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1. Health related quality of life and associated factors among children living in previous leprosarium and nonleprosarium areas of Eastern Ethiopia

Author

Assefa Desalew, Siraj Aliyi Adem, Fitsum Weldegebreal, Getachew Kabew Mekonnen, Temam Beshir Raru, Ukash Umer, Mulualem Keneni, and Kedir Urgesa

Subjects
Health related quality of life, Children, Previous leprosy settlements, Non-leprosy settlements, Eastern Ethiopia, Medicine, Science
Abstract

Abstract Children and their families living in leprosarium areas may have a lower quality of life than the general population. However, there is limited evidence on health-related quality of life and its associated factors among children living in previous leprosarium settlement areas. Hence, this study aimed to compare the health-related quality of life among children living in previous leprosarium and non-leprosarium settlement areas in eastern Ethiopia. A community-based comparative cross-sectional study was conducted among 515 randomly selected children aged 8 to 18 years living in the Amir Nur and Babile districts from January to February 30, 2024. Data were collected through interviews with children and parents using the Pediatric Quality of Life Inventory Version 4. The data were analyzed using STATA version 14. Simple and multiple linear regression was employed to identify associations between independent and outcome variables. The overall mean health-related quality of life scores were 73.98 ± 18.47 and 77.67 ± 14.72 in the child self-reports (P = 0.01) and 55.78 ± 12.03 and 55.61 ± 8.50 (P = 0.85) in the parent proxy reports in the previous leprosarium and nonleprosarium settlement areas, respectively. In multiple linear regression, child education (β = 14.69; 95% CI: 8.69, 20.69), the absence of neglected and tropical diseases (β = 4.02; 95% CI: 0.66, 7.37), and child face washing habits (β = 5.54, 95% CI: 2.14, 8.95) increase health-related quality of life. However, a previous history of neglected and tropical diseases (β = -8.54; 95% CI: -12.93, -4.15) and the absence of hand washing facilities (β = -8.57; 95% CI, -15.22, -1.92) decrease the mean health-related quality of life. Based on child self-reports, one in four children from previous leprosarium areas had poor health-related quality of life compared to children living in none leprosarium areas. Children’s educational status, their daily habits of washing their face, not having neglected, and tropical diseases had improved health-related quality of life. To improve health-related quality of life, stakeholders should pay attention to and work on the early detection and treatment of neglected and tropical diseases, child education, and proper sanitation practices in the leprosarium community.

Published
2024
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2. Prevalence of active trachoma and its associated factors among children aged 1–9 years in previous leprosarium and non-leprosarium areas in eastern Ethiopia: a community-based comparative study

Author

Fitsum Weldegebreal, Mitiku Getachew, Getachew Kabew Mekonnen, Assefa Desalew, Shambel Mekonnen, Temam Beshir Raru, Ukash Umer, and Kedir Urgesa

Subjects
active trachoma, children, leprosy, non-leprosy, settlement, Ethiopia, Arctic medicine. Tropical medicine, RC955-962
Abstract

BackgroundTrachoma is a neglected tropical disease that mainly affects impoverished and marginalized communities with inadequate shelter and sanitation. Nevertheless, the prevalence of active trachoma and the specific factors contributing to it among communities residing in former leprosy settlements in eastern Ethiopia are not well explored. Therefore, the objective of this study was to compare the prevalence of active trachoma and its associated factors among children aged 1-9 years in the previous leprosarium and non-leprosarium areas, as well as urban and rural areas in eastern Ethiopia.MethodsA community-based comparative cross-sectional study was conducted among 580 systematically selected households from January 1 to 30, 2024. Data were collected by interviewing the children’s caregivers, observing the child and environment, and conducting a clinical examination of their eyes. Data were entered in EpiData version 4.6 and exported to Statistical Package of Social Science (SPSS) version 26 software for analysis. A chi-square test was also done. The association was presented as an adjusted odds ratio with a 95% confidence interval, and variables with a p-value less than 0.05 were regarded as statistically significant.ResultsThe overall prevalence of active trachoma was 12.9% (95% CI: 10.5%-15.3%). The prevalence of active trachoma was 15.6%, 9.8%, 18.3%, and 7.5% among children in previous leprosy and non-leprosy settlements and rural and urban areas, respectively (x²=5.65, p-value = 0.017). Having eye discharge (AOR = 10.7’; 95% CI: 4.32, 26.51), latrine distance from home of less than 10 m(AOR=3.12; 95% CI: 1.16–8.34), being a rural resident (AOR=4.1; 95% CI: 1.69-10.18), presence of solid waste around their home (AOR=6.5; 95% CI: 2.14-19.72), and household monthly income less than 5000 Ethiopian birrs (AOR=2.9; 95%CI: 1.04-8.30) were statistically associated with active trachoma in the previous leprosy settlements. In the non-leprosy settlements, children who had eye discharge (AOR = 7.6; 95% CI: 5.37, 58.05), latrine distance from home of less than 10 m (AOR=3.12; 95%CI: 1.11, 8.77), habit of playing with soil (AOR=9.0; 95% CI: 2.92, 28.24), and presence of animal dung (AOR=6.98; 95% CI: 3.44, 48.47) were statistically associated with active trachoma.ConclusionIn this study, the prevalence of active trachoma among children aged from 1-9 years old was higher than the WHO target for the elimination of active trachoma (

Published
2024
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3. Water, sanitation, and hygiene service inequalities and their associated factors among urban slums and rural communities in Eastern Ethiopia

Author

Getachew Kabew Mekonnen, Abdurauf Zako, Fitsum Weldegebreal, Assefa Desalew, Temam Beshir Raru, Ukash Umer, and Kedir Urgesa

Subjects
Eastern Ethiopia, hygiene, inequality, rural, sanitation, urban slum, Public aspects of medicine, RA1-1270
Abstract

BackgroundUnderstanding the level of inadequate water, sanitation, and hygiene (WaSH) services in urban and rural settlements is crucial for prioritizing community interventions and resource allocation. However, there is a lack of evidence regarding discrepancies in WaSH services across rural and urban slum communities in Ethiopia.ObjectiveThis study aims to assess inequalities in households’ WaSH services and their associated factors among urban slums and rural communities in Eastern Ethiopia from February to April 2024.MethodsA comparative community-based cross-sectional study design was conducted, with study participants selected through stratified random sampling using proportional-to-size allocation. Data were entered into Epi Data version 3.1 and then exported to STATA version 17 for analysis. Bi-variable and multivariable logistic regression was conducted, and associations were reported as odds ratios (ORs) with 95% confidence intervals (CI), using a p-value less than 0.05 as the significance threshold.ResultA total of 278 urban and 301 rural households participated in the study, with a response rate of 94%. Key indicators showed that WaSH services were significantly better in urban areas compared to rural households. For example, 98% (95% CI: 96, 99) of urban households had access to an improved water source compared to 76% (95% CI: 71, 80) of rural households. The proportion of households with improved latrines was 44% (95% CI: 38, 50) in urban areas and only 14% (95% CI: 11, 19) in rural areas. Handwashing practices at all five critical times were reported by 52% (95% CI: 46, 58) of urban household heads, compared to 22% (95% CI: 18, 27) of rural households. Additionally, occupation (such as being a farmer, p = 0.000) and water service satisfaction (p = 0.000) were significantly associated with these key WaSH outcomes.ConclusionThe study revealed that the WaSH services in urban slums are considerably better than in rural households. Socioeconomic factors significantly influence the existing disparities in WaSH services. Stakeholders should focus on providing targeted, strategic support to communities to address the challenges in WaSH service provision.

Published
2024
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4. Poor glycemic control and its associated factors among children with type 1 diabetes mellitus in Harar, eastern Ethiopia: A cross-sectional study

Author

Betelhem Demeke Habteyohans, Betre Shimelis Hailu, Fentahun Meseret, Ahmed Mohammed, Yeshi Berhanu, Ayichew Alemu, Gadissa Tolosa, Mulualem Keneni, and Assefa Desalew

Subjects
Glycemic control, Associated factors, Type 1 child and adolescent, Hiwot Fana Compressive Specialized University Hospital, Harar, Jugol General Hospital, Diseases of the endocrine glands. Clinical endocrinology, RC648-665
Abstract

Abstract Background Poor glycemic control increases the risk of acute metabolic derangements and long-term consequences, which are the main causes of morbidity and mortality. Maintaining adequate glycemic control is challenging for children with diabetes, particularly in resource-limited settings. There is a paucity of data on the magnitude of poor glycemic control and its predisposing factors in Ethiopian particularly in this study setting. Hence, we aimed to assess the magnitude of poor glycemic control and its associated factors among children and adolescents with type 1 diabetic mellitus in Jugol and Hiwot Fana Compressive Specialized University Hospitals in Harar, eastern Ethiopia. Methods A facility-based cross-sectional study was conducted among 231 children and adolescents with type 1 diabetes mellitus in Jugol and Hiwot Fana Compressive Specialized University Hospitals. Participants were included consecutively in the follow-up clinic from November 15, 2022 to January 15, 2023. Data were collected through an interviewer-administered structured questionnaire and a review of medical records. A binary logistic regression model with an adjusted odds ratio (aOR) and a 95% confidence interval (CI) was used to identify the factors associated with poor glycemic control. Statistical significance was set at p

Published
2023
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5. Risk factors associated with acute kidney injury in a pediatric intensive care unit in Addis Ababa Ethiopia: case-control study

Author

Mulualem Keneni, Rajalakshmi Murugan, Ketema Bizuwork, Tesfaye Asfaw, Sosina Tekle, Gadissa Tolosa, and Assefa Desalew

Subjects
Acute kidney Injury, PICU, Children, Risk factors, Ethiopia, Diseases of the genitourinary system. Urology, RC870-923
Abstract

Abstract Background Acute kidney injury (AKI) is a serious health problem in critically ill children. It is associated with poor treatment outcomes and high morbidity and mortality rates. Globally, one in three critically ill children suffers from acute kidney injury. However, limited data are available in Africa, particularly Ethiopia, which highlighting the risk factors related to acute kidney injury. Therefore, this study aimed to identify the risk factors associated with acute kidney injury among critically ill children admitted to the pediatric intensive care unit (PICU) at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. Methods A facility-based unmatched case-control study was carried out on 253 (85 cases and 168 controls) critically ill children admitted to the pediatric intensive care unit from January 2011 to December 2021. Participants were selected using a systematic random sampling technique for the control group and all cases consecutively. Data were collected using a structured checklist. Data were entered using Epi data version 4.6 and analyzed using SPSS version 25. Multivariable analysis was carried out using the adjusted odds ratio (aOR) with a 95% confidence interval (CI) to identify associated factors with acute kidney injury. Statistical significance was set at P

Published
2023
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6. Predictors of congenital anomalies among neonates admitted to public hospitals in eastern Ethiopia: a case–control study

Author

Nano Belama, Assefa Desalew, Magarsa Lami, Mulualem Keneni, and Kedir Teji Roba

Subjects
Medicine (General), R5-920
Abstract

Objective Over 8 million newborns worldwide have congenital anomalies; 3.2 million have resultant disabilities. Ethiopia has a high burden of neonatal congenital anomalies, but research on predictors is limited. This study investigated predictors of neonatal congenital anomalies in eastern Ethiopia. Methods A facility-based unmatched case–control study on 387 mother–infant pairs (129 cases, 258 controls) in public hospitals was conducted. Data were obtained using an interviewer-administered structured questionnaire and a medical record review. Binary logistic regression with adjusted odds ratios (AOR) and 95% confidence intervals (CI) was used to identify predictors of congenital anomaly. Results Nervous system anomalies were most common 84 (65.1%), followed by gastrointestinal system anomalies 20 (15.5%). Maternal anemia (AOR: 4.37, 95% CI: 2.48–7.69), alcohol consumption during index pregnancy (AOR: 4.01, 95% CI: 1.88–8.54), khat chewing (AOR: 1.73; 95% CI: 1.04–2.85), rural residence (AOR: 1.73, 95% CI: 1.04–2.85) and antenatal care attendance (AOR: 0.43, 95% CI: 0.22–0.84) were significant predictors of congenital anomaly. Conclusion Several risk factors for congenital anomalies were identified. To reduce risk, antenatal care services should be improved and mothers encouraged to avoid harmful substances during pregnancy and maintain a healthy lifestyle. Intervention strategies are needed to target these risk factors.

Published
2024
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7. Hyponatremia and its associated factors in children admitted to the pediatric intensive care unit in eastern Ethiopia: a cross-sectional study

Author

Yeshi Berhanu, Turina Yusuf, Ahmed Mohammed, Fentahun Meseret, Betelhem Demeke Habteyohans, Ayichew Alemu, Gadissa Tolosa, Mulualem Keneni, Fitsum Weldegebreal, and Assefa Desalew

Subjects
Hyponatremia, Hiwot Fana Comprehensive Specialized University Hospital, Children, Ethiopia, Pediatrics, RJ1-570
Abstract

Abstract Background Hyponatremia is a serious problem that leads to substantial increases morbidity and mortality in critically ill children. The identification of risk factors, implementation of preventive measures, and timely diagnosis and management are crucial to reduce adverse events related to hyponatremia. Despite the higher burden of the problem in Ethiopia, evidence related to the risk factors for hyponatremia among children in Ethiopia is limited; in particular, no study has been identified in eastern Ethiopia. Therefore, we aimed to determine the magnitude of hyponatremia and its associated factors in children admitted to the pediatric intensive care unit at the Hiwot Fana Comprehensive Specialized University Hospital. Methods A facility-based cross-sectional study was conducted using 422 medical records of pediatric patients admitted to the pediatric intensive care unit at Hiwot Fana Comprehensive Specialized University Hospital from January 2019 to December 2022. Medical records were reviewed to collect data. Data were analyzed using a statistical package for social sciences (SPSS) version 26. A binary logistic regression model with an adjusted odds ratio (aOR) and a 95% confidence interval (CI) was used to identify factors associated with the outcome variable. Statistical significance was set at p

Published
2023
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8. Neonatal Birth Trauma and Its Predisposing Factors Among Newborns Admitted to Public Hospitals in Eastern Ethiopia: A Cross-Sectional Study

Author

Gadissa Tolosa MSc, Nega Assefa PhD, Mulualem Keneni MSc, Arega Abebe Lonsako MSc, and Assefa Desalew MSc

Subjects
Pediatrics, RJ1-570
Abstract

Objectives: This study is to investigate the magnitude and predisposing factors for neonatal birth trauma in public hospitals in eastern Ethiopia. It is a major cause of neonatal morbidity and mortality. Despite its higher burden, evidence is limited in eastern Ethiopia. Methods : A cross-sectional study was conducted on 492 newborns selected using systematic random sampling. Data were analyzed using a binary logistic regression model. Statistical significance was set at P

Published
2023
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9. Clinical profile and treatment outcome of acute intussusception among children in eastern Ethiopia: A seven years retrospective study

Author

Dawit Desta Tesfaye, Burka Mohammed Adem, Indeshaw Ketema, Ame Mehadi, Bajrond Eshetu, Tilahun Teshager, Henock Asfaw, and Assefa Desalew

Subjects
acute intussusception, treatment outcome, pediatrics, harar, eastern Ethiopia, Pediatrics, RJ1-570
Abstract

BackgroundAcute intussusception is the main cause of abdominal surgical emergencies worldwide in young children, with an incidence of approximately 1 to 4 per 2,000 children. An accurate estimate of the treatment outcomes of acute intussusception in children is unknown in low-and middle-income countries like Ethiopia. Hence, this study aimed to determine the clinical profile, treatment outcomes of acute intussusception and its associated factors among children admitted to Hiwot Fana Specialized University Hospital in eastern Ethiopia.MethodsAn institutional-based retrospective cross-sectional study was conducted from November 01 to 30, 2021, among children admitted and managed for acute intussusception. All medical records of children admitted and managed for acute intussusception at Hiwot Fana Specialized University hospital between January 2014 and December 2020 were included. Data were collected using pretested structured checklists through a review of medical records, entered and analyzed using Statistical Package for Social Sciences version 25.0. Chi-square (χ2) tests were applied to determine the associated factors with treatment outcome. The statistical significance was considered at a p-value

Published
2022
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10. Exclusive Breastfeeding Practice and its Associated Factors among Mothers with Children Aged 6-23 Months in Dire Dawa, Eastern Ethiopia: A Community-based Cross-sectional Study

Author

Assefa Desalew, Alekaw Sema, and Yalelet Belay

Subjects
exclusive breastfeeding, neonate, ethiopia, Gynecology and obstetrics, RG1-991
Abstract

Background & aim: Exclusive breastfeeding (EBF) is an essential need for the development and survival of the neonates, particularly in low-income countries. Therefore, the purpose of this survey was to determine the prevalence of EBF practice and its associated factors among mothers with children of 6-23 months in Dire Dawa Administration, eastern Ethiopia. Methods: This community-based cross-sectional survey was conducted on 704 participants in 15 kebeles in the Dire Dawa Administration using multistage sampling in 2018. The data were collected using a pretested interviewer-administered questionnaire. Binary logistic regression was used to identify the factors associated with EBF. Results: The magnitude of EBF practice was 81.1% (95% CI: 78.0-83.8). In the multivariate logistic analysis, the odds of EBF practice were significantly higher among unemployed mothers (AOR: 1.93; 95% CI: 1.17-3.20), antenatal care (ANC) users (AOR: 1.69; 95% CI: 1.05-2.72), as well as the young mothers within the age ranges of 15-25 (AOR: 4.41; 95% CI: 1.90-10.20) and 26-35 (AOR: 2.16; 95% CI: 1.12-4.18) years. However, the subjects with bottle-feeding practice had lower odds (AOR: 0.55; 95% CI: 0.35-0.87), compared to those reported with EBF practice. Conclusion: The magnitude of EBF practice was almost as high as the recommended level. The unemployment status, ANC visit, maternal age, and bottle-feeding practice were the factors associated with EBF. Therefore, employed mothers should be provided with a special room in their workplace to breastfeed their children, daycare facilities, and/or six-month maternity leave. Also, healthcare workers should give attention to the encouragement of mothers to receive ANC.

Published
2020
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11. Cause and predictors of neonatal mortality among neonates admitted to neonatal intensive care units of public hospitals in eastern Ethiopia: a facility-based prospective follow-up study

Author

Assefa Desalew, Yitagesu Sintayehu, Nardos Teferi, Firehiwot Amare, Bifitu Geda, Teshager Worku, Kebebush Abera, and Abiyot Asefaw

Subjects
Facility-based study, Neonatal mortality, Predictors, NICU, Ethiopia, Pediatrics, RJ1-570
Abstract

Abstract Background The first month is the most crucial period for child survival. Neonatal mortality continues to remain high with little improvement over the years in Sub-Saharan Africa, including Ethiopia. This region shows the least progress in reducing neonatal mortality and continues to be a significant public health issue. In this study setting, the causes and predictors of neonatal death in the neonatal intensive care units are not well documented. Hence, this study aimed to determine the causes and predictors of neonatal mortality among infants admitted to neonatal intensive care units in eastern Ethiopia. Methods A facility-based in prospective follow-up study was conducted among neonates admitted to neonatal intensive care units of public hospitals of eastern Ethiopia from November 1 to December 30, 2018. Data were collected using a pre-tested structured questionnaire and a follow-up checklist. The main outcomes and causes of death were set by pediatricians and medical residents. EpiData 3.1 and Statistical Package for Social Sciences Version 25 software were used for data entry and analysis, respectively. Multivariable logistic regression was used to identify the predictors of facility-based neonatal mortality. Results The proportion of facility-based neonatal mortality was 20% (95% CI:16.7–23.8%). The causes of death were complications of preterm birth (28.58%), birth asphyxia (22.45%), neonatal infection (18.36%), meconium aspiration syndrome (9.18%), respiratory distress syndrome (7.14%), and congenital malformation (4.08%). Low birth weight, preterm births, length of stay of the neonatal intensive care unit, low 5 min APGAR score, hyperthermia, and initiation of feeding were predictors of neonatal death among infants admitted to the neonatal intensive care units of public hospitals in eastern Ethiopia. Conclusions The proportion of facility-based neonatal deaths was unacceptably high. The main causes of death were preventable and treatable. Hence, improving the timing and quality of antenatal care is essential for early detection, anticipating high-risk newborns, and timely interventions. Furthermore, early initiation of feeding and better referral linkage to tertiary health facilities could lead to a reduction in neonatal death in this setting.

