOR = 2.89; 95% CI: 1.29, 6.47), and experiencing morning sickness (AOR = 2.57; 95% CI: 1.13, 5.84) were higher among cases than controls. The odds of breakfast skipping were higher for every increase in family size (AOR = 1.65; 95% CI: 1.25, 2.18), but decrease with every unit increase in mid-upper arm circumference (AOR = 0.58; 95% CI: 0.46, 0.72) and weekly frequency of drinking coffee leaf tea beverage (AOR = 0.84; 95% CI: 0.78, 0.89). Findings of this study showed that poor economic status, lack of formal education, poor dietary knowledge, having morning sickness, having large family size, maternal nutritional status, and frequent consumption of coffee leaf tea beverage were significantly associated with breakfast skipping among pregnant women. Thus, efforts should focus on improving dietary awareness during pregnancy, strengthening dietary counseling during antenatal care, enhancing access to contraceptive services, and ensuring timely management of morning sickness.

Understanding the distribution of socioeconomic status (SES) and its temporal dynamics within a population is critical to ensure that policies and interventions adequately and equitably contribute to the well-being and life chances of all individuals. This study assesses the dynamics of SES in a typical rural South African setting over the period 2001–2013 using data on household assets from the Agincourt Health and Demographic Surveillance System. Three SES indices, an absolute index, principal component analysis index and multiple correspondence analysis index, are constructed from the household asset indicators. Relative distribution methods are then applied to the indices to assess changes over time in the distribution of SES with special focus on location and shape shifts. Results show that the proportion of households that own assets associated with greater modern wealth has substantially increased over time. In addition, relative distributions in all three indices show that the median SES index value has shifted up and the distribution has become less polarized and is converging towards the middle. However, the convergence is larger from the upper tail than from the lower tail, which suggests that the improvement in SES has been slower for poorer households. The results also show persistent ethnic differences in SES with households of former Mozambican refugees being at a disadvantage. From a methodological perspective, the study findings demonstrate the comparability of the easy-to-compute absolute index to other SES indices constructed using more advanced statistical techniques in assessing household SES.

In Ethiopia, the reduction in perinatal mortality rates is still falling short of national and global targets set for 2030. Additionally, accurate recording is challenging, as many births occur at home. This study aimed to assess the trends and determinants of perinatal mortality using population-based longitudinal data from 2009 to 2016 across three Health and Demographic Surveillance Systems (HDSS) in Ethiopia: Gelgel-Gibe, Dabat, and Kilite-Awlaelo. Data on vital events and pregnancies were continuously collected at these HDSS sites. The study utilized follow-up data from prospective linked pregnancy and birth cohorts from January 2009 to December 31, 2016. Perinatal mortality was defined as deaths occurring from 28 weeks of gestation until six days after birth, measured per 1000 live births. Relevant health, demographic, and socioeconomic data were included in the analysis. Poisson regression was employed to assess factors associated with perinatal mortality. Out of 38,691 pregnancies that led to births, there were 1214 perinatal deaths (456 stillbirths and 758 early neonatal deaths), resulting in a perinatal mortality rate of 31 deaths per 1000 total births. The early neonatal death rate was higher, at 19.6 deaths per 1000 total births, compared to the stillbirth rate of 11.8 per 1000 total births. The perinatal mortality rate declined from 40.6 in 2009 to 29.1 per 1000 total births in 2016, reflecting an average annual rate reduction of 2.4%. Determinants of perinatal mortality included being a male newborn, multiple births, first-time pregnancies (primi-gravidity), lack of antenatal care visits, absence of delivery services, and residing in tropical zones. The primary causes of death were asphyxia, sepsis, and preterm birth. Overall, perinatal mortality rates were high in the three HDSS sites, with slow reductions over time and significant variations between them. Addressing the issue of stillbirths and improving the availability and quality of emergency obstetric care are crucial. Continuous home visits in rural communities to prevent stillbirths and newborn deaths, are also essential.

Background Depression is one of the main contributors to the global burden of disease. Data on depression in low- and middle-income countries are still lacking, making optimal intervention planning and programming difficult. Methods We used regionally representative data from the Taabo Multiple Generations Cohort (Taabo MGC) to describe the prevalence of depression in rural Côte d’Ivoire. Moderate or severe depression was defined as a PHQ-9 score > = 10. We investigated overall prevalence rates as well as prevalence rates by sex, age, residence and wealth. Results Data from 5,093 women and 3,600 men were analyzed. Overall, 7.8% of the individuals in our sample reported moderate to severe depression symptoms. The prevalence of moderate to severe depression was almost double in women (9.6% [8.83–10.45%]) than in men (5.2% [4.52–5.98%])). Adults over 60 years of age showed the highest rates of depression, with 13.4% (11.40–15.45%). Conclusions The results presented here suggest that the depression burden in rural Côte d’Ivoire is moderate, with a particularly high burden among women and elderly individuals. Mental health services are needed to specifically support this population.