Published
2020
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12. Parental satisfaction and its associated factors with neonatal intensive care unit services at public hospitals in Bahir Dar, Northwest Ethiopia

Author

Ayichew Alemu, Balew Zeleke, Friehiwot Girma Gessesse, Fentahun Meseret, Fenta Wondimeneh, and Assefa Desalew

Subjects
Neonatal satisfaction survey (NSS-8), Parents, Satisfaction, Neonate care, Bahir Dar, Ethiopia, History of Africa, DT1-3415, Nursing, RT1-120
Abstract

Background: Parental satisfaction is an effective strategy to improve the quality of neonatal care and reduce neonatal mortality. Low parental satisfaction may result in discharge against medical advice, increased neonatal readmission, morbidity, and mortality. We found a scarcity of research on parental satisfaction and its factors associated with neonatal care unit services. This study aimed to assess parental satisfaction and its associated factors in public referral hospitals in Bahir Dar, Ethiopia. Methods: A facility-based cross-sectional study was conducted on 400 parent-neonate pairs. Participants were selected using a systematic random sampling technique. We used the Neonatal Satisfaction Survey (NSS-8) tool to collect data through face-to-face interviews. Data were entered using Epi data 3.1 and analyzed using the Statistical Package for the Social Sciences (SPSS) version 25. Multivariable logistic regression analysis was conducted using the adjusted odds ratio (aOR) with a 95% confidence interval (CI) to identify associated factors. Statistical significance was set at p

Published
2022
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13. Knowledge and involvement of husbands in the reproductive rights of women in Harar, eastern Ethiopia

Author

Aminu Mohammed, Tadesse Alemayehu, Assefa Desalew, Adera Debela, Alekaw Sema, Yalelet Belay, and Yadeta Dessie

Subjects
Medicine (General), R5-920
Abstract

Objective: Reproductive rights violations are a serious public health concern worldwide, particularly in Sub-Saharan Africa, where more than 38.83% of victims live. Understanding the status of husbands’ knowledge and involvement helps to establish important programs and interventions. However, there are limited data related to husbands’ roles in women’s reproductive rights in the study setting. Therefore, this study aimed to assess husbands’ knowledge and involvement in women’s reproductive rights and their associated factors in Harar, eastern Ethiopia. Methods: A community-based cross-sectional study was conducted among 611 husbands in March 2020. A systematic random sampling technique was used to select the study participants. Data were collected using a structured and pretested interviewer-administered questionnaire. Data were entered using EpiData 3.1 and analyzed with SPSS Version 22. A multivariable logistic regression model was applied to examine the factors associated with the outcome variable using an adjusted odds ratio with a 95% confidence interval, and a p -value

Published
2021
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14. Minimum Dietary Diversity Practice and Associated Factors among Children Aged 6 to 23 Months in Dire Dawa City, Eastern Ethiopia: A Community-Based Cross-Sectional Study

Author

Alekaw Sema MSc, Yalelet Belay MSc, Yonatan Solomon MSc, Assefa Desalew MSc, Abebaw Misganaw MSc, Tameru Menberu MSc, Yitagesu Sintayehu MSc, Yibeltal Getachew MSc, Alemu Guta MSc, and Daniel Tadesse MSc

Subjects
Pediatrics, RJ1-570
Abstract

Objective: Malnutrition because of poor dietary diversity contributing to child morbidity and mortality. Two-thirds of child mortality occurs within the first 2 years. However, there is limited data related to dietary diversity among children aged 6 to 23 months in Ethiopia. Thus, this study aimed to assess dietary diversity and factors among children aged 6 to 23 months in the study setting. Methods : A community-based cross-sectional study conducted on 438 children aged 6 to 23 months in Dire Dawa, 1-30/02/2019. Simple random sampling was used to select study subjects. Data collected using a structured and pretested interview administered questionnaire. Data entered using EpiData 4.2 and analyzed with SPSS Version 22. Multivariable logistic regression was used to examine associated factors. Adjusted odd-ratio with 95% confidence interval (CI) used, and P -value

Published
2021
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15. Antipsychotic-induced extrapyramidal side effects: A systematic review and meta-analysis of observational studies.

Author

Tilahun Ali, Mekonnen Sisay, Mandaras Tariku, Abraham Nigussie Mekuria, and Assefa Desalew

Subjects
Medicine, Science
Abstract

BackgroundAntipsychotic agents are the basis for the pharmacological management of acute and chronic schizophrenia, bipolar disorders, mood disorders with psychotic feature, and other psychotic disorders. Antipsychotic medication use is frequently associated with unfavorable adverse effects such as extrapyramidal side effects (EPSEs). Hence, this systematic review and meta-analysis was aimed to determine the magnitude of antipsychotic-induced EPSEs.MethodA literature search was conducted using legitimate databases, indexing services, and directories including PubMed/MEDLINE (Ovid®), EMBASE (Ovid®), google scholar and WorldCat to retrieve studies. Following screening and eligibility, the relevant data were extracted from the included studies using an Excel sheet and exported to STATA 15.0 software for analyses. The Random effects pooling model was used to analyze outcome measures at a 95% confidence interval. Besides, publication bias analysis was conducted. The protocol has been registered on PROSPERO with ID: CRD42020175168.ResultIn total, 15 original articles were included for the systematic review and meta-analysis. The pooled prevalence of antipsychotic-induced EPSEs among patient taking antipsychotic medications was 37% (95% CI: 18-55%, before sensitivity) and 31% (95% CI: 19-44%, after sensitivity). The prevalence of antipsychotic-induced parkinsonism, akathisia, and tardive dyskinesia was 20% (95% CI: 11-28%), 11% (95% CI: 6-17%), and 7% (95% CI: 4-9%), respectively. To confirm a small-study effect, Egger's regression test accompanied by funnel plot asymmetry demonstrated that there was a sort of publication bias in studies reporting akathisia and tardive dyskinesia.ConclusionThe prevalence of antipsychotic-induced EPSEs was considerably high. One in five and more than one in ten patients experienced parkinsonism and akathisia, respectively. Appropriate prevention and early management of these effects can enhance the net benefits of antipsychotics.

Published
2021
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16. Pregnant women’s satisfaction with antenatal care services and its associated factors at public health facilities in the Harari region, Eastern Ethiopia

Author

Simon Birhanu, Melake Demena, Yohannes Baye, Assefa Desalew, Bedru Dawud, and Gudina Egata

Subjects
Medicine (General), R5-920
Abstract

Background: Antenatal care coverage is very low in low-and middle-income countries, including Ethiopia. Self-reported pregnant women’s satisfaction may be important in identifying the demographic, provider-, and facility-related factors that can be improved to increase antenatal care satisfaction. However, there is a paucity of data on pregnant women’s satisfaction in Ethiopia, particularly in the study setting. Therefore, this study aimed to assess antenatal care service satisfaction and associated factors among pregnant women at public health facilities in the Harari region of eastern Ethiopia. Methods: A health institution–based cross-sectional study was conducted among women who were attending antenatal care clinics in February 2017. All 531 pregnant women were selected using a systematic random sampling method. Data were collected using an interviewer-administered questionnaire, entered into EpiData version 3.1, and analyzed using SPSS version 22.0 software. A logistic regression model was applied to control for confounders. The level of significance was determined at a p-value of less than 0.05. Results: The magnitude of pregnant women’s satisfaction with antenatal care services was 70.3% (95% confidence interval (CI) = 66.4%–74.3%). Receiving antenatal care services from the hospital (adjusted odds ratio (AOR) = 2.44, 95% CI = 1.50–3.98), did not attend formal education (AOR = 2.53, 95% CI = 1.52–4.20) and attended primary education (AOR = 2.17, 95% CI = 1.17–4.04), having a repeated visit to antenatal care (AOR = 4.62, 95% CI = 2.98–7.17), initiating antenatal care services within the first trimester (AOR = 1.74, 95% CI = 1.12–2.71), having no history of stillbirth (AOR = 2.52, 95% CI = 1.37–4.65), and waiting for no more than 30 min in the health facility to get service (AOR = 2.31, 95% CI = 1.28–4.16) were factors associated with pregnant women’s satisfaction with antenatal care services. Conclusion: More than two-thirds of pregnant women were satisfied with the antenatal care service. The type of health facility, education status, number and initiation time of antenatal visit, history of stillbirth, and waiting time to get service were factors associated with pregnant women’s satisfaction with antenatal care services.

Published
2020
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17. Neural Tube Defects and Associated Factors among Neonates Admitted to the Neonatal Intensive Care Units in Hiwot Fana Specialized University Hospital, Harar, Ethiopia

Author

Yunus Edris MD, Hanan Abdurahman MD, Assefa Desalew MSc, and Fitsum Weldegebreal MSc

Subjects
Pediatrics, RJ1-570
Abstract

Background: Neural tube defects are a major public health problem and substantially contribute to morbidity and mortality, particularly in low-income countries, including Ethiopia. There are a paucity of data on the magnitude and associated factors of neural tube defects in Ethiopia, particularly in the study setting. Objective: This study aimed to assess the magnitude of neural tube defects and associated factors among neonates admitted to the neonatal intensive care unit in Hiwot Fana Specialized University Hospital, Harar, Ethiopia. Methods: A hospital-based cross-sectional study was employed from October 2019 to January 2020. A total of 420 newborn-mother pairs were included consecutively. Data were collected using a face-to-face interviewer-administered questionnaire and clinical examination. Data were entered into Epi Data version 3.1 and analyzed using the statistical package for Social Sciences version 20.0 software. An adjusted odds ratio (AOR) with 95% confidence interval (CI) was used to identify the associated factors. A p -value

Published
2020
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18. Cervical Cancer Screening Utilization and Associated Factors Among Women Aged 30 to 49 Years in Dire Dawa, Eastern Ethiopia

Author

Yalelet Belay MSc, Merga Dheresa PhD, Alekaw Sema MSc, Assefa Desalew MSc, and Nega Assefa PhD

Subjects
Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

Background: Cervical cancer is a public health problem and one of the leading causes of death in women worldwide. In Ethiopia, the government expands cervical cancer screening centers and recommends services to age-eligible and high-risk groups of women. However, evidence indicates that the utilization of services among eligible and high-risk women in the country has remained very low, and data are scarce in Dire Dawa. Therefore, this study aimed to assess cervical cancer screening service utilization and associated factors among women aged 30 to 49 years in Dire Dawa, eastern Ethiopia. Methods: A facility-based cross-sectional study was undertaken in Dire Dawa from February 01 to March 01, 2017. Only two facilities provided the screening service in Dire Dawa Administration. Six- hundred and one women aged 30 to 49 years were selected using a systematic sampling method. Data were collected using a pretested face-to-face interview administered questionnaire. Data were entered using EpiData 3.1, and analyzed using the Statistical Package for Social Science Version 21. Multivariable logistic regression was used to examine the factors associated with cervical cancer screening utilization. An adjusted odds ratio (AOR) with a 95% confidence interval (CI) was used, and a p-value

Published
2020
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19. Incomplete Vaccination and Its Predictors among Children in Ethiopia: A Systematic Review and Meta-Analysis

Author

Assefa Desalew MSc, Agumasie Semahegn PhD, Simon Birhanu MPH, and Gezahegn Tesfaye PhD

Subjects
Pediatrics, RJ1-570
Abstract

Background . Vaccination is an effective public health intervention that has contributed to a substantial reduction in the burden of vaccine-preventable diseases. Abridged evidence on incomplete vaccination is not well established in Ethiopia. Therefore, this meta-analysis aimed to estimate the pooled prevalence of incomplete vaccination and its predictors among children aged 12 to 23 months. Methods . Primary studies conducted in Ethiopia were searched. The methodological quality of the included studies was assessed using the Joanna Briggs Institute (JBI) checklist. The analysis was conducted using STATA 14 and RevMan. The presence of statistical heterogeneity was checked using the Cochran Q test, and its level was quantified using I2 statistics. Pooled prevalence and odds ratio (OR) were computed at a 95% confidence interval (CI). Results . The pooled prevalence of incomplete vaccination was 30% (95% CI: 25-35). Maternal illiteracy (OR = 1.96; 95% CI: 1.40, 2.74) and home delivery (OR = 2.78; 95% CI: 2.28, 3.38) were associated factors that increased incomplete vaccination. However, maternal autonomy (OR = 0.54; 95% CI: 0.33, 0.89), maternal knowledge (OR = 0.31; 95% CI: 0.20, 0.47), husband employment (OR = 0.49; 95% CI: 0.35, 0.67), urban residence (OR = 0.61; 95% CI: 0.43, 0.86), ANC visits (OR = 0.30; 95% CI: 0.23, 0.39), postnatal care (OR = 0.39; 95% CI: 0.30, 0.52), and tetanus toxoid vaccine (3+) (OR = 0.42; 95% CI: 0.26, 0.69) were factors that reduced incomplete vaccination. Conclusion . In Ethiopia, 3 out of 10 children have incomplete vaccination. Policies should focus on strengthening and improving women’s education, maternal health knowledge, empowering women, and the utilization of prenatal care can overcome some of the barriers.

Published
2020
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20. Mapping geographical inequalities in access to drinking water and sanitation facilities in low-income and middle-income countries, 2000–17

Author

Aniruddha Deshpande, Molly K Miller-Petrie, Paulina A Lindstedt, Mathew M Baumann, Kimberly B Johnson, Brigette F Blacker, Hedayat Abbastabar, Foad Abd-Allah, Ahmed Abdelalim, Ibrahim Abdollahpour, Kedir Hussein Abegaz, Ayenew Negesse Abejie, Lucas Guimarães Abreu, Michael R.M. Abrigo, Ahmed Abualhasan, Manfred Mario Kokou Accrombessi, Abdu A Adamu, Oladimeji M Adebayo, Isaac Akinkunmi Adedeji, Rufus Adesoji Adedoyin, Victor Adekanmbi, Olatunji O Adetokunboh, Tara Ballav Adhikari, Mohsen Afarideh, Marcela Agudelo-Botero, Mehdi Ahmadi, Keivan Ahmadi, Muktar Beshir Ahmed, Anwar E Ahmed, Temesgen Yihunie Akalu, Ali S Akanda, Fares Alahdab, Ziyad Al-Aly, Samiah Alam, Noore Alam, Genet Melak Alamene, Turki M Alanzi, James Albright, Ammar Albujeer, Jacqueline Elizabeth Alcalde-Rabanal, Animut Alebel, Zewdie Aderaw Alemu, Muhammad Ali, Mehran Alijanzadeh, Vahid Alipour, Syed Mohamed Aljunid, Ali Almasi, Amir Almasi-Hashiani, Hesham M Al-Mekhlafi, Khalid A Altirkawi, Nelson Alvis-Guzman, Nelson J. Alvis-Zakzuk, Saeed Amini, Arianna Maever L. Amit, Gianna Gayle Herrera Amul, Catalina Liliana Andrei, Mina Anjomshoa, Ansariadi Ansariadi, Carl Abelardo T. Antonio, Benny Antony, Ernoiz Antriyandarti, Jalal Arabloo, Hany Mohamed Amin Aref, Olatunde Aremu, Bahram Armoon, Amit Arora, Krishna K Aryal, Afsaneh Arzani, Mehran Asadi-Aliabadi, Daniel Asmelash, Hagos Tasew Atalay, Seyyede Masoume Athari, Seyyed Shamsadin Athari, Sachin R Atre, Marcel Ausloos, Shally Awasthi, Nefsu Awoke, Beatriz Paulina Ayala Quintanilla, Getinet Ayano, Martin Amogre Ayanore, Yared Asmare Aynalem, Samad Azari, Andrew S Azman, Ebrahim Babaee, Alaa Badawi, Mojtaba Bagherzadeh, Shankar M Bakkannavar, Senthilkumar Balakrishnan, Maciej Banach, Joseph Adel Mattar Banoub, Aleksandra Barac, Miguel A Barboza, Till Winfried Bärnighausen, Sanjay Basu, Vo Dinh Bay, Mohsen Bayati, Neeraj Bedi, Mahya Beheshti, Meysam Behzadifar, Masoud Behzadifar, Diana Fernanda Bejarano Ramirez, Michelle L Bell, Derrick A. Bennett, Habib Benzian, Dessalegn Ajema Berbada, Robert S Bernstein, Anusha Ganapati Bhat, Krittika Bhattacharyya, Soumyadeep Bhaumik, Zulfiqar A Bhutta, Ali Bijani, Boris Bikbov, Muhammad Shahdaat Bin Sayeed, Raaj Kishore Biswas, Somayeh Bohlouli, Soufiane Boufous, Oliver J Brady, Andrey Nikolaevich Briko, Nikolay Ivanovich Briko, Gabrielle B Britton, Alexandria Brown, Sharath Burugina Nagaraja, Zahid A Butt, Luis Alberto Cámera, Ismael R Campos-Nonato, Julio Cesar Campuzano Rincon, Jorge Cano, Josip Car, Rosario Cárdenas, Felix Carvalho, Carlos A Castañeda-Orjuela, Franz Castro, Ester Cerin, Binaya Chalise, Vijay Kumar Chattu, Ken Lee Chin, Devasahayam J Christopher, Dinh-Toi Chu, Natalie Maria Cormier, Vera Marisa Costa, Elizabeth A Cromwell, Abel Fekadu Fekadu Dadi, Tukur Dahiru, Saad M A Dahlawi, Rakhi Dandona, Lalit Dandona, Anh Kim Dang, Farah Daoud, Aso Mohammad Darwesh, Amira Hamed Darwish, Ahmad Daryani, Jai K Das, Rajat Das Gupta, Aditya Prasad Dash, Claudio Alberto Dávila-Cervantes, Nicole Davis Weaver, Fernando Pio De la Hoz, Jan-Walter De Neve, Dereje Bayissa Demissie, Gebre Teklemariam Demoz, Edgar Denova-Gutiérrez, Kebede Deribe, Assefa Desalew, Samath Dhamminda Dharmaratne, Preeti Dhillon, Meghnath Dhimal, Govinda Prasad Dhungana, Daniel Diaz, Isaac Oluwafemi Dipeolu, Hoa Thi Do, Christiane Dolecek, Kerrie E Doyle, Eleonora Dubljanin, Andre Rodrigues Duraes, Hisham Atan Edinur, Andem Effiong, Aziz Eftekhari, Nevine El Nahas, Maysaa El Sayed Zaki, Maha El Tantawi, Hala Rashad Elhabashy, Shaimaa I. El-Jaafary, Ziad El-Khatib, Hajer Elkout, Aisha Elsharkawy, Shymaa Enany, Daniel Adane Endalew, Babak Eshrati, Sharareh Eskandarieh, Arash Etemadi, Oluchi Ezekannagha, Emerito Jose A. Faraon, Mohammad Fareed, Andre Faro, Farshad Farzadfar, Alebachew Fasil Fasil, Mehdi Fazlzadeh, Valery L. Feigin, Wubalem Fekadu, Netsanet Fentahun, Seyed-Mohammad Fereshtehnejad, Eduarda Fernandes, Irina Filip, Florian Fischer, Carsten Flohr, Nataliya A. Foigt, Morenike Oluwatoyin Folayan, Masoud Foroutan, Richard Charles Franklin, Joseph Jon Frostad, Takeshi Fukumoto, Mohamed M Gad, Gregory M Garcia, Augustine Mwangi Gatotoh, Reta Tsegaye Gayesa, Ketema Bizuwork Gebremedhin, Yilma Chisha Dea Geramo, Hailay Abrha Gesesew, Kebede Embaye Gezae, Ahmad Ghashghaee, Farzaneh Ghazi Sherbaf, Tiffany K Gill, Paramjit Singh Gill, Themba G Ginindza, Alem Girmay, Zemichael Gizaw, Amador Goodridge, Sameer Vali Gopalani, Bárbara Niegia Garcia Goulart, Alessandra C Goulart, Ayman Grada, Manfred S Green, Mohammed Ibrahim Mohialdeen Gubari, Harish Chander Gugnani, Davide Guido, Rafael Alves Guimarães, Yuming Guo, Rajeev Gupta, Rahul Gupta, Giang Hai Ha, Juanita A. Haagsma, Nima Hafezi-Nejad, Dessalegn H Haile, Michael Tamene Haile, Brian J. Hall, Samer Hamidi, Demelash Woldeyohannes Handiso, Hamidreza Haririan, Ninuk Hariyani, Ahmed I. Hasaballah, Md. Mehedi Hasan, Amir Hasanzadeh, Hamid Yimam Hassen, Desta Haftu Hayelom, Mohamed I Hegazy, Behzad Heibati, Behnam Heidari, Delia Hendrie, Andualem Henok, Claudiu Herteliu, Fatemeh Heydarpour, Hagos Degefa de Hidru, Thomas R Hird, Chi Linh Hoang, Gillian I Hollerich, Praveen Hoogar, Naznin Hossain, Mehdi Hosseinzadeh, Mowafa Househ, Guoqing Hu, Ayesha Humayun, Syed Ather Hussain, Mamusha Aman A Hussen, Segun Emmanuel Ibitoye, Olayinka Stephen Ilesanmi, Milena D. Ilic, Mohammad Hasan Imani-Nasab, Usman Iqbal, Seyed Sina Naghibi Irvani, Sheikh Mohammed Shariful Islam, Rebecca Q Ivers, Chinwe Juliana Iwu, Nader Jahanmehr, Mihajlo Jakovljevic, Amir Jalali, Achala Upendra Jayatilleke, Ensiyeh Jenabi, Ravi Prakash Jha, Vivekanand Jha, John S Ji, Jost B. Jonas, Jacek Jerzy Jozwiak, Ali Kabir, Zubair Kabir, Tanuj Kanchan, André Karch, Surendra Karki, Amir Kasaeian, Gebremicheal Gebreslassie Kasahun, Habtamu Kebebe Kasaye, Gebrehiwot G Kassa, Getachew Mullu Kassa, Gbenga A. Kayode, Mihiretu M Kebede, Peter Njenga Keiyoro, Daniel Bekele Ketema, Yousef Saleh Khader, Morteza Abdullatif Khafaie, Nauman Khalid, Rovshan Khalilov, Ejaz Ahmad Khan, Junaid Khan, Md Nuruzzaman Khan, Khaled Khatab, Mona M Khater, Amir M Khater, Maryam Khayamzadeh, Mohammad Khazaei, Mohammad Hossein Khosravi, Jagdish Khubchandani, Ali Kiadaliri, Yun Jin Kim, Ruth W Kimokoti, Sezer Kisa, Adnan Kisa, Sonali Kochhar, Tufa Kolola, Hamidreza Komaki, Soewarta Kosen, Parvaiz A Koul, Ai Koyanagi, Kewal Krishan, Barthelemy Kuate Defo, Nuworza Kugbey, Pushpendra Kumar, G Anil Kumar, Manasi Kumar, Dian Kusuma, Carlo La Vecchia, Ben Lacey, Aparna Lal, Dharmesh Kumar Lal, Hilton Lam, Faris Hasan Lami, Van Charles Lansingh, Savita Lasrado, Georgy Lebedev, Paul H Lee, Kate E LeGrand, Mostafa Leili, Tsegaye Lolaso Lenjebo, Cheru Tesema Leshargie, Aubrey J Levine, Sonia Lewycka, Shanshan Li, Shai Linn, Shiwei Liu, Jaifred Christian F Lopez, Platon D Lopukhov, Muhammed Magdy Abd El Razek, D.R. Mahadeshwara Prasad, Phetole Walter Mahasha, Narayan B. Mahotra, Azeem Majeed, Reza Malekzadeh, Deborah Carvalho Malta, Abdullah A Mamun, Navid Manafi, Mohammad Ali Mansournia, Chabila Christopher Mapoma, Gabriel Martinez, Santi Martini, Francisco Rogerlândio Martins-Melo, Manu Raj Mathur, Benjamin K Mayala, Mohsen Mazidi, Colm McAlinden, Birhanu Geta Meharie, Man Mohan Mehndiratta, Entezar Mehrabi Nasab, Kala M Mehta, Teferi Mekonnen, Tefera Chane Mekonnen, Gebrekiros Gebremichael Meles, Hagazi Gebre Meles, Peter T N Memiah, Ziad A Memish, Walter Mendoza, Ritesh G Menezes, Seid Tiku Mereta, Tuomo J Meretoja, Tomislav Mestrovic, Workua Mekonnen Metekiya, Bartosz Miazgowski, Ted R Miller, GK Mini, Erkin M Mirrakhimov, Babak Moazen, Bahram Mohajer, Yousef Mohammad, Dara K. Mohammad, Naser Mohammad Gholi Mezerji, Roghayeh Mohammadibakhsh, Shafiu Mohammed, Jemal Abdu Mohammed, Hassen Mohammed, Farnam Mohebi, Ali H Mokdad, Yoshan Moodley, Masoud Moradi, Ghobad Moradi, Mohammad Moradi-Joo, Paula Moraga, Linda Morales, Abbas Mosapour, Jonathan F. Mosser, Simin Mouodi, Seyyed Meysam Mousavi, Miliva Mozaffor, Sandra B Munro, Moses K. Muriithi, Christopher J L Murray, Kamarul Imran Musa, Ghulam Mustafa, Saravanan Muthupandian, Mehdi Naderi, Ahamarshan Jayaraman Nagarajan, Mohsen Naghavi, Gurudatta Naik, Vinay Nangia, Bruno Ramos Nascimento, Javad Nazari, Duduzile Edith Ndwandwe, Ionut Negoi, Henok Biresaw Netsere, Josephine W. Ngunjiri, Cuong Tat Nguyen, Huong Lan Thi Nguyen, QuynhAnh P Nguyen, Solomon Gedlu Nigatu, Dina Nur Anggraini Ningrum, Chukwudi A Nnaji, Marzieh Nojomi, Ole F Norheim, Jean Jacques Noubiap, Bogdan Oancea, Felix Akpojene Ogbo, In-Hwan Oh, Andrew T Olagunju, Jacob Olusegun Olusanya, Bolajoko Olubukunola Olusanya, Obinna E Onwujekwe, Doris V. Ortega-Altamirano, Osayomwanbo Osarenotor, Frank B Osei, Mayowa O Owolabi, Mahesh P A, Jagadish Rao. Padubidri, Smita Pakhale, Adrian Pana, Eun-Kee Park, Sangram Kishor Patel, Ashish Pathak, Ajay Patle, Kebreab Paulos, Veincent Christian Filipino Pepito, Norberto Perico, Aslam Pervaiz, Julia Moreira Pescarini, Konrad Pesudovs, Hai Quang Pham, David M Pigott, Thomas Pilgrim, Meghdad Pirsaheb, Mario Poljak, Ian Pollock, Maarten J Postma, Farshad Pourmalek, Akram Pourshams, Sergio I Prada, Liliana Preotescu, Hedley Quintana, Navid Rabiee, Mohammad Rabiee, Amir Radfar, Alireza Rafiei, Fakher Rahim, Siavash Rahimi, Vafa Rahimi-Movaghar, Muhammad Aziz Rahman, Mohammad Hifz Ur Rahman, Fatemeh Rajati, Chhabi Lal Ranabhat, Puja C Rao, Davide Rasella, Goura Kishor Rath, Salman Rawaf, Lal Rawal, Wasiq Faraz Rawasia, Giuseppe Remuzzi, Vishnu Renjith, Andre M.N. Renzaho, Serge Resnikoff, Seyed Mohammad Riahi, Ana Isabel Ribeiro, Jennifer Rickard, Leonardo Roever, Luca Ronfani, Enrico Rubagotti, Salvatore Rubino, Anas M Saad, Siamak Sabour, Ehsan Sadeghi, Sahar Saeedi Moghaddam, Yahya Safari, Rajesh Sagar, Mohammad Ali Sahraian, S. Mohammad Sajadi, Mohammad Reza Salahshoor, Nasir Salam, Ahsan Saleem, Hosni Salem, Marwa Rashad Salem, Yahya Salimi, Hamideh Salimzadeh, Abdallah M Samy, Juan Sanabria, Itamar S Santos, Milena M. Santric-Milicevic, Bruno Piassi Sao Jose, Sivan Yegnanarayana Iyer Saraswathy, Nizal Sarrafzadegan, Benn Sartorius, Brijesh Sathian, Thirunavukkarasu Sathish, Maheswar Satpathy, Monika Sawhney, Mehdi Sayyah, Alyssa N Sbarra, Lauren E Schaeffer, David C Schwebel, Anbissa Muleta Senbeta, Subramanian Senthilkumaran, Sadaf G Sepanlou, Edson Serván-Mori, Azadeh Shafieesabet, Amira A Shaheen, Izza Shahid, Masood Ali Shaikh, Ali S Shalash, Mehran Shams-Beyranvand, MohammadBagher Shamsi, Morteza Shamsizadeh, Mohammed Shannawaz, Kiomars Sharafi, Rajesh Sharma, Aziz Sheikh, B Suresh Kumar Shetty, Wondimeneh Shibabaw Shiferaw, Mika Shigematsu, Jae Il Shin, Rahman Shiri, Reza Shirkoohi, K M Shivakumar, Si Si, Soraya Siabani, Tariq Jamal Siddiqi, Diego Augusto Santos Silva, Virendra Singh, Narinder Pal Singh, Balbir Bagicha Singh Singh, Jasvinder A. Singh, Ambrish Singh, Dhirendra Narain Sinha, Malede Mequanent Sisay, Eirini Skiadaresi, David L Smith, Adauto Martins Soares Filho, Mohammad Reza Sobhiyeh, Anton Sokhan, Joan B Soriano, Muluken Bekele Sorrie, Ireneous N Soyiri, Emma Elizabeth Spurlock, Chandrashekhar T Sreeramareddy, Agus Sudaryanto, Mu'awiyyah Babale Sufiyan, Hafiz Ansar Rasul Suleria, Bryan L. Sykes, Rafael Tabarés-Seisdedos, Takahiro Tabuchi, Degena Bahrey Tadesse, Ingan Ukur Tarigan, Bineyam Taye, Yonatal Mesfin Tefera, Arash Tehrani-Banihashemi, Shishay Wahdey Tekelemedhin, Merhawi Gebremedhin Tekle, Mohamad-Hani Temsah, Berhe Etsay Tesfay, Fisaha Haile Tesfay, Zemenu Tadesse Tessema, Kavumpurathu Raman Thankappan, Akhil Soman ThekkePurakkal, Nihal Thomas, Robert L Thompson, Alan J Thomson, Roman Topor-Madry, Marcos Roberto Tovani-Palone, Eugenio Traini, Bach Xuan Tran, Khanh Bao Tran, Irfan Ullah, Bhaskaran Unnikrishnan, Muhammad Shariq Usman, Olalekan A Uthman, Benjamin S. Chudi Uzochukwu, Pascual R Valdez, Santosh Varughese, Yousef Veisani, Francesco S Violante, Sebastian Vollmer, Feleke Gebremeskel W/hawariat, Yasir Waheed, Mitchell Taylor Wallin, Yuan-Pang Wang, Yafeng Wang, Kinley Wangdi, Daniel J Weiss, Girmay Teklay Weldesamuel, Adhena Ayaliew Werkneh, Ronny Westerman, Taweewat Wiangkham, Kirsten E Wiens, Tissa Wijeratne, Charles Shey Wiysonge, Haileab Fekadu Wolde, Dawit Zewdu Wondafrash, Tewodros Eshete Wonde, Getasew Taddesse Worku, Ali Yadollahpour, Seyed Hossein Yahyazadeh Jabbari, Tomohide Yamada, Mehdi Yaseri, Hiroshi Yatsuya, Alex Yeshaneh, Mekdes Tigistu Yilma, Paul Yip, Engida Yisma, Naohiro Yonemoto, Mustafa Z Younis, Hebat-Allah Salah A Yousof, Chuanhua Yu, Hasan Yusefzadeh, Siddhesh Zadey, Telma Zahirian Moghadam, Zoubida Zaidi, Sojib Bin Zaman, Mohammad Zamani, Hamed Zandian, Heather J Zar, Taddese Alemu Zerfu, Yunquan Zhang, Arash Ziapour, Sanjay Zodpey, Yves Miel H Zuniga, Simon I Hay, and Robert C Reiner, Jr

Subjects
Public aspects of medicine, RA1-1270
Abstract

Summary: Background: Universal access to safe drinking water and sanitation facilities is an essential human right, recognised in the Sustainable Development Goals as crucial for preventing disease and improving human wellbeing. Comprehensive, high-resolution estimates are important to inform progress towards achieving this goal. We aimed to produce high-resolution geospatial estimates of access to drinking water and sanitation facilities. Methods: We used a Bayesian geostatistical model and data from 600 sources across more than 88 low-income and middle-income countries (LMICs) to estimate access to drinking water and sanitation facilities on continuous continent-wide surfaces from 2000 to 2017, and aggregated results to policy-relevant administrative units. We estimated mutually exclusive and collectively exhaustive subcategories of facilities for drinking water (piped water on or off premises, other improved facilities, unimproved, and surface water) and sanitation facilities (septic or sewer sanitation, other improved, unimproved, and open defecation) with use of ordinal regression. We also estimated the number of diarrhoeal deaths in children younger than 5 years attributed to unsafe facilities and estimated deaths that were averted by increased access to safe facilities in 2017, and analysed geographical inequality in access within LMICs. Findings: Across LMICs, access to both piped water and improved water overall increased between 2000 and 2017, with progress varying spatially. For piped water, the safest water facility type, access increased from 40·0% (95% uncertainty interval [UI] 39·4–40·7) to 50·3% (50·0–50·5), but was lowest in sub-Saharan Africa, where access to piped water was mostly concentrated in urban centres. Access to both sewer or septic sanitation and improved sanitation overall also increased across all LMICs during the study period. For sewer or septic sanitation, access was 46·3% (95% UI 46·1–46·5) in 2017, compared with 28·7% (28·5–29·0) in 2000. Although some units improved access to the safest drinking water or sanitation facilities since 2000, a large absolute number of people continued to not have access in several units with high access to such facilities (>80%) in 2017. More than 253 000 people did not have access to sewer or septic sanitation facilities in the city of Harare, Zimbabwe, despite 88·6% (95% UI 87·2–89·7) access overall. Many units were able to transition from the least safe facilities in 2000 to safe facilities by 2017; for units in which populations primarily practised open defecation in 2000, 686 (95% UI 664–711) of the 1830 (1797–1863) units transitioned to the use of improved sanitation. Geographical disparities in access to improved water across units decreased in 76·1% (95% UI 71·6–80·7) of countries from 2000 to 2017, and in 53·9% (50·6–59·6) of countries for access to improved sanitation, but remained evident subnationally in most countries in 2017. Interpretation: Our estimates, combined with geospatial trends in diarrhoeal burden, identify where efforts to increase access to safe drinking water and sanitation facilities are most needed. By highlighting areas with successful approaches or in need of targeted interventions, our estimates can enable precision public health to effectively progress towards universal access to safe water and sanitation. Funding: Bill & Melinda Gates Foundation.

Published
2020
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21. The global distribution of lymphatic filariasis, 2000–18: a geospatial analysis

Author

Aniruddha Deshpande, Molly K Miller-Petrie, Paulina A Lindstedt, Mathew M Baumann, Kimberly B Johnson, Brigette F Blacker, Hedayat Abbastabar, Foad Abd-Allah, Ahmed Abdelalim, Ibrahim Abdollahpour, Kedir Hussein Abegaz, Ayenew Negesse Abejie, Lucas Guimarães Abreu, Michael R.M. Abrigo, Ahmed Abualhasan, Manfred Mario Kokou Accrombessi, Abdu A Adamu, Oladimeji M Adebayo, Isaac Akinkunmi Adedeji, Rufus Adesoji Adedoyin, Victor Adekanmbi, Olatunji O Adetokunboh, Tara Ballav Adhikari, Mohsen Afarideh, Marcela Agudelo-Botero, Mehdi Ahmadi, Keivan Ahmadi, Muktar Beshir Ahmed, Anwar E Ahmed, Temesgen Yihunie Akalu, Ali S Akanda, Fares Alahdab, Ziyad Al-Aly, Samiah Alam, Noore Alam, Genet Melak Alamene, Turki M Alanzi, James Albright, Ammar Albujeer, Jacqueline Elizabeth Alcalde-Rabanal, Animut Alebel, Zewdie Aderaw Alemu, Muhammad Ali, Mehran Alijanzadeh, Vahid Alipour, Syed Mohamed Aljunid, Ali Almasi, Amir Almasi-Hashiani, Hesham M Al-Mekhlafi, Khalid A Altirkawi, Nelson Alvis-Guzman, Nelson J. Alvis-Zakzuk, Saeed Amini, Arianna Maever L. Amit, Gianna Gayle Herrera Amul, Catalina Liliana Andrei, Mina Anjomshoa, Ansariadi Ansariadi, Carl Abelardo T. Antonio, Benny Antony, Ernoiz Antriyandarti, Jalal Arabloo, Hany Mohamed Amin Aref, Olatunde Aremu, Bahram Armoon, Amit Arora, Krishna K Aryal, Afsaneh Arzani, Mehran Asadi-Aliabadi, Daniel Asmelash, Hagos Tasew Atalay, Seyyede Masoume Athari, Seyyed Shamsadin Athari, Sachin R Atre, Marcel Ausloos, Shally Awasthi, Nefsu Awoke, Beatriz Paulina Ayala Quintanilla, Getinet Ayano, Martin Amogre Ayanore, Yared Asmare Aynalem, Samad Azari, Andrew S Azman, Ebrahim Babaee, Alaa Badawi, Mojtaba Bagherzadeh, Shankar M Bakkannavar, Senthilkumar Balakrishnan, Maciej Banach, Joseph Adel Mattar Banoub, Aleksandra Barac, Miguel A Barboza, Till Winfried Bärnighausen, Sanjay Basu, Vo Dinh Bay, Mohsen Bayati, Neeraj Bedi, Mahya Beheshti, Meysam Behzadifar, Masoud Behzadifar, Diana Fernanda Bejarano Ramirez, Michelle L Bell, Derrick A. Bennett, Habib Benzian, Dessalegn Ajema Berbada, Robert S Bernstein, Anusha Ganapati Bhat, Krittika Bhattacharyya, Soumyadeep Bhaumik, Zulfiqar A Bhutta, Ali Bijani, Boris Bikbov, Muhammad Shahdaat Bin Sayeed, Raaj Kishore Biswas, Somayeh Bohlouli, Soufiane Boufous, Oliver J Brady, Andrey Nikolaevich Briko, Nikolay Ivanovich Briko, Gabrielle B Britton, Alexandria Brown, Sharath Burugina Nagaraja, Zahid A Butt, Luis Alberto Cámera, Ismael R Campos-Nonato, Julio Cesar Campuzano Rincon, Jorge Cano, Josip Car, Rosario Cárdenas, Felix Carvalho, Carlos A Castañeda-Orjuela, Franz Castro, Ester Cerin, Binaya Chalise, Vijay Kumar Chattu, Ken Lee Chin, Devasahayam J Christopher, Dinh-Toi Chu, Natalie Maria Cormier, Vera Marisa Costa, Elizabeth A Cromwell, Abel Fekadu Fekadu Dadi, Tukur Dahiru, Saad M A Dahlawi, Rakhi Dandona, Lalit Dandona, Anh Kim Dang, Farah Daoud, Aso Mohammad Darwesh, Amira Hamed Darwish, Ahmad Daryani, Jai K Das, Rajat Das Gupta, Aditya Prasad Dash, Claudio Alberto Dávila-Cervantes, Nicole Davis Weaver, Fernando Pio De la Hoz, Jan-Walter De Neve, Dereje Bayissa Demissie, Gebre Teklemariam Demoz, Edgar Denova-Gutiérrez, Kebede Deribe, Assefa Desalew, Samath Dhamminda Dharmaratne, Preeti Dhillon, Meghnath Dhimal, Govinda Prasad Dhungana, Daniel Diaz, Isaac Oluwafemi Dipeolu, Hoa Thi Do, Christiane Dolecek, Kerrie E Doyle, Eleonora Dubljanin, Andre Rodrigues Duraes, Hisham Atan Edinur, Andem Effiong, Aziz Eftekhari, Nevine El Nahas, Maysaa El Sayed Zaki, Maha El Tantawi, Hala Rashad Elhabashy, Shaimaa I. El-Jaafary, Ziad El-Khatib, Hajer Elkout, Aisha Elsharkawy, Shymaa Enany, Daniel Adane Endalew, Babak Eshrati, Sharareh Eskandarieh, Arash Etemadi, Oluchi Ezekannagha, Emerito Jose A. Faraon, Mohammad Fareed, Andre Faro, Farshad Farzadfar, Alebachew Fasil Fasil, Mehdi Fazlzadeh, Valery L. Feigin, Wubalem Fekadu, Netsanet Fentahun, Seyed-Mohammad Fereshtehnejad, Eduarda Fernandes, Irina Filip, Florian Fischer, Carsten Flohr, Nataliya A. 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Subjects
Public aspects of medicine, RA1-1270
Abstract

Summary: Background: Lymphatic filariasis is a neglected tropical disease that can cause permanent disability through disruption of the lymphatic system. This disease is caused by parasitic filarial worms that are transmitted by mosquitos. Mass drug administration (MDA) of antihelmintics is recommended by WHO to eliminate lymphatic filariasis as a public health problem. This study aims to produce the first geospatial estimates of the global prevalence of lymphatic filariasis infection over time, to quantify progress towards elimination, and to identify geographical variation in distribution of infection. Methods: A global dataset of georeferenced surveyed locations was used to model annual 2000–18 lymphatic filariasis prevalence for 73 current or previously endemic countries. We applied Bayesian model-based geostatistics and time series methods to generate spatially continuous estimates of global all-age 2000–18 prevalence of lymphatic filariasis infection mapped at a resolution of 5 km2 and aggregated to estimate total number of individuals infected. Findings: We used 14 927 datapoints to fit the geospatial models. An estimated 199 million total individuals (95% uncertainty interval 174–234 million) worldwide were infected with lymphatic filariasis in 2000, with totals for WHO regions ranging from 3·1 million (1·6–5·7 million) in the region of the Americas to 107 million (91–134 million) in the South-East Asia region. By 2018, an estimated 51 million individuals (43–63 million) were infected. Broad declines in prevalence are observed globally, but focal areas in Africa and southeast Asia remain less likely to have attained infection prevalence thresholds proposed to achieve local elimination. Interpretation: Although the prevalence of lymphatic filariasis infection has declined since 2000, MDA is still necessary across large populations in Africa and Asia. Our mapped estimates can be used to identify areas where the probability of meeting infection thresholds is low, and when coupled with large uncertainty in the predictions, indicate additional data collection or intervention might be warranted before MDA programmes cease. Funding: Bill & Melinda Gates Foundation.