Introduction Primary axillary hyperhidrosis significantly impacts the quality of life of affected individuals. miraDry ® , a non-invasive local precisely controlled thermal energy procedure, represents a promising treatment option. This retrospective analysis aimed to evaluate the treatment success and patient safety following miraDry ® procedure in the treatment of primary axillary hyperhidrosis. Material and Methods A total of 139 patients receiving miraDry ® procedure from 2019 to 2023 with miraDry ® fresh protocol for treatment of excessive axillary hyperhidrosis were analyzed. Subjective assessment was performed before and after treatment using hyperhidrosis disease severity scale (HDSS). Minor test (iodine starch test) was done before treatment and 6 months after treatment to objectively quantify sweat severity. Patients with subjective or objective unsatisfied results after first procedure were scheduled for a second treatment. Results The majority of treated patients (84%) could effectively be treated with one single treatment, while only 16% ( n  = 22) required a secondary intervention. HDSS after treatment completion (single and double treatment) showed a significant improvement ( p  < 0.001) in subjective evaluation of the treatment success. Minor tests demonstrated a significant reduction in sweat severity ( p  < 0.001), with 95% of patients experiencing no or minimal sweating after treatment completion. The miraDry® procedure demonstrated a favorable safety profile with typical and transient treatment reactions that mostly resolved within 6 months (94.2%) Conclusion Our data demonstrate that miraDry ® procedure is an effective and safe treatment option for primary axillary hyperhidrosis, which results in an immense improvement in quality of life and high satisfaction of affected individuals. Level of Evidence II This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors   www.springer.com/00266 .

All-cause mortality among people with HIV (PWH) in sub-Saharan Africa declined after antiretroviral therapy's introduction, but data in rural settings on evolving causes of death as this population age remain limited. To compare all-cause and cause-specific mortality trends among PWH and people without HIV (PWOH) in western Kenya using a prospective cohort study. Data from the Siaya Health and Demographic Surveillance System were used to estimate mortality rates from 2011 to 2018 among persons aged 15-64 years, with the study population (PWH/PWOH) determined through HIV testing. InterVA-4 was used to ascertain the cause of death. 45,581 individuals with an HIV test result contributed 209,078 person-years (py) of follow-up. The HIV prevalence was 14.5%. Median age among PWH increased from 37 to 42 years from 2011 to 2018. For PWOH, this was between 29 and 31 years. 1386 individuals died, 48.8% were PWH. HIV/AIDS/tuberculosis (319 deaths; 58.2%) was the leading mortality cause for PWH and non-communicable diseases (NCDs) (235; 40.9%) for PWOH. From 2011 to 2017, HIV/AIDS/tuberculosis mortality rates declined among PWH from 19.0 to 7.0 deaths/1,000py, and mortality due to NCDs increased from 3.7 in 2014 to 5.1/1,000py in 2017. For PWOH, cause-specific mortality trends were stable over time. Among PWH, HIV/AIDS/tuberculosis mortality decreased from 2011 to 2017, while mortality rates due to NCDs rose over time as the population aged. Among PWOH, NCDs were the leading cause of death. Managing HIV and the increasing burden of NCDs in this community requires education on prevention, active screening, and delivery of treatment and palliative care services.

Background Broad and specific causes of adult mortalities are often neglected indicators of wellbeing in low-income countries like Ethiopia due to lack of strong vital statistics. Thus, this database study aimed to assess the causes of adult mortality using demographic surveillance data. Methods An 8-year (12 September 2009–11 September 2017) surveillance data from the Arba Minch Health and Demographic Surveillance Site was used for this study. Verbal autopsy methods and ICD codes were used to identify the causes of the adult deaths. The collected data were entered to the database by data clerks. We used Microsoft Excel and STATA version 16 software for data cleaning and analysis. Chi-squared test was used to see the significances of the trend analyses. Result From the 943 adult deaths from 2009 to 2017 in the Health and Demographic Surveillance Site in southern Ethiopia, more than half of them were females. The specific leading cause of death in the adults were tuberculosis (16.8%), malaria (9.7%), and intestinal infectious diseases (9.6%). Communicable diseases (49.2%, 95% C.I 45.7, 52.7) accounted for about half of the deaths followed by non-communicable diseases (35%, 95% C.I 31.7, 38.4) where both categories showed an increasing trend. Conclusion Although pieces of evidences are showing the shift from communicable diseases to non-communicable diseases as the major causes of adult death in developing countries, this study showed that communicable diseases are still the major causes of adult deaths. Efforts and emphasis should be given to control infectious diseases such as tuberculosis and malaria.

PurposeThe main objective of this study was to assess the impact on quality of life after rubber band ligation (RBL) in patients with symptomatic grade II-III haemorrhoids who did not improve after 6 months of conservative treatment, using quality of life scores.MethodsThis was a prospective cohort observational study where patients with haemorrhoidal disease and indication for RBL were included between December 2019 and December 2020. RBL was offered as first-line treatment in this group. Patient´s quality of life was assessed by scores: HDSS (Hemorrhoidal Disease Symptom Score) and SHS (Short Health Scale).Secondary objectives were: to evaluate the rate of patients requiring one or more RBL procedures, to establish the overall success rate of RBL and to analyse complications.ResultsA total of 100 patients were finally included. Regarding the impact on quality of life after RBL, a significant reduction was found in the HDSS and SHS scores (p < 0.001). The main improvement was found in the first month and it was maintained until the sixth month. A high degree of satisfaction with the procedure was reported by 76% of patients. The overall success rate of banding was 89%. A 12% complication rate was detected, the most frequent complication was severe anal pain (58.3%) and self-limiting bleeding (41.7%).ConclusionRubber band ligation, as a treatment for symptomatic grade II-III haemorrhoids that do not respond to medical treatment, leads to a significant improvement in patients' symptoms and quality of life. It also has a high degree of satisfaction between patients.