Published
2020
Full Text
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22. Mapping geographical inequalities in oral rehydration therapy coverage in low-income and middle-income countries, 2000–17

Author

Kirsten E Wiens, Paulina A Lindstedt, Brigette F Blacker, Kimberly B Johnson, Mathew M Baumann, Lauren E Schaeffer, Hedayat Abbastabar, Sr, Foad Abd-Allah, Ahmed Abdelalim, Ibrahim Abdollahpour, Kedir Hussein Abegaz, Ayenew Negesse Abejie, Lucas Guimarães Abreu, Michael R M Abrigo, Ahmed Abualhasan, Manfred Mario Kokou Accrombessi, Dilaram Acharya, Maryam Adabi, Abdu A Adamu, Oladimeji M Adebayo, Rufus Adesoji Adedoyin, Sr, Victor Adekanmbi, Olatunji O Adetokunboh, Sr, Beyene Meressa Adhena, Mohsen Afarideh, Sohail Ahmad, Keivan Ahmadi, Anwar E Ahmed, Muktar Beshir Ahmed, Rushdia Ahmed, Temesgen Yihunie Akalu, Fares Alahdab, Ziyad Al-Aly, Noore Alam, Sr, Samiah Alam, Genet Melak Alamene, Turki M Alanzi, Jacqueline Elizabeth Alcalde-Rabanal, Beriwan Abdulqadir Ali, Mehran Alijanzadeh, Vahid Alipour, Syed Mohamed Aljunid, Ali Almasi, Sr, Amir Almasi-Hashiani, Hesham M Al-Mekhlafi, Khalid A Altirkawi, Nelson Alvis-Guzman, Nelson J Alvis-Zakzuk, Saeed Amini, Sr, Arianna Maever L Amit, Sr, Catalina Liliana Andrei, Sr, Mina Anjomshoa, Amir Anoushiravani, Sr, Fereshteh Ansari, Carl Abelardo T Antonio, Benny Antony, Ernoiz Antriyandarti, Jalal Arabloo, Hany Mohamed Amin Aref, Sr, Olatunde Aremu, Bahram Armoon, Amit Arora, Sr, Krishna K Aryal, Afsaneh Arzani, Mehran Asadi-Aliabadi, Hagos Tasew Atalay, Seyyed Shamsadin Athari, Sr, Seyyede Masoume Athari, Sachin R Atre, Marcel Ausloos, Nefsu Awoke, Beatriz Paulina Ayala Quintanilla, Getinet Ayano, Martin Amogre Ayanore, Sr, Yared Asmare Aynalem IV, Samad Azari, Peter S Azzopardi, Ebrahim Babaee, Tesleem Kayode Babalola, Alaa Badawi, Sr, Mohan Bairwa, Shankar M Bakkannavar, Senthilkumar Balakrishnan, Ayele Geleto Bali, Maciej Banach, Sr, Joseph Adel Mattar Banoub, Sr, Aleksandra Barac, Till Winfried Bärnighausen, Huda Basaleem, Sanjay Basu, Vo Dinh Bay, Mohsen Bayati, Estifanos Baye, Neeraj Bedi, Mahya Mahya Beheshti Beheshti, Masoud Behzadifar, Meysam Behzadifar, Bayu Begashaw Bekele, Yaschilal Muche Belayneh, Michellr L Bell, 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Krishan, Nuworza Kugbey, G Anil Kumar, Manasi Kumar, Sr, Pushpendra Kumar, Vivek Kumar, Dian Kusuma, Carlo La Vecchia, Ben Lacey, Sheetal D Lad, Dharmesh Kumar Lal, Felix Lam, Faris Hasan Lami, Sr, Prabhat Lamichhane, Van Charles Lansingh, Savita Lasrado, Avula Laxmaiah, Paul H Lee, Sr, Kate E LeGrand, Mostafa Leili, Tsegaye Lolaso Lenjebo, Cheru Tesema Leshargie, Sr, Aubrey J Levine, Shanshan Li, Sr, Shai Linn, Shiwei Liu, Simin Liu, Rakesh Lodha, Joshua Longbottom, Jaifred Christian F Lopez, Hassan Magdy Abd El Razek, Muhammed Magdy Abd El Razek, D R Mahadeshwara Prasad, Phetole Walter Mahasha, Sr, Narayan B Mahotra, Azeem Majeed, Reza Malekzadeh, Sr, Deborah Carvalho Malta, Abdullah A Mamun, Sr, Navid Manafi, Sr, Ana Laura Manda, Narendar Dawani Dawanu Manohar, Mohammad Ali Mansournia, Chabila Christopher Mapoma, Joemer C Maravilla, Gabriel Martinez, Sr, Santi Martini, Francisco Rogerlândio Martins-Melo, Anthony Masaka, Benjamin Ballard Massenburg, Manu Raj Mathur, Benjamin K Mayala, Mohsen Mazidi, Colm McAlinden, Birhanu Geta Meharie, Man Mohan Mehndiratta, Sr, Kala M Mehta, Tefera C Chane Mekonnen, Gebrekiros Gebremichael Meles, Peter T N Memiah, Ziad A Memish, Sr, Walter Mendoza, Ritesh G Menezes, Seid Tiku Mereta, Tuomo J Meretoja, Sr, Tomislav Mestrovic, Bartosz Miazgowski, Kebadnew Mulatu Mihretie, Sr, Ted R Miller, GK Mini, Erkin M Mirrakhimov, Babak Moazen, Bahram Mohajer, Amjad Mohamadi-Bolbanabad, Dara K Mohammad, Karzan Abdulmuhsin Mohammad, Yousef Mohammad, Naser Mohammad Gholi Mezerji, Roghayeh Mohammadibakhsh, Noushin Mohammadifard, Jemal Abdu Mohammed, Sr, Shafiu Mohammed, Farnam Mohebi, Ali H Mokdad, Mariam Molokhia, Lorenzo Monasta, Yoshan Moodley, Sr, Catrin E Moore, Sr, Ghobad Moradi, Masoud Moradi, Mohammad Moradi-Joo, Maziar Moradi-Lakeh, Paula Moraga, Linda Morales, Ilais Moreno Velásquez, Abbas Mosapour, Simin Mouodi, Seyyed Meysam Mousavi, Miliva Mozaffor I, Kindie Fentahun Muchie, Sr, Getahun Fentaw Mulaw, Sr, Sandra B Munro, Moses K Muriithi, Christopher J L Murray, GVS Murthy, Kamarul Imran Musa, Ghulam Mustafa, Sr, Saravanan Muthupandian, Sr, Ashraf F Nabhan, Mehdi Naderi, Ahamarshan Jayaraman Nagarajan, Kovin S Naidoo, Gurudatta Naik, Farid Najafi, Vinay Nangia, Sr, Jobert Richie Nansseu, Bruno Ramos Nascimento, Sr, Javad Nazari, Duduzile Edith Ndwandwe, Sr, Ionut Negoi, Sr, Henok Biresaw Netsere Netsere, Sr, Josephine W Ngunjiri, Sr, Cuong Tat Nguyen, Huong Lan Thi Nguyen, Trang Huyen Nguyen, Dabere Nigatu, Solomon Gedlu Nigatu, Dina Nur Anggraini Ningrum, Chukwudi A Nnaji, Marzieh Nojomi, Vuong Minh Nong, Ole F Norheim, Sr, Jean Jacques Noubiap, Soraya Nouraei Motlagh, Bogdan Oancea, Okechukwu Samuel Ogah, Felix Akpojene Ogbo, In-Hwan Oh, Andrew T Olagunju, Tinuke O Olagunju, Bolajoko Olubukunola Olusanya, Jacob Olusegun Olusanya, Obinna E Onwujekwe, Sr, Eyal Oren, Doris V V Ortega-Altamirano, Sr, Osayomwanbo Osarenotor, Frank B Osei, Sr, Mayowa O Owolabi, Mahesh P A, Sr, Jagadish Rao Padubidri, Smita Pakhale, Sangram Kishor Patel, Angel J Paternina-Caicedo, Sr, Ashish Pathak, Sr, George C Patton, Deepak Paudel, Sr, Kebreab Paulos, Sr, Veincent Christian Filipino Pepito, Alexandre Pereira, Norberto Perico, Aslam Pervaiz, Julia Moreira Pescarini, Bakhtiar Piroozi, Meghdad Pirsaheb, Maarten J Postma, Hadi Pourjafar, Farshad Pourmalek, Sr, Akram Pourshams, Hossein Poustchi, Sergio I Prada, Sr, Narayan Prasad, Liliana Preotescu, Hedley Quintana, Navid Rabiee, Amir Radfar, Alireza Rafiei, Fakher Rahim, Afarin Rahimi-Movaghar, Vafa Rahimi-Movaghar, Mohammad Hifz Ur Rahman, Muhammad Aziz Rahman, SHAFIUR Rahman, Fatemeh Rajati, Sr, Saleem Muhammad Rana, Sr, Chhabi Lal Ranabhat, Davide Rasella, David Laith Rawaf, Salman Rawaf, Sr, Lal Rawal, Wasiq Faraz Rawasia, Vishnu Renjith, Andre M N Renzaho, Sr, Serge Resnikoff, Sr, Melese Abate Reta, Negar Rezaei, Mohammad sadegh Rezai, Seyed Mohammad Riahi, Ana Isabel Ribeiro, Jennifer Rickard, Sr, Maria Rios-Blancas, Leonardo Roever, Luca Ronfani, Elias Merdassa Roro, Sr, Jennifer M Ross, Enrico Rubagotti, Salvatore Rubino, Anas M Saad, Yogesh Damodar Sabde, Siamak Sabour, Ehsan Sadeghi, Sr, Yahya Safari, Roya Safari-Faramani, Rajesh Sagar, Amirhossein Sahebkar, Mohammad Ali Sahraian, S Mohammad Sajadi, Mohammad Reza Salahshoor, Nasir Salam, Sr, Payman Salamati, Hosni Salem, Marwa R Rashad Salem I, Yahya Salimi, Hamideh Salimzadeh, Abdallah M Samy, Juan Sanabria, Sr, Milena M Santric-Milicevic, Bruno Piassi Sao Jose, Sivan Yegnanarayana Iyer Saraswathy, Kaushik Sarkar, Sr, Abdur Razzaque Sarker, Nizal Sarrafzadegan I, Benn Sartorius, Brijesh Sathian, Thirunavukkarasu Sathish, Monika Sawhney, Sonia Saxena, Sr, David C Schwebel, Sr, Anbissa Muleta Senbeta IV, Subramanian Senthilkumaran, Sadaf G Sepanlou, Edson Serván-Mori, Sr, Hosein Shabaninejad, Azadeh Shafieesabet, Sr, Masood Ali Shaikh, Ali S Shalash, Sr, Seifadin Ahmed Shallo, Mehran Shams-Beyranvand, MohammadBagher Shamsi, Morteza Shamsizadeh, Mohammed Shannawaz, Kiomars Sharafi, Hamid Sharifi, Hatem Samir Shehata, Sr, Aziz Sheikh, B Suresh Kumar Shetty, Sr, Kenji Shibuya, Sr, Wondimeneh Shibabaw Shiferaw, Sr, Desalegn Markos Shifti, Mika Shigematsu, Jae Il Shin, Rahman Shiri, Sr, Reza Shirkoohi, Soraya Siabani, Tariq Jamal Siddiqi, Diego Augusto Santos Silva, Ambrish Singh, Jasvinder A Singh, Narinder Pal Singh, Virendra Singh, Malede Mequanent Sisay, Eirini Skiadaresi, Mohammad Reza Sobhiyeh, Sr, Anton Sokhan, Shahin Soltani, Ranjani Somayaji, Moslem Soofi, Muluken Bekele Sorrie, Sr, Ireneous N Soyiri, Chandrashekhar T Sreeramareddy, Agus Sudaryanto, Mu'awiyyah Babale Sufiyan, Sr, Hafiz Ansar Rasul Suleria, Marufa Sultana, Bruno Fokas Sunguya, Bryan L Sykes, Rafael Tabarés-Seisdedos, Takahiro Tabuchi, Degena Bahrey Tadesse, Jr, Ingan Ukur Tarigan, Aberash Abay Tasew, Yonatal Mesfin Tefera, Sr, Merhawi Gebremedhin Tekle, Mohamad-Hani Temsah, Berhe Etsay Tesfay I, Fisaha Haile Haile Tesfay, Belay Tessema, Zemenu Tadesse Tessema, Kavumpurathu Raman Thankappan, Nihal Thomas, Alemayehu Toma Toma, Sr, Roman Topor-Madry, Marcos Roberto Roberto Tovani-Palone, Eugenio Traini, Bach Xuan Tran, Khanh Bao Tran, Irfan Ullah, Bhaskaran Unnikrishnan, Muhammad Shariq Usman, Sr, Benjamin S Chudi Uzochukwu, Sr, Pascual R Valdez, Santosh Varughese, Sr, Francesco S Violante, Sr, Sebastian Vollmer, Sr, Feleke Gebremeskel W/hawariat, Sr, Yasir Waheed, Mitchell Taylor Wallin, Yafeng Wang, Yuan-Pang Wang, Marcia Weaver, Bedilu Girma Weji, Girmay Teklay Weldesamuel, Catherine A Welgan, Andrea Werdecker, Ronny Westerman, Sr, Taweewat Wiangkham, Charles Shey Wiysonge, Sr, Haileab Fekadu Wolde, Sr, Dawit Zewdu Wondafrash, Tewodros Eshete Wonde, Sr, Getasew Taddesse Worku, Sr, Ai-Min Wu, Gelin Xu, Ali Yadollahpour, Seyed Hossein Yahyazadeh Jabbari, Tomohide Yamada, Sr, Hiroshi Yatsuya, Alex Yeshaneh, Christopher Sabo Yilgwan, Mekdes Tigistu Yilma, Paul Yip, Sr, Engida Yisma, Naohiro Yonemoto, Sr, Seok-Jun Yoon, Mustafa Z Younis, Mahmoud Yousefifard, Hebat-Allah Salah A Yousof, Chuanhua Yu, Hasan Yusefzadeh, Siddhesh Zadey, Zoubida Zaidi, Sojib Bin Zaman, Mohammad Zamani, Hamed Zandian, Nejimu Biza Zepro, Taddese Alemu Zerfu, Yunquan Zhang, Xiu-Ju George Zhao, Arash Ziapour, Sanjay Zodpey, Sr, Yves Miel H Zuniga, Simon I Hay, and Robert C Reiner, Jr

Subjects
Public aspects of medicine, RA1-1270
Abstract

Summary: Background: Oral rehydration solution (ORS) is a form of oral rehydration therapy (ORT) for diarrhoea that has the potential to drastically reduce child mortality; yet, according to UNICEF estimates, less than half of children younger than 5 years with diarrhoea in low-income and middle-income countries (LMICs) received ORS in 2016. A variety of recommended home fluids (RHF) exist as alternative forms of ORT; however, it is unclear whether RHF prevent child mortality. Previous studies have shown considerable variation between countries in ORS and RHF use, but subnational variation is unknown. This study aims to produce high-resolution geospatial estimates of relative and absolute coverage of ORS, RHF, and ORT (use of either ORS or RHF) in LMICs. Methods: We used a Bayesian geostatistical model including 15 spatial covariates and data from 385 household surveys across 94 LMICs to estimate annual proportions of children younger than 5 years of age with diarrhoea who received ORS or RHF (or both) on continuous continent-wide surfaces in 2000–17, and aggregated results to policy-relevant administrative units. Additionally, we analysed geographical inequality in coverage across administrative units and estimated the number of diarrhoeal deaths averted by increased coverage over the study period. Uncertainty in the mean coverage estimates was calculated by taking 250 draws from the posterior joint distribution of the model and creating uncertainty intervals (UIs) with the 2·5th and 97·5th percentiles of those 250 draws. Findings: While ORS use among children with diarrhoea increased in some countries from 2000 to 2017, coverage remained below 50% in the majority (62·6%; 12 417 of 19 823) of second administrative-level units and an estimated 6 519 000 children (95% UI 5 254 000–7 733 000) with diarrhoea were not treated with any form of ORT in 2017. Increases in ORS use corresponded with declines in RHF in many locations, resulting in relatively constant overall ORT coverage from 2000 to 2017. Although ORS was uniformly distributed subnationally in some countries, within-country geographical inequalities persisted in others; 11 countries had at least a 50% difference in one of their units compared with the country mean. Increases in ORS use over time were correlated with declines in RHF use and in diarrhoeal mortality in many locations, and an estimated 52 230 diarrhoeal deaths (36 910–68 860) were averted by scaling up of ORS coverage between 2000 and 2017. Finally, we identified key subnational areas in Colombia, Nigeria, and Sudan as examples of where diarrhoeal mortality remains higher than average, while ORS coverage remains lower than average. Interpretation: To our knowledge, this study is the first to produce and map subnational estimates of ORS, RHF, and ORT coverage and attributable child diarrhoeal deaths across LMICs from 2000 to 2017, allowing for tracking progress over time. Our novel results, combined with detailed subnational estimates of diarrhoeal morbidity and mortality, can support subnational needs assessments aimed at furthering policy makers' understanding of within-country disparities. Over 50 years after the discovery that led to this simple, cheap, and life-saving therapy, large gains in reducing mortality could still be made by reducing geographical inequalities in ORS coverage. Funding: Bill & Melinda Gates Foundation.

Published
2020
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23. Childhood hearing impairment and its associated factors in sub-Saharan Africa in the 21st century: A systematic review and meta-analysis

Author

Assefa Desalew, Tilayie Feto Gelano, Agumasie Semahegn, Biftu Geda, and Tilahun Ali

Subjects
Medicine (General), R5-920
Abstract

Background: Childhood hearing impairment is still a significant cause of disability in the 21st century in developing countries. Particularly, the burden is more severe in sub-Saharan Africa, where the majority of children with hearing problems is living. Thre are great variations and inconsistencies of available findings conducted in sub-Saharan Africa. Hence, the aim of this review was to determine the pooled prevalence of childhood hearing impairment and its associated factors in sub-Saharan Africa. Methods: Studies were searched from main databases (PubMed, CINAHL, and African Journals Online), Google Scholar, and other relevant sources using electronic and manual techniques. All observational studies, written in English and conducted among participants (aged less than 18 years) from 2000 to 2018, were eligible. Heterogeneity between included studies was assessed using I 2 , and publication bias was explored using visual inspection of the funnel plot. Statistical analysis was carried out to determine pooled prevalence using Stata version 14. In addition, subgroup analysis was carried out for the normality criteria of hearing thresholds and characteristics of the study populations. Results: The pooled prevalence of hearing impairment was 10% (95% confidence interval (CI): 9%–11%). The magnitude of hearing impairment varies with the normality criterion used. The most commonly used threshold was 25 and 30 dB hearing level. The prevalence of hearing impairment based on normality criterion (>20 dB, >25 dB, >30 dB, and >35 dB) were 17%, 19%, 2%, and 1%, respectively. While in the questionnaire-based evaluation, the prevalence was 6% (95% CI: 3%–9%). In addition, based on population characteristics, the prevalence of hearing impairment for school or community-based children was 6% (95% CI: 5%–7%) while the prevalence for children with comorbidities was 23% (95% CI: 15%–31%). Chronic suppurative otitis media, impacted cerumen, advanced stage of human immunodeficiency virus, tuberculosis infection, and age of the children were associated with hearing impairment in sub-Saharan Africa. Conclusion: Hearing impairment in children and adolescents in sub-Saharan Africa was high, and associated with preventable and treatable risk factors.

Published
2020
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24. Basic neonatal resuscitation skills of midwives and nurses in Eastern Ethiopia are not well retained: An observational study.

Author

Yitagesu Sintayehu, Assefa Desalew, Biftu Geda, Getahun Tiruye, Haymanot Mezmur, Kasiye Shiferaw, and Teshale Mulatu

Subjects
Medicine, Science
Abstract

BackgroundNeonatal resuscitation is a life-saving intervention for birth asphyxia, a leading cause of neonatal mortality. Worldwide, four million neonate deaths happen annually, and birth asphyxia accounts for one million deaths. Improving providers' neonatal resuscitation skills is critical for delivering quality care and for morbidity and mortality reduction. However, retention of these skills has been challenging in developing countries, including Ethiopia. Hence, this study aimed to assess neonatal resuscitation skills retention and associated factors among midwives and nurses in Eastern Ethiopia.MethodsAn institution-based cross-sectional study was conducted using a pre-tested, structured, observational checklist. A total of 427 midwives and nurses were included from 28 public health facilities by cluster sampling and simple random sampling methods. Data were collected on facility type, availability of essential resuscitation equipment, socio-demographic characteristics of participants, current working unit, years of professional experience, whether a nurse or midwife received refresher training, and skills and knowledge related to neonatal resuscitation. Binary logistic regression was used to analyse the association between neonatal resuscitation skill retention and independent variables.ResultsAbout 11.2% of nurses and midwives were found to have retention of neonatal resuscitation skills. Being a midwife (AOR, 7.39 [95% CI: 2.25, 24.24]), ever performing neonatal resuscitation (AOR, 3.33 [95% CI: 1.09, 10.15]), bachelor sciences degree or above (AOR, 4.21 [95% CI: 1.60, 11.00]), and good knowledge of neonatal resuscitation (AOR, 3.31 [95% CI: 1.41, 7.73]) were significantly associated with skill retention of midwives and nurses.ConclusionBasic neonatal resuscitation skills of midwives and nurses in Eastern Ethiopia are not well retained. This could increase the death of neonates due to asphyxia. Being a midwife, Bachelor Sciences degree or above educational status, ever performing neonatal resuscitation, and good knowledge were associated with skill retention. Providers should be encouraged to upgrade their educational level to build their skill retention and expose themselves to NR. Further, understanding factors affecting how midwives and nurses gain and retain skills using high-level methodology are essential.

Published
2020
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25. Determinants of congenital anomalies in neonates admitted to public hospitals in Eastern Ethiopia: A Case-Control study

Author

Nano Belama, Assefa Desalew, Magarsa Lami, and Kedir Teji Roba

Abstract

Background More than 8 million newborns are born with congenital anomalies worldwide, and 3.2 million children are disabled as a result of congenital anomalies. Despite the high prevalence of congenital anomalies in Ethiopia, research on their determinants of congenital anomalies in newborns is limited, particularly in eastern Ethiopia. Methods A facility-based unmatched case-control study of 387 participants (129 cases and 258 controls) born in public hospitals in the Harari region and the Dire Dawa administration was conducted. An interviewer-administered structured questionnaire and a review of medical records were used to collect data. The determinants of congenital malformations were studied using a multivariate logistic regression analysis. Multivariable logistic regression analysis was used to determine a significant association with a p-value of 0.05. Results According to this study, the most common type of congenital anomaly was nervous system anomalies (84.6%), followed by musculoskeletal system anomalies (16.4%). In multivariable logistic regression analysis, neonates from anemic mothers (AOR: 4.37, 95% CI: 2.48–7.69), maternal alcohol consumption during index pregnancy (AOR: 4.01, 95% CI: 1.88–8.54), rural residence (AOR: 1.73, 95% CI: 1.04–2.85), and antenatal care visits (AOR: 0.43, 95% CI: 0.22–0.84) were significant predictors of congenital anomalies. Conclusion Maternal anemia, substance use during pregnancy, antenatal care visits, and rural residence were risk factors for congenital anomalies. Reducing the burden of congenital anomalies requires addressing modifiable factors such as maternal anemia, alcohol consumption, chewing Khat, and increasing antenatal care follow-up.

Published
2023
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26. Fear of childbirth among pregnant women in Eastern Ethiopia

Author

Adisalem Dereje, Merga Dheresa, Assefa Desalew, and Abera Kenay Tura

Subjects
Fear of childbirth, Pregnant women, Maternity and Midwifery, Obstetrics and Gynecology, Wijma delivery expectancy questionnaire, Ethiopia
Abstract

Introduction: Fear of childbirth refers to feelings of uncertainty and anxiety before, during, or after childbirth by thinking about future labor and birth or experience of others. Evidence on burden of fear of childbirth and its associated factors is limited in Ethiopia. In this study, we assessed magnitude of fear of childbirth and its associated factors among pregnant women in Eastern Ethiopia. Methods: A community-based cross-sectional study was conducted among randomly selected pregnant women recruited from Kersa Health and Demographic Surveillance System—an open cohort consisting of continuous registry of health and demographic conditions in eastern Ethiopia. Women were interviewed and fear of childbirth was assessed using the Wijma Delivery Expectancy Questionnaire. Data were entered using EpiData 3.1 and analyzed using SPSS 20. Factors associated with fear of childbirth were identified using binary and multiple logistic regression and described using adjusted odds ratio (aOR) along with 95% confidence interval (CI). Finally, statistical significance was set at p < 0.05 in the multiple logistic regression. Results: Of a total of 476 pregnant women included in the study, 111(23.3%; 95% CI 19.3-26.9) had fear of childbirth. Fear of childbirth was more likely among women who had no antenatal care (aOR = 2.6; 95% CI:1.22-5.50), no husband support (aOR = 5.7; 95% CI: 2.32-13.10), unplanned pregnancy (aOR = 7.8; 95% CI: 3.92-15.42), and had history of complication in labor and pregnancy (aOR = 10.4; 95% CI: 5.20-20.81). Conclusion: A quarter of pregnant women in eastern Ethiopia had fear of childbirth. Helping women to have positive pregnancy experience requires strengthening antenatal care, partner support, and prevention of unwanted pregnancy.

Published
2023

27. Risk factors associated with acute kidney injury in a pediatric intensive care unit in Addis Ababa, Ethiopia. Case control study

Author

Mulualem Keneni, Rajalakshmi Murugan, Ketema Bizuwork, Tesfaye Asfaw, Sosina Tekle, Gadisa Tolosa, and Assefa Desalew

Abstract

Background: Acute kidney injury (AKI) is a serious problem in critically ill children. It is associated with poor treatment outcomes and a high rate of morbidity and mortality. Globally, one in three critically ill admitted children suffer from acute kidney injury. However, limited data are available in Africa, particularly in Ethiopia, highlighting the risk factors related to acute kidney injury. Therefore, this study aimed to identify the risk factors associated with acute kidney injury among critically ill children admitted to the pediatric intensive care unit at the Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. Methods: A facility-based unmatched case-control study was carried out on 253 (85 cases and 168 controls) children admitted to the pediatric intensive care unit from January 2011 to December 2021. Participants were selected using a systematic random sampling technique for the control group and all cases consecutively. Data were collected using a structured checklist. Data were entered using Epi data version 4.6 and analyzed using SPSS version 25. Multivariate analysis was carried out using the adjusted odds ratio (AOR) with a 95% confidence interval (CI) to identify associated factors with acute kidney injury. Statistical significance was set at P Results: The median age of the participants was two years. About 55.6 % of cases and 53.1% of controls were females. The diagnosis of hypertension (AOR= 5.36; 95% CI: 2.06- 13.93)], shock (AOR=3.88, 95% CI: 1.85- 8.12), exposure to nephrotoxic drugs (AOR=4.09; 95% CI: 1. 45- 11.59), sepsis or infection AOR=3.36; 95% CI: 1.42-7.99), nephritic syndrome (AOR=2.97; 95% CI :1.19, 7.43), and mechanical ventilation AOR=2.25, 95% CI: 1.12, 4.51) were significantly associated with acute kidney injury. Conclusion: In this study, the diagnosis of sepsis or infection, hypertension, shock, nephrotoxic drugs, demand for mechanical ventilation support, and nephritic syndrome increased the risk of AKI among critically ill children. Multiple risk factors for AKI are associated with illness and its severity. All measures that ensure adequate renal perfusion must be taken in children with identified risk factors to avoid the development of AKI.

Published
2022
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28. Preterm birth and associated factors among mothers who gave birth in Dire Dawa, Ethiopia

Author

Assefa Desalew, Alekaw Sema, Alemu Guta, Yitagesu Sintayehu, Legesse Abera, Bezabih Amsalu, Yalelet Belay, and Nigus Kassie

Subjects
03 medical and health sciences, 030219 obstetrics & reproductive medicine, 0302 clinical medicine, Maternity and Midwifery, 030212 general & internal medicine
Abstract

Background The highest rate of preterm birth in the world is in Sub-Saharan Africa and Asia. However, there is limited data in this study area. Therefore, this study aims to assess the prevalence and associated factors of preterm birth in Dire Dawa City, Eastern Ethiopia. Method An institutional-based, cross-sectional study was conducted with 420 respondents. Conclusion Preterm birth is still a major public health problem in Dire Dawa City.

Published
2021
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29. Risk Factors Associated with Breast Cancer among Women in Addis Ababa, Ethiopia: Unmatched Case–Control Study

Author

Endalew Gemechu Sendo, Negalign Getahun Dinegde, Lidia Tolessa, and Assefa Desalew

Subjects
International Journal of Women's Health, Overweight, 03 medical and health sciences, breast cancer, 0302 clinical medicine, Breast cancer, Maternity and Midwifery, risk factors, Medicine, 030212 general & internal medicine, Family history, Original Research, 030219 obstetrics & reproductive medicine, business.industry, Case-control study, Obstetrics and Gynecology, Cancer, Odds ratio, medicine.disease, Obesity, Oncology, Menarche, women, Ethiopia, medicine.symptom, business, Demography
Abstract

Lidia Tolessa,1 Endalew Gemechu Sendo,2 Negalign Getahun Dinegde,2 Assefa Desalew1 1School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 2Department of Nursing and Midwifery, College of Health Science, Addis Ababa University, Addis Ababa, EthiopiaCorrespondence: Assefa DesalewCollege of Health and Medical Sciences, Haramaya University, P.O. Box: 235, Harar, EthiopiaTel +251913083613Email assefad100@gmail.comBackground: Breast cancer is a common public health problem and the main cause of cancer-related death worldwide. There is a paucity of evidence on the risk factors of breast cancer in Ethiopia. Therefore, we aimed to identify the risk factors of breast cancer among women in Addis Ababa, Ethiopia.Methods: We conducted an institutional-based unmatched case–control study with a sample of 348 women (116 cases and 232 controls). Participants were selected by a systematic random sampling technique. Data were collected using an interviewer-administered questionnaire. Data were entered using EpiData version 4.6 and analyzed using SPSS version 25. Multivariable analysis was carried out using the adjusted odds ratio (AOR) with a 95% confidence interval (CI). P-value of less than 0.05 was considered statistically significant.Results: The mean age (+SD) of the participants was 42.7 (± 11.3) and 40.7 (± 14.6) for the cases and controls, respectively. Early onset of menarche (AOR= 4.10; 95% CI: 1.84, 9.15), rural women (AOR= 3.64; 95% CI:1.38, 9.57), utilization of packed foods or drinks (AOR= 2.80; 95% CI:1.52, 5.15), and smoke-dried meat (AOR= 2.41; 95% CI:1.36, 4.27), family history of cancer (AOR= 2.11; 95% CI:1.04, 4.26), overweight and/or obesity (AOR= 2.38; 95% CI:1.31, 4.31), and women with one or less children (AOR= 1.86; 95% CI:1.01, 3.41) were associated factors with breast cancer risk.Conclusion: In this study, early onset of menarche, rural women, utilization of packed foods or drinks and smoke-dried meat, family history of cancer, overweight and/or obesity, and women with one or fewer children were factors that increased breast cancer risk. Therefore, focusing on modifiable risk factors and increasing awareness of the community such as a healthy diet, promotion of breast self-examination, and creation of programs to increase women’s knowledge is important to reduce the increasing burden of breast cancer.Keywords: breast cancer, risk factors, women, Ethiopia

Published
2021
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30. Tuberculous Meningitis in Children: Treatment Outcomes at Discharge and Its Associated Factors in Eastern Ethiopia: A Five Years Retrospective Study

Author

Ahmed Abdella, Endayen Deginet, Fitsum Weldegebreal, Indeshaw Ketema, Bajrond Eshetu, and Assefa Desalew

Subjects
Pharmacology, Infectious Diseases, Infection and Drug Resistance, Pharmacology (medical)
Abstract

Ahmed Abdella,1 Endayen Deginet,1 Fitsum Weldegebreal,2 Indeshaw Ketema,3 Bajrond Eshetu,4 Assefa Desalew5 1Department of Pediatrics and Child Health, School of Medicine, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 2School of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 3Department of Emergency and Critical Care Nursing, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 4Department of Midwifery, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 5Department of Pediatrics and Child Health Nursing, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, EthiopiaCorrespondence: Assefa Desalew, Email assefad100@gmail.comBackground: Tuberculous meningitis is a serious public health problem, particularly in low-income countries. It is associated with high rates of mortality and morbidity. The outcome of tuberculous meningitis in children is not well documented in Ethiopia, particularly in eastern Ethiopia. This study aimed to determine the treatment outcomes of tuberculous meningitis at discharge and its associated factors in eastern Ethiopia.Methods: An institutional-based retrospective cross-sectional study was conducted on 121 children who were admitted and treated for tuberculous meningitis between January 2017 and December 2021. Data were collected using a pretested checklist, coded and entered into EpiData version 3.1, and analyzed using Statistical Package for the Social Sciences (SPSS) version 25. Factors associated with treatment outcomes were identified using multivariable logistic regression analyses. The association was described using the adjusted odds ratio (AOR) at a 95% confidence interval (CI). Finally, statistical significance was set at a p-value < 0.05.Results: Of the 121 medical records of children, 33.9% (95% CI:25– 42%) died. Among the survivors, 28.1% were discharged with neurological sequelae and the remains (38.0%) were discharged with normal outcomes. In multivariable analyses, nutritional status (AOR=2.87; 95% CI:1.04– 7.94), duration of illness (AOR = 0.33; 95% CI: 0.15– 0.86), hydrocephalus (AOR=3.78; 95% CI:1.08– 13.34), and stage-III Tuberculous Meningitis (AOR = 5.29; 95% CI:1.88– 14.84) were identified as significantly associated factors with poor clinical outcomes.Conclusion: The treatment outcomes for tuberculous meningitis in children are unfavorable. Two-thirds of children had poor treatment outcomes. Malnutrition, disease stage, hydrocephalus, and illness duration were associated with poor treatment outcomes at discharge. Health workers in primary health care should be aware of the importance of early screening, diagnosis, and treatment to improve clinical outcomes and reduce associated mortality and disability. In practice, more attention should be paid to children with malnutrition and hydrocephalus.Keywords: tuberculous meningitis, pediatric, children, clinical outcome, Ethiopia

Published
2022

31. Underfive Mortality and Associated Factors among Children Born from 15-49 Years Old Mothers in Haramaya Town, Eastern Ethiopia

Author

Nega Assefa, Melake Demena, Zelalem Teklemariam, Mohammed Ahmed, and Assefa Desalew

Subjects
Geography, Under five mortality, Demography
Abstract

BACKGROUNDGlobally, since 2000, a decline in the underfive mortality rate has been recorded, indicating that over 50 million children’s lives have been saved. More than 80 countries globally, specifically 69 developing nations, have reduced the underfive mortality by half since 2000. In the eastern part of Ethiopia, evidence from the Kersa Health and Demographic Surveillance System in the Kersa district of East Hararghe Zone, Oromia Region, suggested a decline in the underfive mortality rate from 131.8 per 1000 live births in 2008 to 77.4 per 1000 live births in 2013. The death rates still remain far from the Sustainable Development Goals’ target reduction to 25 or less per 1000 live births by 2030. However, the magnitude and determinants of underfive mortalities have not been studied in Haramaya town.OBJECTIVETo assess the underfive mortality rate and its associated factors among children born from 7th August 2015 to 6th August 2020 in Haramaya town, east Ethiopia, by 7th–31st August 2020.METHODOLOGYA quantitative cross-sectional population-based study was conducted on 391 pairs of 15- to 49-year-old mothers and their live-born underfive children selected using a systematic random sampling technique from Haramaya town to compare child mortality between the =25 mother’s age groups. Data were collected using an interview-based questionnaire, double entered into EpiData 3.1, and then exported to the statistical package for social sciences program version 20.0 for analysis. Binary logistic regression analysis (p value RESULTSThe deaths of 28 out of 372 live births resulted in an underfive mortality rate of 75 per 1000 live births. Children born in households with fewer than 6 members had 7. 98 times higher odds of dying than those born in households with at least 6 members (AOR =7.98, 95% CI =1.59-40.17). Those children who did not feed colostrum were associated with a 17.45 times increased risk of underfive deaths compared to colostrum-fed children (AOR =17.45, 95% CI =6.54-46.55).CONCLUSIONThe study suggests that 75 per 1000 live births die before celebrating their fifth birth day. Household size and colostrum feeding are significantly associated factors.RECOMMENDATIONAll concerned should inform the mothers of the role of identified factors such as household size and colostrum feeding in child survival.

Published
2022
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32. Knowledge of Basic Neonatal Resuscitation and Associated Factors Among Midwives and Nurses in Public Health Institutions in Eastern Ethiopia

Author

Kasiye Shiferaw, Assefa Desalew, Teshale Mulatu, Yitagesu Sintayehu, Getahun Tiruye, Biftu Geda, and Haymanot Mezmur

Subjects
Asphyxia, medicine.medical_specialty, Resuscitation, business.industry, media_common.quotation_subject, Public health, General Medicine, 030204 cardiovascular system & hematology, Bachelor, Logistic regression, 03 medical and health sciences, 0302 clinical medicine, 030220 oncology & carcinogenesis, Intervention (counseling), Family medicine, Medicine, Limited evidence, medicine.symptom, business, Neonatal resuscitation, media_common
Abstract

Background Neonatal resuscitation is a means to restore life to a baby from the state of asphyxia. It is a single intervention of birth asphyxia. Over 1.2 million African babies are supposed to die in the first four weeks of their life and many of them in the first 24 hours of birth in Sub-Saharan Africa. The major cause of early neonatal death is neonatal asphyxia, which can be prevented by neonatal resuscitation. However, there is limited evidence on midwives' and nurses' knowledge of neonatal resuscitation in the study area. Therefore, this study aimed to assess the knowledge of midwives and nurses about neonatal resuscitation and its associated factors. Methods This facility-based cross-sectional study was done on 427 midwives and nurses, who were selected using simple random sampling technique. Data were collected on facility type, availability of essential equipment, socio-demographic characteristics, working unit, professional experience, in-service training, and knowledge of neonatal resuscitation. First-degree holder midwives collected the data using a pre-tested face-to-face interviewer-administered questionnaire. Bivariate and multivariate logistic regression was used to analyze the association between the dependent and independent variables. Results The study showed that 9.8% of the study participants had good knowledge about neonatal resuscitation. Factors significantly associated with knowledge of neonatal resuscitation were being trained on newborn resuscitation (AOR = 3.79, 95% CI: 1.73, 8.32), being unmarried (AOR = 2.36, 95% CI: 1.11, 5.02), holding bachelor sciences degree or above (AOR = 2.67, 95% CI: 1.11, 6.47), and working under West Hararghe health institutions (AOR = 0.30, 95% CI: 0.10, 0.88). Conclusion The study participants had low knowledge of neonatal resuscitation. Being unmarried, holding bachelor sciences degree or above, being trained on neonatal resuscitation, and working under West Hararghe health institutions were factors associated with the knowledge of the study participants on neonatal resuscitation.

Published
2020
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33. Knowledge and involvement of husbands in the reproductive rights of women in Harar, eastern Ethiopia

Author

Alekaw Sema, Yadeta Dessie, Assefa Desalew, Tadesse Alemayehu, Aminu Mohammed, Adera Debela, and Yalelet Belay

Subjects
knowledge, medicine.medical_specialty, Medicine (General), business.industry, Public health, reproductive rights, General Medicine, involvement, Husband, R5-920, Harar, Reproductive rights, medicine, Original Research Article, women, Ethiopia, business, Socioeconomics
Abstract

Objective: Reproductive rights violations are a serious public health concern worldwide, particularly in Sub-Saharan Africa, where more than 38.83% of victims live. Understanding the status of husbands’ knowledge and involvement helps to establish important programs and interventions. However, there are limited data related to husbands’ roles in women’s reproductive rights in the study setting. Therefore, this study aimed to assess husbands’ knowledge and involvement in women’s reproductive rights and their associated factors in Harar, eastern Ethiopia. Methods: A community-based cross-sectional study was conducted among 611 husbands in March 2020. A systematic random sampling technique was used to select the study participants. Data were collected using a structured and pretested interviewer-administered questionnaire. Data were entered using EpiData 3.1 and analyzed with SPSS Version 22. A multivariable logistic regression model was applied to examine the factors associated with the outcome variable using an adjusted odds ratio with a 95% confidence interval, and a p-value Results: The levels of husbands’ knowledge and involvement were 48.3% and 40.1%, respectively. Social media utilization (adjusted odds ratio = 4.97, 95% confidence interval = 2.79–8.85), partners’ discussion (adjusted odds ratio = 2.33, 95% confidence interval = 1.60–3.39), and type of facility: hospital (adjusted odds ratio = 3.21, 95% confidence interval = 1.23–8.36) and health post (adjusted odds ratio = 2.86, 95% confidence interval = 1.20–6.94) were factors associated with knowledge of husbands. Likewise, the experience of using reproductive services (adjusted odds ratio = 2.15, 95% confidence interval = 1.52–3.03), partner discussion (adjusted odds ratio = 1.95, 95% confidence interval = 1.35–2.82), social media utilization (adjusted odds ratio = 1.74, 95% confidence interval = 1.05–2.89), and age 40–49 years (adjusted odds ratio = 1.99, 95% confidence interval = 1.19–3.32) were factors associated with husbands’ involvement. Conclusion: Less than half of the husbands were knowledgeable and involved in executing partners’ reproductive rights. Promoting and creating effective media utilization is important for creating awareness of reproductive rights. Moreover, working on reproductive health service utilization, women empowerment, and making open discussions between partners are crucial to increase the knowledge and involvement of husbands.

Published
2021

34. Hearing loss prevalence and years lived with disability, 1990-2019: findings from the Global Burden of Disease Study 2019

Author

Rezaul Karim Ripon, Lydia M. Haile, Richard C. Franklin, Virginia Núñez-Samudio, Sonali G. Choudhari, Chythra R Rao, Maria Inês Schmidt, Jeff T. Zhao, Hanadi Al Hamad, Bing-Fang Hwang, Christopher R. Cederroth, Howard J. Hoffman, Naohiro Yonemoto, Rajaa Al-Raddadi, Avina Vongpradith, David Laith Rawaf, Valentin Yurievich Skryabin, Maja Pasovic, Ismail Tareque, Alessandra Lugo, Theo Vos, Rabia Hussain, Golnaz Heidari, Tarik A. Rashid, Ghozali Ghozali, Stephen S Lim, Bay Vo, Emma Elizabeth Spurlock, Himal Kandel, Jitendra Singh, Adrian Davis, Pankaj Bhardwaj, Houman Sotoudeh, Arif Mohammed, Rekha Thapar, Mohammad Rabiee, Florian Fischer, Deepika Singhal, Haroon Ahmed, Irina Filip, Michael Ekholuenetale, Amirhossein Sahebkar, Abdallah M. Samy, Fatemeh Pashazadeh Kan, Sathish Kumar Jayapal, Ionela-Roxana Glavan, Mikhail Sergeevich Zastrozhin, Bruce Bartholow Duncan, Aziz Rezapour, Jalal Arabloo, Sahel Valadan Tahbaz, Chuanhua Yu, Huong Lan Thi Nguyen, Vahid Rashedi, Shrikant Pawar, Shelly Chadha, Mahaveer Golechha, Bach Xuan Tran, Jaimie D Steinmetz, Deepak Dhamnetiya, Olayinka Stephen Ilesanmi, Masood Ali Shaikh, Charlie Ashbaugh, Stany W. Lobo, Akshaya Srikanth Bhagavathula, Biruk Wogayehu Taddele, Baye Dagnew, Walter Mendoza, Morteza Arab-Zozani, Turki Alanzi, Sandhya Neupane Kandel, Kebadnew Mulatu Mihretie, Zaheer-Ud-Din Babar, Jasvinder A. Singh, Veer Bala Gupta, Maheswar Satpathy, Ali H. Mokdad, Simon I. Hay, Sadia Bibi, Louis Jacob, Christopher J L Murray, Liaqat Ali, Keyvan Pakshir, Allen Seylani, Andre M. N. Renzaho, Eman Abu-Gharbieh, Till Bärnighausen, Segun Emmanuel Ibitoye, Voilet Rodrigues, Vahit Yigit, Mohammed Shannawaz, Mohammad Ali Moni, Ali Yadollahpour, Rose G Bender, Victor M. Oguoma, Rohollah Kalhor, Saif Ullah, Mohammad Zamani, Anna Aleksandrovna Skryabina, Mowafa Househ, Milena Santric-Milicevic, Juwel Rana, Fakher Rahim, Soraya Siabani, Mokhtar Mohammadi, Bolajoko O. Olusanya, Khezar Hayat, Teroj Abdulrahman Mohamed, Palash Chandra Banik, Nikha Bhardwaj, Brijesh Sathian, Fahad Alanezi, Jean Jacques Noubiap, Jagadish Rao Padubidri, Hans Orru, Nawzad K. Al-Salihi, Navid Rabiee, Xuefeng Liu, Iván Landires, Paul S Briant, Jost B. Jonas, Mayowa O. Owolabi, Zhi Jiang Zhang, Farhad Ghamari, Vahid Alipour, Sowmya J. Rao, Mehdi Hosseinzadeh, Desta Debalkie Atnafu, Lalit Dandona, Molly R Nixon, Rovshan Khalilov, Ai Koyanagi, Silvano Gallus, Saad M.A. Dahlawi, Salman Rawaf, Mohammad Abdollahi, Ted R. Miller, Masao Iwagami, Amanual Getnet Mersha, Savita Lasrado, Marcos Roberto Tovani-Palone, Umar Saeed, Fares Alahdab, Vafa Rahimi-Movaghar, Ivo Iavicoli, Yonas Akalu, Amir Masoud Rahmani, Kathleen Pillsbury Hopf, Assefa Desalew, Sheikh Mohammed Shariful Islam, Amare Belachew Dagnew, Ravi Prakash Jha, Jacob Olusegun Olusanya, Jingkai Wei, Mandira Lamichhane Dhimal, Kaloyan Kamenov, Anasthasia Zastrozhina, Samer Hamidi, Gbenga A. Kayode, Katrin Burkart, Anjali Singal, Shahina Pardhan, Rakhi Dandona, Jaykaran Charan, Akram Pourshams, Xiaochen Dai, Meghnath Dhimal, Kerrie E. Doyle, Seyed Sina Naghibi Irvani, Shilpa Gaidhane, Francesco Saverio Violante, Monika Sawhney, Animut Tagele Tamiru, Hai Quang Pham, Atif Amin Baig, Hubert Amu, Judie Arulappan, Ayele Semachew Kasa, Alaa Makki, Syed Amir Gilani, Abdollah Mohammadian-Hafshejani, Soewarta Kosen, Abhay Gaidhane, Birhanu Wubale Yirdaw, Ismaeel Yunusa, Ali Bijani, Billy Randall Hammond, Neeti Rustagi, Bogdan Oancea, Ahmad Ghashghaee, Amadou Barrow, Mosiur Rahman, Ashkan Afshin, Yigizie Yeshaw, Mahalaqua Nazli Khatib, Amir Radfar, Winfried Schlee, Andrew T Olagunju, Dinh-Toi Chu, Vasily Vlassov, Ejaz Ahmad Khan, Sanjeev Misra, Rosa A. S. Couto, Marina Pinheiro, Mohammad Hifz Ur Rahman, Amir Abdoli, Bárbara Niegia Garcia de Goulart, Wondimeneh Shibabaw Shiferaw, Seyed Hossein Yahyazadeh Jabbari, Aislyn U. Orji, Vivek Gupta, Giang Thu Vu, G Anil Kumar, Haile L.M., Kamenov K., Briant P.S., Orji A.U., Steinmetz J.D., Abdoli A., Abdollahi M., Abu-Gharbieh E., Afshin A., Ahmed H., Rashid T.A., Akalu Y., Alahdab F., Alanezi F.M., Alanzi T.M., Al Hamad H., Ali L., Alipour V., Al-Raddadi R.M., Amu H., Arabloo J., Arab-Zozani M., Arulappan J., Ashbaugh C., Atnafu D.D., Babar Z.-U.-D., Baig A.A., Banik P.C., Barnighausen T.W., Barrow A., Bender R.G., Bhagavathula A.S., Bhardwaj N., Bhardwaj P., Bibi S., Bijani A., Burkart K., Cederroth C.R., Charan J., Choudhari S.G., Chu D.-T., Couto R.A.S., Dagnew A.B., Dagnew B., Dahlawi S.M.A., Dai X., Dandona L., Dandona R., Desalew A., Dhamnetiya D., Dhimal M.L., Dhimal M., Doyle K.E., Duncan B.B., Ekholuenetale M., Filip I., Fischer F., Franklin R.C., Gaidhane A.M., Gaidhane S., Gallus S., Ghamari F., Ghashghaee A., Ghozali G., Gilani S.A., Glavan I.-R., Golechha M., Goulart B.N.G., Gupta V.B., Gupta V.K., Hamidi S., Hammond B.R., Hay S.I., Hayat K., Heidari G., Hoffman H.J., Hopf K.P., Hosseinzadeh M., Househ M., Hussain R., Hwang B.-F., Iavicoli I., Ibitoye S.E., Ilesanmi O.S., Irvani S.S.N., Islam S.M.S., Iwagami M., Jacob L., Jayapal S.K., Jha R.P., Jonas J.B., Kalhor R., Al-Salihi N.K., Kandel H., Kasa A.S., Kayode G.A., Khalilov R., Khan E.A., Khatib M.N., Kosen S., Koyanagi A., Kumar G.A., Landires I., Lasrado S., Lim S.S., Liu X., Lobo S.W., Lugo A., Makki A., Mendoza W., Mersha A.G., Mihretie K.M., Miller T.R., Misra S., Mohamed T.A., Mohammadi M., Mohammadian-Hafshejani A., Mohammed A., Mokdad A.H., Moni M.A., Kandel S.N., Nguyen H.L.T., Nixon M.R., Noubiap J.J., Nunez-Samudio V., Oancea B., Oguoma V.M., Olagunju A.T., Olusanya B.O., Olusanya J.O., Orru H., Owolabi M.O., Padubidri J.R., Pakshir K., Pardhan S., Kan F.P., Pasovic M., Pawar S., Pham H.Q., Pinheiro M., Pourshams A., Rabiee N., Rabiee M., Radfar A., Rahim F., Rahimi-Movaghar V., Ur Rahman M.H., Rahman M., Rahmani A.M., Rana J., Rao C.R., Rao S.J., Rashedi V., Rawaf D.L., Rawaf S., Renzaho A.M.N., Rezapour A., Ripon R.K., Rodrigues V., Rustagi N., Saeed U., Sahebkar A., Samy A.M., Santric-Milicevic M.M., Sathian B., Satpathy M., Sawhney M., Schlee W., Schmidt M.I., Seylani A., Shaikh M.A., Shannawaz M., Shiferaw W.S., Siabani S., Singal A., Singh J.A., Singh J.K., Singhal D., Skryabin V.Y., Skryabina A.A., Sotoudeh H., Spurlock E.E., Taddele B.W., Tamiru A.T., Tareque M.I., Thapar R., Tovani-Palone M.R., Tran B.X., Ullah S., Tahbaz S.V., Violante F.S., Vlassov V., Vo B., Vongpradith A., Vu G.T., Wei J., Yadollahpour A., Jabbari S.H.Y., Yeshaw Y., Yigit V., Yirdaw B.W., Yonemoto N., Yu C., Yunusa I., Zamani M., Zastrozhin M.S., Zastrozhina A., Zhang Z.-J., Zhao J.T., Murray C.J.L., Davis A.C., Vos T., Chadha S., Haile, Lydia M, Kamenov, Kaloyan, Briant, Paul Svitil, Orji, Aislyn U, Steinmetz, Jaimie D, Abdoli, Amir, Abdollahi, Mohammad, Abu-Gharbieh, Eman, Afshin, Ashkan, Ahmed, Haroon, Ahmed Rashid, Tarik, Akalu, Yona, Alahdab, Fare, Alanezi, Fahad Mashhour, Alanzi, Turki M, Al Hamad, Hanadi, Ali, Liaqat, Alipour, Vahid, Al-Raddadi, Rajaa M, Amu, Hubert, Arabloo, Jalal, Arab-Zozani, Morteza, Arulappan, Judie, Ashbaugh, Charlie, Atnafu, Desta Debalkie, Babar, Zaheer-Ud-Din, Baig, Atif Amin, Banik, Palash Chandra, Bärnighausen, Till Winfried, Barrow, Amadou, Bender, Rose G, Bhagavathula, Akshaya Srikanth, Bhardwaj, Nikha, Bhardwaj, Pankaj, Bibi, Sadia, Bijani, Ali, Burkart, Katrin, Cederroth, Christopher R, Charan, Jaykaran, Choudhari, Sonali Gajanan, Chu, Dinh-Toi, Couto, Rosa A S, Dagnew, Amare Belachew, Dagnew, Baye, Dahlawi, Saad M A, Dai, Xiaochen, Dandona, Lalit, Dandona, Rakhi, Desalew, Assefa, Dhamnetiya, Deepak, Dhimal, Mandira Lamichhane, Dhimal, Meghnath, Doyle, Kerrie E, Duncan, Bruce B, Ekholuenetale, Michael, Filip, Irina, Fischer, Florian, Franklin, Richard Charle, Gaidhane, Abhay Motiramji, Gaidhane, Shilpa, Gallus, Silvano, Ghamari, Farhad, Ghashghaee, Ahmad, Ghozali, Ghozali, Gilani, Syed Amir, Glavan, Ionela-Roxana, Golechha, Mahaveer, Goulart, Bárbara Niegia Garcia, Gupta, Veer Bala, Gupta, Vivek Kumar, Hamidi, Samer, Hammond, Billy Randall, Hay, Simon I, Hayat, Khezar, Heidari, Golnaz, Hoffman, Howard J, Hopf, Kathleen Pillsbury, Hosseinzadeh, Mehdi, Househ, Mowafa, Hussain, Rabia, Hwang, Bing-Fang, Iavicoli, Ivo, Ibitoye, Segun Emmanuel, Ilesanmi, Olayinka Stephen, Irvani, Seyed Sina Naghibi, Islam, Sheikh Mohammed Shariful, Iwagami, Masao, Jacob, Loui, Jayapal, Sathish Kumar, Jha, Ravi Prakash, Jonas, Jost B, Kalhor, Rohollah, Kameran Al-Salihi, Nawzad, Kandel, Himal, Kasa, Ayele Semachew, Kayode, Gbenga A, Khalilov, Rovshan, Khan, Ejaz Ahmad, Khatib, Mahalaqua Nazli, Kosen, Soewarta, Koyanagi, Ai, Kumar, G Anil, Landires, Iván, Lasrado, Savita, Lim, Stephen S, Liu, Xuefeng, Lobo, Stany W, Lugo, Alessandra, Makki, Alaa, Mendoza, Walter, Mersha, Amanual Getnet, Mihretie, Kebadnew Mulatu, Miller, Ted R, Misra, Sanjeev, Mohamed, Teroj Abdulrahman, Mohammadi, Mokhtar, Mohammadian-Hafshejani, Abdollah, Mohammed, Arif, Mokdad, Ali H, Moni, Mohammad Ali, Neupane Kandel, Sandhya, Nguyen, Huong Lan Thi, Nixon, Molly R, Noubiap, Jean Jacque, Nuñez-Samudio, Virginia, Oancea, Bogdan, Oguoma, Victor Maduabuchi, Olagunju, Andrew T, Olusanya, Bolajoko Olubukunola, Olusanya, Jacob Olusegun, Orru, Han, Owolabi, Mayowa O, Padubidri, Jagadish Rao, Pakshir, Keyvan, Pardhan, Shahina, Pashazadeh Kan, Fatemeh, Pasovic, Maja, Pawar, Shrikant, Pham, Hai Quang, Pinheiro, Marina, Pourshams, Akram, Rabiee, Navid, Rabiee, Mohammad, Radfar, Amir, Rahim, Fakher, Rahimi-Movaghar, Vafa, Rahman, Mohammad Hifz Ur, Rahman, Mosiur, Rahmani, Amir Masoud, Rana, Juwel, Rao, Chythra R, Rao, Sowmya J, Rashedi, Vahid, Rawaf, David Laith, Rawaf, Salman, Renzaho, Andre M N, Rezapour, Aziz, Ripon, Rezaul Karim, Rodrigues, Voilet, Rustagi, Neeti, Saeed, Umar, Sahebkar, Amirhossein, Samy, Abdallah M, Santric-Milicevic, Milena M, Sathian, Brijesh, Satpathy, Maheswar, Sawhney, Monika, Schlee, Winfried, Schmidt, Maria Inê, Seylani, Allen, Shaikh, Masood Ali, Shannawaz, Mohammed, Shiferaw, Wondimeneh Shibabaw, Siabani, Soraya, Singal, Anjali, Singh, Jasvinder A, Singh, Jitendra Kumar, Singhal, Deepika, Skryabin, Valentin Yurievich, Skryabina, Anna Aleksandrovna, Sotoudeh, Houman, Spurlock, Emma Elizabeth, Taddele, Biruk Wogayehu, Tamiru, Animut Tagele, Tareque, Md Ismail, Thapar, Rekha, Tovani-Palone, Marcos Roberto, Tran, Bach Xuan, Ullah, Saif, Valadan Tahbaz, Sahel, Violante, Francesco S, Vlassov, Vasily, Vo, Bay, Vongpradith, Avina, Vu, Giang Thu, Wei, Jingkai, Yadollahpour, Ali, Yahyazadeh Jabbari, Seyed Hossein, Yeshaw, Yigizie, Yigit, Vahit, Yirdaw, Birhanu Wubale, Yonemoto, Naohiro, Yu, Chuanhua, Yunusa, Ismaeel, Zamani, Mohammad, Zastrozhin, Mikhail Sergeevich, Zastrozhina, Anasthasia, Zhang, Zhi-Jiang, Zhao, Jeff T, Murray, Christopher J L, Davis, Adrian C, Vos, Theo, and Chadha, Shelly

Subjects
Hearing aid, Male, Hearing loss, medicine.medical_treatment, Psychological intervention, 030204 cardiovascular system & hematology, Affect (psychology), Health Services Accessibility, Global Burden of Disease, 03 medical and health sciences, Tinnitus, Medicine, General & Internal, 0302 clinical medicine, Neonatal Screening, Hearing Aids, Acquired immunodeficiency syndrome (AIDS), Hearing, General & Internal Medicine, Health care, otorhinolaryngologic diseases, Prevalence, Medicine, Humans, Age Factor, Disabled Persons, 030212 general & internal medicine, Hearing Loss, Hearing Lo, 11 Medical and Health Sciences, Science & Technology, business.industry, Infant, Newborn, Age Factors, Infant, GBD 2019 Hearing Loss Collaborators, General Medicine, Articles, medicine.disease, Otitis, Hearing Aid, Cytomegalovirus Infections, Disabled Person, Female, medicine.symptom, business, Life Sciences & Biomedicine, Human, Demography
Abstract

© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Hearing loss affects access to spoken language, which can affect cognition and development, and can negatively affect social wellbeing. We present updated estimates from the Global Burden of Disease (GBD) study on the prevalence of hearing loss in 2019, as well as the condition's associated disability. Methods: We did systematic reviews of population-representative surveys on hearing loss prevalence from 1990 to 2019. We fitted nested meta-regression models for severity-specific prevalence, accounting for hearing aid coverage, cause, and the presence of tinnitus. We also forecasted the prevalence of hearing loss until 2050. Findings: An estimated 1·57 billion (95% uncertainty interval 1·51–1·64) people globally had hearing loss in 2019, accounting for one in five people (20·3% [19·5–21·1]). Of these, 403·3 million (357·3–449·5) people had hearing loss that was moderate or higher in severity after adjusting for hearing aid use, and 430·4 million (381·7–479·6) without adjustment. The largest number of people with moderate-to-complete hearing loss resided in the Western Pacific region (127·1 million people [112·3–142·6]). Of all people with a hearing impairment, 62·1% (60·2–63·9) were older than 50 years. The Healthcare Access and Quality (HAQ) Index explained 65·8% of the variation in national age-standardised rates of years lived with disability, because countries with a low HAQ Index had higher rates of years lived with disability. By 2050, a projected 2·45 billion (2·35–2·56) people will have hearing loss, a 56·1% (47·3–65·2) increase from 2019, despite stable age-standardised prevalence. Interpretation: As populations age, the number of people with hearing loss will increase. Interventions such as childhood screening, hearing aids, effective management of otitis media and meningitis, and cochlear implants have the potential to ameliorate this burden. Because the burden of moderate-to-complete hearing loss is concentrated in countries with low health-care quality and access, stronger health-care provision mechanisms are needed to reduce the burden of unaddressed hearing loss in these settings. Funding: Bill & Melinda Gates Foundation and WHO.

Published
2020

35. Husband's Knowledge and Involvement in the Reproductive Rights of Women in Harar, Eastern Ethiopia

Author

Alekaw Sema, Yalelet Belay, Adera Debella, Assefa Desalew, Aminu Mohammed, Tadesse Alemayehu, and Yadeta Dessie

Subjects
Political science, Reproductive rights, Socioeconomics
Abstract

Objective: Reproductive rights violations are a serious public health concern worldwide, particularly in Sub-Saharan Africa including Ethiopia, where more than 38.83% of victims are living. Understanding the status of husbands’ knowledge and involvement helps to set important programs and interventions. However, there is a paucity of data related to husbands' roles in women's reproductive rights in the study setting. Therefore, this study aimed to assess husbands’ knowledge and involvement in women's reproductive rights and associated factors in Harar, eastern Ethiopia. Methods: A community-based cross-sectional study was conducted on 611 husbands in March 2020. A multi-stage sampling and a systematic random sampling technique were used to select districts and study participants. Data were collected using an interviewer-administered questionnaire. Data were entered using EpiData 3.1 and analyzed with SPSS Version 22. Multivariable logistic regression was used to examine associated factors. An adjusted odds ratio (AOR) with a 95% confidence interval (CI) was used, and a p-value Results: The magnitude of husbands' knowledge and involvement were 48.3% and 40.1% respectively. Social media utilization (AOR=4.97; 95% CI: 2.79-8.85), Spousal discussion (AOR=2.33; 95% CI: 1.60-3.39), nearby facility types: hospital (AOR=3.21; 95% CI: 1.23-8.36) and health post (AOR=2.86; 95% CI: 1.20-6.94) were associated factors with knowledge of husbands. Likewise, experience of using reproductive health services (AOR=2.15; 95% CI: 1.52-3.03), spousal discussion (AOR=1.95; 95% CI: 1.35-2.82), social media use (AOR=1.74; 95% CI: 1.05-2.89) and age 40 to 49 years (AOR=1.99, 95%CI: 1.19-3.32) were associated with husbands involvement.Conclusions: Less than half of the husbands were knowledgeable and involved in the protection of partners’ reproductive rights. Promoting and creating effective media utilization is very important to create awareness of reproductive rights. Moreover, using reproductive health services and empowering women to have an open discussion is crucial to increase the knowledge and involvement of husbands.

Published
2020
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36. Neural Tube Defects and Associated Factors among Neonates Admitted to the Neonatal Intensive Care Units in Hiwot Fana Specialized University Hospital, Harar, Ethiopia

Author

Assefa Desalew, Hanan Abdurahman, Yunus Edris, and Fitsum Weldegebreal

Subjects
NICU, medicine.medical_specialty, business.industry, Public health, Neural tube, lcsh:RJ1-570, lcsh:Pediatrics, University hospital, Pediatrics, 03 medical and health sciences, 0302 clinical medicine, medicine.anatomical_structure, neural tube defects, newborn, Intensive care, Pediatrics, Perinatology and Child Health, Emergency medicine, medicine, Original Article, 030212 general & internal medicine, Ethiopia, business, 030217 neurology & neurosurgery
Abstract

Background: Neural tube defects are a major public health problem and substantially contribute to morbidity and mortality, particularly in low-income countries, including Ethiopia. There are a paucity of data on the magnitude and associated factors of neural tube defects in Ethiopia, particularly in the study setting. Objective: This study aimed to assess the magnitude of neural tube defects and associated factors among neonates admitted to the neonatal intensive care unit in Hiwot Fana Specialized University Hospital, Harar, Ethiopia. Methods: A hospital-based cross-sectional study was employed from October 2019 to January 2020. A total of 420 newborn-mother pairs were included consecutively. Data were collected using a face-to-face interviewer-administered questionnaire and clinical examination. Data were entered into Epi Data version 3.1 and analyzed using the statistical package for Social Sciences version 20.0 software. An adjusted odds ratio (AOR) with 95% confidence interval (CI) was used to identify the associated factors. A p-value Results: The magnitude of neural tube defects was 5.71% (95% CI: 3.5-7.9). Approximately 83.5% of infants had spinal bifida and 16.5% anencephaly. In multivariable logistic regression analyses, preterm birth (32-34 weeks) (AOR= 3.84; 95% CI: 2.1,10.7), low birth weight (1000-1500 g) (AOR = 4.74; 95% CI: 1.8, 9.1), 1500-2500 g (AOR = 3.01; 95% CI: 2. 1, 13.2), maternal coffee consumption (AOR = 11.2; 95% CI: 3.1, 23.7), a history of abortion or stillbirth (AOR = 9.6; 95% CI:7.6,19.4), radiation exposure (AOR = 5.0; 95% CI:1.6,14.3), and intake of anticonvulsant drugs during pregnancy (AOR = 4.75; 95% CI: 1.5,16.2) were factors associated with neural tube defects. Conclusion: In this study, the burden of neural tube defects was 5.71% among neonates admitted to the neonatal intensive care unit, which was a public health concern. Increased attention to the monitoring of neural tube defects in eastern Ethiopia is crucial to improve birth outcomes in the study setting.

Published
2020

37. Cause and Predictors of Neonatal Mortality among Neonates admitted to Neonatal Intensive Care Units of Public Hospitals in eastern Ethiopia: Facilities based Prospective follow-up study

Author

Assefa Desalew, Yitagesu Sintayehu, Nardos Teferi, Firehiwot Amare, Bifitu Geda, Teshager Worku, Kebebush Abera, and Abiyot Asefaw

Abstract

Background: The first month is the most crucial period for child survival. Neonatal mortality is stagnated in sub-Saharan Africa including Ethiopia. And the trend in reduction is slower than infant and child mortality. The facilities-based cause and predictor of neonatal death in the neonatal intensive care unit were not well documented in this study setting. Hence the aim of this study was to determine the cause and predictors of neonatal mortality among neonates admitted in neonatal intensive care units in eastern Ethiopia. Method: Facilities-based prospective follow-up study was conducted among neonates admitted in neonatal intensive care units of public hospitals in eastern Ethiopia from November to December 2018. Data were collected using pre-tested, structured questionnaire and follow-up checklist. The main outcomes, cause of death was set by senior pediatricians and residents. Epi-Data 3.1 and SPSS 25 version software were used for entry and analysis. Binary logistic regression was used to find out the predictors of facilities-based neonatal mortality.Result: The proportion of facilities-based neonatal mortality was 20%. The top five cause of death was a complication of prematurity 49%, birth asphyxia 37.8%, infection 32.6%, meconium aspiration syndrome 17.3% and congenital malformation 6.1%. Low birth weight, preterm births, length of stay, low 5thminutes Apgar score, hyperthermia and initiation of feeding were predictors of neonatal death among Neonates admitted in neonatal intensive care units in public hospitals, eastern Ethiopia.ConclusionIn summary, the proportion of facilities-based Neonatal death was unacceptably high. The main causes of death were preventable and treatable. Hence, early detection, anticipating high-risk newborns and timely intervention is very essential. Furthermore, early initiation of feeding and a better referral linkage to tertiary facilities could contribute for reduction of neonatal death in this setting.

Published
2020
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38. Cervical Cancer Screening Utilization and Associated Factors Among Women Aged 30 to 49 Years in Dire Dawa, Eastern Ethiopia

Author

Assefa Desalew, Yalelet Belay, Alekaw Sema, Nega Assefa, and Merga Dheresa

Subjects
Adult, medicine.medical_specialty, Health Knowledge, Attitudes, Practice, cervical cancer, Uterine Cervical Neoplasms, Cervical cancer screening, lcsh:RC254-282, 03 medical and health sciences, 0302 clinical medicine, Surveys and Questionnaires, medicine, Humans, 030212 general & internal medicine, Early Detection of Cancer, screening utilization, Cervical cancer, Government, business.industry, Public health, Age Factors, Hematology, General Medicine, Middle Aged, medicine.disease, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, Original Research Paper, Cross-Sectional Studies, Oncology, 030220 oncology & carcinogenesis, Family medicine, Female, Dire Dawa, Ethiopia, Health Facilities, business
Abstract

Background: Cervical cancer is a public health problem and one of the leading causes of death in women worldwide. In Ethiopia, the government expands cervical cancer screening centers and recommends services to age-eligible and high-risk groups of women. However, evidence indicates that the utilization of services among eligible and high-risk women in the country has remained very low, and data are scarce in Dire Dawa. Therefore, this study aimed to assess cervical cancer screening service utilization and associated factors among women aged 30 to 49 years in Dire Dawa, eastern Ethiopia. Methods: A facility-based cross-sectional study was undertaken in Dire Dawa from February 01 to March 01, 2017. Only two facilities provided the screening service in Dire Dawa Administration. Six- hundred and one women aged 30 to 49 years were selected using a systematic sampling method. Data were collected using a pretested face-to-face interview administered questionnaire. Data were entered using EpiData 3.1, and analyzed using the Statistical Package for Social Science Version 21. Multivariable logistic regression was used to examine the factors associated with cervical cancer screening utilization. An adjusted odds ratio (AOR) with a 95% confidence interval (CI) was used, and a p-value Results: In this study, the magnitude of cervical cancer screening service utilization was 4.0% (95% CI: 2.5-5.7). The factors associated with cervical cancer screening service utilization were older age (AOR = 4.2; 95% CI:1.3-13.8), attending private health facilities (AOR = 8.9; 95% CI: 2.8-28.0), being employed (AOR = 3.3; 95% CI: 1.3-8.8), visiting the gynecology departments (AOR = 3.8; 95% CI: 1.5-9.8), being knowledgeable (AOR = 4.8; 95% CI: 1.5-15.5), being counseled by health professionals (AOR = 4.1; 95% CI: 1.5-11.3), and user’s of family planning (AOR = 4.9; 95% CI: 1.2-20.0). Conclusion: The magnitude of cervical cancer screening utilization was very low. Hence, to improve the screening service utilization of cervical cancer, a campaign on community awareness, strengthening service linkage among departments, expansion of the centers for cervical cancer screening, and promotion of family planning method utilization are recommended.

Published
2020

39. The global distribution of lymphatic filariasis, 2000–18:a geospatial analysis

Author

Nataliya Foigt, Dina Nur Anggraini Ningrum, Ayenew Negesse Abejie, Samath Dhamminda Dharmaratne, Paramjit Gill, Marcela Agudelo-Botero, Alyssa N. Sbarra, Mario Poljak, Siavash Rahimi, Olalekan A. Uthman, Animut Alebel, Mohsen Naghavi, Olatunji O. Adetokunboh, Maarten J. Postma, Zemichael Gizaw, Chhabi Lal Ranabhat, Leonardo Roever, Mojtaba Bagherzadeh, Smita Pakhale, Seyyed Meysam Mousavi, Morenike Oluwatoyin Folayan, Robert C. Reiner, Phetole Walter Mahasha, Walter Mendoza, Azeem Majeed, Agus Sudaryanto, Dessalegn Ajema Berbada, Kate E. LeGrand, Takeshi Fukumoto, Mehdi Sayyah, Konrad Pesudovs, Mahesh P A, Nihal Thomas, Man Mohan Mehndiratta, Malede Mequanent Sisay, Azadeh Shafieesabet, Muhammad Usman, Balbir Singh, Ahsan Saleem, Ahmed Abualhasan, Maheswar Satpathy, Vijay Kumar Chattu, Mehdi Fazlzadeh, Ali H. Mokdad, Irfan Ullah, Sahar Saeedi Moghaddam, Luca Ronfani, James Albright, Si Si, Bartosz Miazgowski, Moses K. Muriithi, Catalina Liliana Andrei, Isaac Oluwafemi Dipeolu, Brijesh Sathian, Shishay Wahdey Tekelemedhin, Tufa Kolola, Mona M. Khater, Reta Tsegaye Gayesa, Andrew T Olagunju, Achala Upendra Jayatilleke, David L. Smith, Raaj Kishore Biswas, Rosario Cardenas, Andre M. N. Renzaho, Benjamin K. Mayala, Soraya Siabani, Ebrahim Babaee, Tsegaye Lolaso Lenjebo, Miliva Mozaffor, Bolajoko O. Olusanya, Joseph Frostad, Emma Elizabeth Spurlock, Hesham M. Al-Mekhlafi, Aso Mohammad Darwesh, Quynh Anh P. Nguyen, Kebede Embaye Gezae, Junaid Khan, Dessalegn Haile, Marcel Ausloos, David C. Schwebel, Bruno Piassi Sao Jose, Milena Ilic, Ionut Negoi, Ninuk Hariyani, Jost B. Jonas, Dian Kusuma, Sachin R Atre, Goura Kishor Rath, Muhammad Aziz Rahman, Dereje Bayissa Demissie, Eirini Skiadaresi, Simon I. Hay, Preeti Dhillon, Ejaz Ahmad Khan, Mohammad Hasan Imani-Nasab, Gebrehiwot G. Kassa, Nicole Davis Weaver, Mowafa Househ, Soumyadeep Bhaumik, Bahram Armoon, Martin Amogre Ayanore, Shaimaa I. El-Jaafary, Deborah Carvalho Malta, Rufus Adesoji Adedoyin, Alexandria Brown, Zewdie Aderaw Alemu, Mihiretu Kebede, Charles Shey Wiysonge, Bach Xuan Tran, Lal B. Rawal, Kala M. Mehta, Guoqing Hu, Yousef Khader, Heather J. Zar, Shiwei Liu, Norberto Perico, I A Adedeji, Sergio I. Prada, Shai Linn, Saad M.A. Dahlawi, Brigette F. Blacker, Anusha Ganapati Bhat, Desta Haftu Hayelom, Amit Arora, Mohammad Hossein Khosravi, Sanjay Zodpey, Farshad Farzadfar, Mehran Asadi-Aliabadi, Bárbara Niegia Garcia de Goulart, D. R. Mahadeshwara Prasad, Ajay Patle, Daniel Adane Endalew, Jagdish Khubchandani, Sharareh Eskandarieh, Mohammed Ibrahim Mohialdeen Gubari, Derrick A Bennett, Ziad A. Memish, Eduarda Fernandes, Chandrashekhar T Sreeramareddy, Seyed Mohammad Riahi, Hisham Atan Edinur, Taddese Alemu Zerfu, Robert S. Bernstein, Nader Jahanmehr, Yuming Guo, Tomohide Yamada, Manfred Mario Kokou Accrombessi, Mohamed I Hegazy, Liliana Preotescu, Sanjay Basu, Mohammad Reza Sobhiyeh, Frank B. Osei, Adhena Ayaliew Werkneh, Hamideh Salimzadeh, Ali Bijani, Shanshan Li, Alem Girmay, Sonali Kochhar, Meghnath Dhimal, Yonatal Mesfin Tefera, Saravanan Muthupandian, Francesco Saverio Violante, Monika Sawhney, Shally Awasthi, Samer Hamidi, Davide Guido, Van C. Lansingh, Engida Yisma, Muhammad Redzwan S Rashid Ali, Nima Hafezi-Nejad, Sadaf G. Sepanlou, Ali Kiadaliri, Hamed Zandian, Aparna Lal, Diana Fernanda Bejarano Ramirez, Dhirendra N Sinha, Florian Fischer, Hebat Allah Salah A. Yousof, Khanh Bao Tran, Kimberly B. Johnson, Senthilkumar Balakrishnan, Vo Dinh Bay, Arianna Maever L. Amit, Gbenga A. Kayode, John S. Ji, Akhil Soman ThekkePurakkal, Santi Martini, Behzad Heibati, Kebreab Paulos, Tefera Chane Mekonnen, Hagazi Gebre Meles, Vishnu Renjith, Paulina A. Lindstedt, Dinh Toi Chu, Gregory M. Garcia, Ahamarshan Jayaraman Nagarajan, Krishna K. Aryal, Irina Filip, Michelle L. Bell, Manfred S. Green, Alaa Badawi, Daniel Bekele Ketema, Claudio Alberto Dávila-Cervantes, Mohamad-Hani Temsah, Anton Sokhan, Julio Cesar Campuzano Rincon, Navid Manafi, Siddhesh Zadey, Davide Rasella, Hedayat Abbastabar, Manu Raj Mathur, Till Bärnighausen, Paula Moraga, Joan B. Soriano, Victor Adekanmbi, Seid Tiku Mereta, Mehran Shams-Beyranvand, Osayomwanbo Osarenotor, Mahya Beheshti, Farnam Mohebi, Genet Melak Alamene, Andem Effiong, Thomas R. Hird, Colm McAlinden, In-Hwan Oh, Arash Etemadi, Thirunavukkarasu Sathish, Rajesh Sharma, Puja C Rao, Masoud Foroutan, Sangram Kishor Patel, Sheikh Mohammed Shariful Islam, Aniruddha Deshpande, Paul H. Lee, Tukur Dahiru, Chinwe Juliana Iwu, Alireza Rafiei, Somayeh Bohlouli, Juan Sanabria, Javad Nazari, Siamak Sabour, Izza Shahid, Tuomo J. Meretoja, Ireneous N. Soyiri, André Karch, Mehdi Yaseri, Huong Lan Thi Nguyen, Khaled Khatab, Pushpendra Kumar, Ziyad Al-Aly, Khalid A. Altirkawi, Emerito Jose A. Faraon, Hagos Tasew Atalay, Sojib Bin Zaman, Gillian I. Hollerich, Hajer Elkout, Jonathan F. Mosser, Fakher Rahim, Kavumpurathu Raman Thankappan, Benny Antony, Nelson Alvis-Guzman, Ismael R. Campos-Nonato, Mohammad Moradi-Joo, Bineyam Taye, Ghulam Mustafa, Cheru Tesema Leshargie, Jacek Jerzy Jozwiak, Krittika Bhattacharyya, Tariq Jamal Siddiqi, Rafael Alves Guimarães, Vahid Alipour, Themba G. Ginindza, Wubalem Fekadu, Rafael Tabarés-Seisdedos, Mika Shigematsu, Bryan L. Sykes, Gebrekiros Gebremichael Meles, Delia Hendrie, Santosh Varughese, Manasi Kumar, Govinda Prasad Dhungana, Aziz Sheikh, Oladimeji M. Adebayo, Mohsen Bayati, B. Suresh Kumar Shetty, Kinley Wangdi, Hiroshi Yatsuya, Marzieh Nojomi, Carlo La Vecchia, Nuworza Kugbey, Zubair Kabir, Aslam Pervaiz, Muhammed Magdy Abd El Razek, Farzaneh Ghazi Sherbaf, Narinder Pal Singh, Jan Walter De Neve, Mohammad Khazaei, G. K. Mini, Eun-Kee Park, Haileab Fekadu Wolde, Zemenu Tadesse Tessema, Amir Radfar, Syed Ather Hussain, Gebre Teklemariam Demoz, Nasir Salam, Mohammad Ali Mansournia, Babak Moazen, Adnan Kisa, Milena Santric-Milicevic, Mitchell T. Wallin, Doris D. V. Ortega-Altamirano, Anwar Ahmed, Yousef Mohammad, Tanuj Kanchan, Feleke Gebremeskel W, Rajesh Sagar, Marwa Rashad Salem, Michael R.M. Abrigo, Fatemeh Heydarpour, Ammar Albujeer, Yasir Waheed, Noore Alam, Vera Marisa Costa, Rajat Das Gupta, Ritesh G. Menezes, Molly K. Miller-Petrie, Amira Shaheen, Seyyede Masoume Athari, Marcos Roberto Tovani-Palone, Ken Lee Chin, Ghobad Moradi, Ruth W Kimokoti, Peter Njenga Keiyoro, Kirsten E. Wiens, Nikolay Ivanovich Briko, K M Shivakumar, Ziad El-Khatib, Narayan Bahadur Mahotra, Ronny Westerman, Kamarul Imran Musa, Farshad Pourmalek, Kiomars Sharafi, Yared Asmare Aynalem, Entezar Mehrabi Nasab, Mu'awiyyah Babale Sufiyan, D J Christopher, Valery L. Feigin, Harish Chander Gugnani, Mathew M. Baumann, Platon D. Lopukhov, Tewodros Eshete Wonde, Hai Quang Pham, Luis Alberto Cámera, Meghdad Pirsaheb, Nelson J. Alvis-Zakzuk, Ahmad Daryani, Teferi Mekonnen, Yousef Veisani, Sharath Burugina Nagaraja, Parvaiz A Koul, Daniel Diaz, Ali S. Akanda, Mohammad Hifz Ur Rahman, Getachew Mullu Kassa, Daniel J. Weiss, Nauman Khalid, Hassen Mohammed, Edson Serván-Mori, Foad Abd-Allah, Fisaha Haile Tesfay, Abdullah Al Mamun, Yoshan Moodley, Adrian Pana, Salman Rawaf, Amir Almasi-Hashiani, Abdu A. Adamu, Fatemeh Rajati, German Martinez, Habib Benzian, Georgy Lebedev, Ben Lacey, Amir Hasanzadeh, Amir Khater, Merhawi Gebremedhin Tekle, Juanita A. Haagsma, Segun Emmanuel Ibitoye, Ahmed I. Hasaballah, Telma Zahirian Moghadam, Mehdi Hosseinzadeh, Virendra Singh, Demelash Woldeyohannes Handiso, Gabrielle Britton, Tiffany K. Gill, Sezer Kisa, Zahid A. Butt, Bruno Ramos Nascimento, Ian Pollock, Ted R. Miller, Rebecca Ivers, Savita Lasrado, Rovshan Khalilov, Ai Koyanagi, Benn Sartorius, Maciej Banach, Berhe Etsay Tesfay, Hedley Quintana, Joseph Adel Mattar Banoub, Praveen Hoogar, Ehsan Sadeghi, Kedir Hussein Abegaz, Hasan Yusefzadeh, Bogdan Oancea, Vafa Rahimi-Movaghar, Anbissa Muleta Senbeta, Subramanian Senthilkumaran, Ole Frithjof Norheim, Ester Cerin, Zulfiqar A Bhutta, Jennifer Rickard, M Alijanzadeh, Ali Almasi, Erkin M. Mirrakhimov, Seyed Hossein Yahyazadeh Jabbari, Sandra B. Munro, Ambrish Singh, Naohiro Yonemoto, Rahman Shiri, Girmay Teklay Weldesamuel, Jacqueline Elizabeth Alcalde-Rabanal, Daniel Asmelash, Mekdes Tigistu Yilma, Ahmad Ghashghaee, Natalie Maria Cormier, Samiah Alam, Yahya Salimi, Henok Biresaw Netsere, Anh Kim Dang, Jae Il Shin, S. Mohammad Sajadi, Francisco Rogerlândio Martins-Melo, Taweewat Wiangkham, Shankar M Bakkannavar, Eleonora Dubljanin, Itamar S. Santos, Temesgen Yihunie Akalu, Amir Kasaeian, Yahya Safari, Abel Fekadu Fekadu Dadi, Mohammad Fareed, Peter Memiah, Ali Kabir, Ensiyeh Jenabi, Ali Yadollahpour, Josephine W. Ngunjiri, Barthelemy Kuate Defo, Carlos A Castañeda-Orjuela, Reza Malekzadeh, Shymaa Enany, Hamidreza Haririan, Ayman Grada, Amador Goodridge, Salvatore Rubino, Jacob Olusegun Olusanya, Jalal Arabloo, Mohammad Reza Salahshoor, Masoud Behzadifar, Fernando de la Hoz, Mohammed Shannawaz, Hosni Salem, Syed Mohamed Aljunid, G Anil Kumar, Veincent Christian Filipino Pepito, Andre Rodrigues Duraes, Duduzile Ndwandwe, Jasvinder A. Singh, Yuan-Pang Wang, Tissa Wijeratne, Ingan Ukur Tarigan, Giuseppe Remuzzi, Sebastian Vollmer, Rakhi Dandona, Ahmed Abdelalim, Akram Pourshams, Felix Akpojene Ogbo, Alan J Thomson, Yves Miel H Zuniga, Alex Yeshaneh, Birhanu Geta Meharie, Mihajlo Jakovljevic, Obinna Onwujekwe, Ali S. Shalash, Bahram Mohajer, Nefsu Awoke, Hoa Thi Do, Jaifred Christian F. Lopez, Ernoiz Antriyandarti, Yilma Chisha Dea Geramo, Lucas Guimarães Abreu, Mohammad Ali Sahraian, Giang Hai Ha, Nizal Sarrafzadegan, Vinay Nangia, David M. Pigott, Arash Ziapour, Seyed Sina Naghibi Irvani, Andrew S. Azman, Amira Hamed Darwish, MohammadBagher Shamsi, Soewarta Kosen, Degena Bahrey Tadesse, Soufiane Boufous, Mehedi Hasan, Franz Castro, Adauto Martins Soares Filho, Oliver J. Brady, Elizabeth A. Cromwell, Olatunde Aremu, Samad Azari, Hala Rashad Elhabashy, Hamid Yimam Hassen, Julia Moreira Pescarini, Saeed Amini, Mehdi Ahmadi, Andualem Henok, Yafeng Wang, Nevine El Nahas, Paul S. F. Yip, Miguel A Barboza, Ibrahim Abdollahpour, Augustine Mwangi Gatotoh, Gurudatta Naik, Carl Abelardo T. Antonio, Morteza Abdullatif Khafaie, Meysam Behzadifar, hawariat, Enrico Rubagotti, Andre Faro, Kebede Deribe, Bhaskaran Unnikrishnan, Robert L. Thompson, Muhammad Shahdaat Bin Sayeed, Lalit Dandona, Seyyed Shamsadin Athari, Ashish Pathak, Masoud Moradi, Muluken Bekele Sorrie, Vivekanand Jha, Cuong Tat Nguyen, Naser Mohammad Gholi Mezerji, Chabila C Mapoma, Aubrey J. Levine, Solomon Gedlu Nigatu, Keivan Ahmadi, Hailay Abrha Gesesew, Getasew Taddesse Worku, Kewal Krishan, Hany Aref, Alebachew Fasil Fasil, Aziz Eftekhari, Claudiu Herteliu, Wasiq Faraz Rawasia, Zoubida Zaidi, Simin Mouodi, Dawit Zewdu Wondafrash, Hafiz Ansar Rasul Suleria, Oluchi Ezekannagha, Getinet Ayano, Gebremicheal Gebreslassie Kasahun, Usman Iqbal, Andrey Nikolaevich Briko, Workua Mekonnen Metekiya, Chuanhua Yu, Pascual R. Valdez, Mohsen Mazidi, Hamidreza Komaki, Turki Alanzi, Amir Jalali, Mina Anjomshoa, Chukwudi A Nnaji, Mostafa Leili, Hagos Degefa Hidru, Morteza Shamsizadeh, Tomislav Mestrovic, Beatriz Paulina Ayala Quintanilla, Chi Linh Hoang, Jemal Abdu Mohammed, Christopher J L Murray, Reza Shirkoohi, Aditya Prasad Dash, Thomas Pilgrim, Alessandra C. Goulart, Rajeev Gupta, Mustafa Z. Younis, Maha El Tantawi, Maysaa El Sayed Zaki, Aleksandra Barac, Christiane Dolecek, Mohammad Mahdi Zamani, Jean Jacques Noubiap, Faris Lami, Mehdi Naderi, Yunquan Zhang, Babak Eshrati, Jagadish Rao Padubidri, Navid Rabiee, Mayowa O. Owolabi, Netsanet Fentahun, Nuruzzaman Khan, Roghayeh Mohammadibakhsh, Seyed-Mohammad Fereshtehnejad, Serge Resnikoff, Dharmesh Kumar Lal, Habtamu Kebebe Kasaye, Ketema Bizuwork Gebremedhin, Surendra Karki, Edgar Denova-Gutiérrez, Félix Carvalho, Yun Jin Kim, Sonia Lewycka, Rashmi Gupta, Olayinka Stephen Ilesanmi, Neeraj Bedi, Binaya Chalise, Masood Ali Shaikh, Lauren E. Schaeffer, Kerrie E. Doyle, Gianna Gayle Herrera Amul, Richard C. Franklin, Dara K. Mohammad, Naznin Hossain, Jorge Cano, Jai K Das, Ana Isabel Ribeiro, Boris Bikbov, Sameer Vali Gopalani, Mohsen Afarideh, Behnam Heidari, Fares Alahdab, Takahiro Tabuchi, J. Car, Hilton Y. Lam, Diego Augusto Santos Silva, Linda Morales, Brian J. Hall, Mamusha Aman Hussen, Carsten Flohr, Ravi Prakash Jha, Shafiu Mohammed, Tara Ballav Adhikari, Abbas Mosapour, Muktar Beshir Ahmed, Wondimeneh Shibabaw Shiferaw, Mohamed M. Gad, Assefa Desalew, Eugenio Traini, Aisha Elsharkawy, Benjamin Uzochukwu, Anas M. Saad, Mohammad Rabiee, Sivan Yegnanarayana Iyer Saraswathy, Ansariadi Ansariadi, Abdallah M. Samy, Roman Topor-Madry, Afsaneh Arzani, Ayesha Humayun, Michael Tamene Haile, Maryam Khayamzadeh, Farah Daoud, Arash Tehrani-Banihashemi, Public Health, Johnson, KB, Local Burden of Disease 2019 Neglected Tropical Diseases Collaborator, Violante FS, Department of Earth Observation Science, UT-I-ITC-ACQUAL, Faculty of Geo-Information Science and Earth Observation, GeoHealth, and Instituto de Saúde Pública da Universidade do Porto

Subjects
medicine.medical_specialty, Geospatial analysis, 030231 tropical medicine, Elephantiasis, ELIMINATION, computer.software_genre, Article, Local Burden of Disease 2019 Neglected Tropical Diseases Collaborators, 1117 Public Health and Health Services, 03 medical and health sciences, 0302 clinical medicine, RA0421, Environmental health, Global health, medicine, 030212 general & internal medicine, Mass drug administration, Lymphatic filariasis, Public health, lcsh:Public aspects of medicine, Tropical disease, lcsh:RA1-1270, General Medicine, medicine.disease, 3. Good health, QR, Geography, Lymphatic system, ITC-ISI-JOURNAL-ARTICLE, A990 Medicine and Dentistry not elsewhere classified, ITC-GOLD, computer, 0605 Microbiology
Abstract

Background Lymphatic filariasis is a neglected tropical disease that can cause permanent disability through disruption of the lymphatic system. This disease is caused by parasitic filarial worms that are transmitted by mosquitos. Mass drug administration (MDA) of antihelmintics is recommended by WHO to eliminate lymphatic filariasis as a public health problem. This study aims to produce the first geospatial estimates of the global prevalence of lymphatic filariasis infection over time, to quantify progress towards elimination, and to identify geographical variation in distribution of infection. Methods A global dataset of georeferenced surveyed locations was used to model annual 2000–18 lymphatic filariasis prevalence for 73 current or previously endemic countries. We applied Bayesian model-based geostatistics and time series methods to generate spatially continuous estimates of global all-age 2000–18 prevalence of lymphatic filariasis infection mapped at a resolution of 5 km2 and aggregated to estimate total number of individuals infected. Findings We used 14 927 datapoints to fit the geospatial models. An estimated 199 million total individuals (95% uncertainty interval 174–234 million) worldwide were infected with lymphatic filariasis in 2000, with totals for WHO regions ranging from 3·1 million (1·6–5·7 million) in the region of the Americas to 107 million (91–134 million) in the South-East Asia region. By 2018, an estimated 51 million individuals (43–63 million) were infected. Broad declines in prevalence are observed globally, but focal areas in Africa and southeast Asia remain less likely to have attained infection prevalence thresholds proposed to achieve local elimination. Interpretation Although the prevalence of lymphatic filariasis infection has declined since 2000, MDA is still necessary across large populations in Africa and Asia. Our mapped estimates can be used to identify areas where the probability of meeting infection thresholds is low, and when coupled with large uncertainty in the predictions, indicate additional data collection or intervention might be warranted before MDA programmes cease. Funding Bill & Melinda Gates Foundation.

Published
2020
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40. Mapping geographical inequalities in access to drinking water and sanitation facilities in low-income and middle-income countries, 2000-17

Author

Joseph Frostad, Eirini Skiadaresi, Mehran Asadi-Aliabadi, Aleksandra Barac, Simon I. Hay, Deborah Carvalho Malta, Achala Upendra Jayatilleke, David L. Smith, Mohamad-Hani Temsah, Brigette F. Blacker, Nuworza Kugbey, Bineyam Taye, Carlo La Vecchia, Kavumpurathu Raman Thankappan, Benny Antony, Cheru Tesema Leshargie, Eduarda Fernandes, Chandrashekhar T Sreeramareddy, Turki Alanzi, Amir Jalali, Chukwudi A Nnaji, Daniel Asmelash, Manu Raj Mathur, Jai K Das, Ana Isabel Ribeiro, Sachin R Atre, Tomislav Mestrovic, Rajeev Gupta, Smita Pakhale, Félix Carvalho, Yun Jin Kim, Quynh Anh P. Nguyen, Sameer Vali Gopalani, Chi Linh Hoang, Jean Jacques Noubiap, Manfred Accrombessi, Christopher J L Murray, Ninuk Hariyani, Ken Lee Chin, Jagadish Rao Padubidri, Mehdi Fazlzadeh, Mohammad Fareed, Mustafa Z. Younis, Navid Rabiee, Osayomwanbo Osarenotor, Brian J. Hall, Ejaz Ahmad Khan, Daniel Diaz, Salman Rawaf, Tara Ballav Adhikari, Mayowa O. Owolabi, Sonia Lewycka, Catalina Liliana Andrei, Henok Biresaw Netsere, Hagos Degefa Hidru, Morteza Shamsizadeh, Shai Linn, Saad M.A. Dahlawi, Demelash Woldeyohannes Handiso, Jemal Abdu Mohammed, Thomas Pilgrim, Alessandra C. Goulart, Ravi Prakash Jha, Norberto Perico, Sergio I. Prada, Ted R. Miller, Rebecca Ivers, Habib Benzian, David C. Schwebel, Milena Ilic, Siddhesh Zadey, Davide Rasella, Hedayat Abbastabar, Aso Mohammad Darwesh, Kinley Wangdi, Ritesh G. Menezes, Jost B. Jonas, Dian Kusuma, Molly K. Miller-Petrie, Savita Lasrado, Goura Kishor Rath, Lalit Dandona, Farshad Farzadfar, Georgy Lebedev, Ahmed I. Hasaballah, Shaimaa I. El-Jaafary, Aniruddha Deshpande, Jacek Jerzy Jozwiak, Joseph Adel Mattar Banoub, Amir Almasi-Hashiani, Praveen Hoogar, Fares Alahdab, Vafa Rahimi-Movaghar, Anbissa Muleta Senbeta, Subramanian Senthilkumaran, Ambrish Singh, Fatemeh Rajati, Sonali Kochhar, Amir Khater, Ali Almasi, Juanita A. Haagsma, Segun Emmanuel Ibitoye, Telma Zahirian Moghadam, Rajesh Sharma, Abel Fekadu Dadi, Sezer Kisa, Arash Etemadi, Zubair Kabir, Aslam Pervaiz, Muhammed Magdy Abd El Razek, Syed Ather Hussain, Mohsen Mazidi, Hamidreza Komaki, Reza Shirkoohi, Alex Yeshaneh, Faris Lami, Maha El Tantawi, Yunquan Zhang, Hamidreza Haririan, Lucas Guimarães Abreu, Tissa Wijeratne, Giuseppe Remuzzi, Bahram Mohajer, Christiane Dolecek, Vinay Nangia, Gebremicheal Gebreslassie Kasahun, Usman Iqbal, Nataliya A. Foigt, Andrey Nikolaevich Briko, Workua Mekonnen Metekiya, Chuanhua Yu, Elizabeth A. Cromwell, Pascual R. Valdez, Jennifer Rickard, Masoud Moradi, Hailay Abrha Gesesew, Naser Mohammad Gholi Mezerji, Getasew Taddesse Worku, Dinh-Toi Chu, Claudiu Herteliu, Dawit Zewdu Wondafrash, Gianna Gayle Herrera Amul, Mostafa Leili, Gebrehiwot G. Kassa, Soumyadeep Bhaumik, Ester Cerin, Bahram Armoon, Martin Amogre Ayanore, Shafiu Mohammed, Alexandria Brown, Charles Shey Wiysonge, Abbas Mosapour, Bach Xuan Tran, Lal B. Rawal, Muktar Beshir Ahmed, Wondimeneh Shibabaw Shiferaw, Mohamed M. Gad, Eugenio Traini, Aisha Elsharkawy, David M. Pigott, Temesgen Yihunie Akalu, Syed Mohamed Aljunid, Reza Malekzadeh, Ahmad Daryani, Olatunde Aremu, Mohammad Reza Salahshoor, Merhawi Gebremedhin Tekle, Derrick A Bennett, Oladimeji M. Adebayo, Bogdan Oancea, Jagdish Khubchandani, Sandra B. Munro, Naohiro Yonemoto, Ahmad Ghashghaee, Mohammed Ibrahim Mohialdeen Gubari, Marcela Agudelo-Botero, Bárbara Niegia Garcia de Goulart, Daniel Adane Endalew, Davide Guido, Alyssa N. Sbarra, Kerrie E. Doyle, Olalekan A. Uthman, Olatunji O. Adetokunboh, Zemichael Gizaw, Muhammad Usman, Farzaneh Ghazi Sherbaf, MohammadBagher Shamsi, Degena Bahrey Tadesse, Aziz Eftekhari, André Karch, Narinder Pal Singh, Carl Abelardo T. Antonio, Morteza Abdullatif Khafaie, Meysam Behzadifar, Amira Hamed Darwish, Soufiane Boufous, Mohammad Reza Sobhiyeh, Frank B. Osei, Adhena Ayaliew Werkneh, Zahid A Butt, Paulina A. Lindstedt, Gregory M. Garcia, Balbir Bagicha Singh, Daniel Bekele Ketema, Genet Melak Alamene, Andem Effiong, André Faro, Amit Arora, Mohammad Hossein Khosravi, Dhirendra N Sinha, Amir Kasaeian, Ali Kabir, Josephine W. Ngunjiri, Hosni Salem, Sharareh Eskandarieh, Akhil Soman ThekkePurakkal, Anwar Ahmed, Tanuj Kanchan, Mu'awiyyah Babale Sufiyan, Bhaskaran Unnikrishnan, Daniel J. Weiss, Ziad El-Khatib, Jorge Cano, Javad Nazari, Ashish Pathak, Krishna Kumar Aryal, Nuruzzaman Khan, Roghayeh Mohammadibakhsh, Seyed-Mohammad Fereshtehnejad, Serge Resnikoff, Dharmesh Kumar Lal, Habtamu Kebebe Kasaye, Harish Chander Gugnani, Ali S. Akanda, Mohammad Hifz Ur Rahman, Muluken Bekele Sorrie, Vivekanand Jha, Abdu A. Adamu, Zulfiqar A. Bhutta, Mohsen Afarideh, Tiffany K. Gill, Nelson Alvis-Guzman, Oliver J. Brady, Ebrahim Babaee, Takahiro Tabuchi, Alebachew Fasil, Anusha Ganapati Bhat, Marwa Rashad Salem, Till Winfried Bärnighausen, Sadaf G. Sepanlou, Paula Moraga, J. Car, Hoa Thi Do, Samad Azari, hawariat, Cuong Tat Nguyen, Michelle L. Bell, Mohamed I Hegazy, Mehedi Hasan, Mamusha Aman Hussen, Erkin M. Mirrakhimov, Seyed Hossein Yahyazadeh Jabbari, Santi Martini, Vishnu Renjith, Haileab Fekadu Wolde, Chabila C Mapoma, Aubrey J. Levine, Solomon Gedlu Nigatu, Hamid Yimam Hassen, Anh Kim Dang, S. Mohammad Sajadi, Francisco Rogerlândio Martins-Melo, Shankar M Bakkannavar, Doris D. V. Ortega-Altamirano, Kala M. Mehta, Boris Bikbov, Assefa Desalew, Carsten Flohr, Yahya Safari, Michael R.M. Abrigo, Mohammad Moradi-Joo, Jan-Walter De Neve, Carlos A Castañeda-Orjuela, Julia Moreira Pescarini, Saeed Amini, Mehdi Ahmadi, Benjamin Uzochukwu, Anas M. Saad, Robert C. Reiner, Ammar Albujeer, Narayan Bahadur Mahotra, Nelson J. Alvis-Zakzuk, Teferi Mekonnen, Lauren E. Schaeffer, Irina Filip, Ali Yadollahpour, Ali Kiadaliri, Hamed Zandian, Fisaha Haile Tesfay, Seyed Mohammad Riahi, Nader Jahanmehr, Yuming Guo, Rafael Tabarés-Seisdedos, Paramjit Gill, Ketema Bizuwork Gebremedhin, Nicole Davis Weaver, Surendra Karki, Masoud Behzadifar, Vo Dinh Bay, Giang Hai Ha, Nizal Sarrafzadegan, In-Hwan Oh, Puja C Rao, Van Charles Lansingh, Kewal Krishan, Hany Aref, Man Mohan Mehndiratta, Shymaa Enany, Ayman Grada, Amador Goodridge, Salvatore Rubino, Zemenu Tadesse Tessema, Maheswar Satpathy, Amir Radfar, Aparna Lal, Isaac Akinkunmi Adedeji, Mehdi Naderi, Siavash Rahimi, Animut Alebel, Mohammad Rabiee, Diana Fernanda Bejarano Ramirez, Sivan Yegnanarayana Iyer Saraswathy, Sojib Bin Zaman, Alem Girmay, Ansariadi Ansariadi, Abdallah M. Samy, Mario Poljak, G Anil Kumar, Beatriz Paulina Ayala Quintanilla, Andrew S. Azman, Ronny Westerman, Thomas R. Hird, Themba G. Ginindza, Babak Moazen, Feleke Gebremeskel W, Meghdad Pirsaheb, Shally Awasthi, Morenike Oluwatoyin Folayan, Roman Topor-Madry, Phetole Walter Mahasha, Kamarul Imran Musa, Hebat Allah Salah A. Yousof, Afsaneh Arzani, Yousef Veisani, Farshad Pourmalek, Sharath Burugina Nagaraja, Ayesha Humayun, Michael Tamene Haile, Kiomars Sharafi, Wasiq Faraz Rawasia, Zoubida Zaidi, Getachew Mullu Kassa, Tsegaye Lolaso Lenjebo, Maryam Khayamzadeh, Nima Hafezi-Nejad, Mohammad Zamani, Takeshi Fukumoto, Masoud Foroutan, Noore Alam, Simin Mouodi, Miliva Mozaffor, Khanh Bao Tran, Farnam Mohebi, Sanjay Basu, Robert L. Thompson, Behzad Heibati, Santosh Varughese, Olayinka Stephen Ilesanmi, Neeraj Bedi, Hafiz Ansar Rasul Suleria, Oluchi Ezekannagha, Gabriel Martinez, Getinet Ayano, Farah Daoud, Konrad Pesudovs, Julio Cesar Campuzano Rincon, Tukur Dahiru, Mehdi Hosseinzadeh, Andualem Henok, Mina Anjomshoa, Rovshan Khalilov, Ai Koyanagi, Raaj Kishore Biswas, Navid Manafi, Yousef Mohammad, Keivan Ahmadi, Seyyed Shamsadin Athari, Binaya Chalise, Masood Ali Shaikh, Joan B. Soriano, Victor Adekanmbi, Seid Tiku Mereta, Delia Hendrie, Vijay Kumar Chattu, Gebrekiros Gebremichael Meles, Si Si, Manasi Kumar, Netsanet Fentahun, Amira Shaheen, Seyyede Masoume Athari, Marcos Roberto Tovani-Palone, Ben Lacey, Peter Njenga Keiyoro, Yared Asmare Aynalem, Entezar Mehrabi Nasab, K M Shivakumar, Tewodros Eshete Wonde, Dessalegn Ajema Berbada, Yahya Salimi, Adnan Kisa, Hisham Atan Edinur, Benn Sartorius, Kate E. LeGrand, Azadeh Shafieesabet, Richard C. Franklin, Dara K. Mohammad, Naznin Hossain, Mona M. Khater, Reta Tsegaye Gayesa, Natalie Maria Cormier, Ghulam Mustafa, Ehsan Sadeghi, Nikolay Ivanovich Briko, Robert S. Bernstein, Samiah Alam, Duduzile Ndwandwe, Andrew T Olagunju, Obinna Onwujekwe, B. Suresh Kumar Shetty, Behnam Heidari, Arianna Maever L. Amit, John S. Ji, Pushpendra Kumar, Sangram Kishor Patel, Vera Marisa Costa, Yafeng Wang, Irfan Ullah, Sahar Saeedi Moghaddam, Virendra Singh, Tufa Kolola, Mehdi Yaseri, Abdullah Al Mamun, Hilton Y. Lam, Diego Augusto Santos Silva, Samath D Dharmaratne, Hajer Elkout, Yoshan Moodley, Linda Morales, Adrian Pana, Nauman Khalid, Hassen Mohammed, Fakher Rahim, Emma Elizabeth Spurlock, Mika Shigematsu, Bryan L. Sykes, Isaac Oluwafemi Dipeolu, Platon D. Lopukhov, Marzieh Nojomi, Khalid A Altirkawi, Dessalegn Haile, Mohsen Bayati, Senthilkumar Balakrishnan, Mohammad Ali Sahraian, Yasir Waheed, Ernoiz Antriyandarti, Tomohide Yamada, Alireza Rafiei, Bruno Ramos Nascimento, Ian Pollock, Ahamarshan Jayaraman Nagarajan, Kebede Embaye Gezae, Anton Sokhan, Mehran Shams-Beyranvand, Junaid Khan, Jacqueline Elizabeth Alcalde-Rabanal, Enrico Rubagotti, Mehran Alijanzadeh, Gillian I. Hollerich, Ismael R. Campos-Nonato, Eleonora Dubljanin, Itamar S. Santos, Wubalem Fekadu, Ole Frithjof Norheim, Florian Fischer, Kedir Hussein Abegaz, Nihal Thomas, Alaa Badawi, Amir Hasanzadeh, Nasir Salam, Muhammad Ali, Mohammad Ali Mansournia, Marcel Ausloos, Ensiyeh Jenabi, Bruno Piassi Sao Jose, Edgar Denova-Gutiérrez, Jae Il Shin, Jacob Olusegun Olusanya, Mohammad Hasan Imani-Nasab, Rajesh Sagar, Ahmed Abdelalim, Benjamin K. Mayala, Fatemeh Heydarpour, Maysaa El Sayed Zaki, Shiwei Liu, Soraya Siabani, Jonathan F. Mosser, Veincent Christian Filipino Pepito, Andre Rodrigues Duraes, Valery L. Feigin, Yuan-Pang Wang, Mathew M. Baumann, Saravanan Muthupandian, Ingan Ukur Tarigan, Jasvinder A. Singh, Sebastian Vollmer, Felix Akpojene Ogbo, Alan J Thomson, Agus Sudaryanto, Birhanu Geta Meharie, Mihajlo Jakovljevic, Ahsan Saleem, Ali S. Shalash, Rakhi Dandona, Mojtaba Bagherzadeh, Ahmed Abualhasan, Muhammad Shahdaat Bin Sayeed, Meghnath Dhimal, Yves Miel H Zuniga, Akram Pourshams, Ionut Negoi, Yilma Chisha Dea Geramo, Franz Castro, Nefsu Awoke, Vahid Alipour, Rosario Cárdenas, Mohammad Khazaei, Mitchell T. Wallin, Yonatal Mesfin Tefera, Sanjay Zodpey, Bolajoko O. Olusanya, Ziad A. Memish, Taddese Alemu Zerfu, Claudio Alberto Dávila-Cervantes, Samer Hamidi, Gbenga A. Kayode, Peter Memiah, Sheikh Mohammed Shariful Islam, Francesco Saverio Violante, Bartosz Miazgowski, Babak Eshrati, Moses K. Muriithi, Mihiretu Kebede, Mowafa Househ, Monika Sawhney, Preeti Dhillon, Desta Haftu Hayelom, Ajay Patle, Thirunavukkarasu Sathish, Krittika Bhattacharyya, Hiroshi Yatsuya, Jaifred Christian F. Lopez, Barthelemy Kuate Defo, Arash Ziapour, Paul H. Lee, Emerito Jose A. Faraon, Seyed Sina Naghibi Irvani, Hagos Tasew Atalay, Tariq Jamal Siddiqi, Rafael Alves Guimarães, Aziz Sheikh, Adauto Martins Soares Filho, Eun-Kee Park, Kirsten E. Wiens, Hai Quang Pham, Berhe Etsay Tesfay, G. K. Mini, Zewdie Aderaw Alemu, Hedley Quintana, Milena Santric-Milicevic, Rajat Das Gupta, Parvaiz A Koul, Edson Serván-Mori, Foad Abd-Allah, Rahul Gupta, Dereje Bayissa Demissie, Chinwe Juliana Iwu, Gabrielle B. Britton, Colm McAlinden, Ayenew Negesse Abejie, Mohsen Naghavi, Maarten J. Postma, Chhabi Lal Ranabhat, Liliana Preotescu, Walter Mendoza, Manfred S. Green, Mahesh P A, Somayeh Bohlouli, Huong Lan Thi Nguyen, Khaled Khatab, Ziyad Al-Aly, Ali H. Mokdad, Aditya P Dash, Andre M. N. Renzaho, Muhammad Aziz Rahman, Ghobad Moradi, Ruth W Kimokoti, Jalal Arabloo, Kimberly B. Johnson, Seyyed Meysam Mousavi, Hesham M. Al-Mekhlafi, D. R. Mahadeshwara Prasad, Rufus A. Adedoyin, Arash Tehrani-Banihashemi, Govinda Prasad Dhungana, Engida Yisma, Azeem Majeed, Dina Nur Anggraini Ningrum, Hagazi Gebre Meles, Hala Elhabashy, Devasahayam J. Christopher, Malede Mequanent Sisay, Juan Sanabria, Gebre Teklemariam Demoz, Leonardo Roever, Shishay Wahdey Tekelemedhin, Guoqing Hu, Yousef Khader, Heather J. Zar, Hamideh Salimzadeh, Ali Bijani, Mehdi Sayyah, Shanshan Li, Kebreab Paulos, Tefera Chane Mekonnen, Mahya Beheshti, Siamak Sabour, Izza Shahid, Tuomo J. Meretoja, Ireneous N. Soyiri, Luca Ronfani, James Albright, Brijesh Sathian, Maciej Banach, Hasan Yusefzadeh, Rahman Shiri, Girmay Teklay Weldesamuel, Mekdes Tigistu Yilma, Taweewat Wiangkham, Soewarta Kosen, Fernando de la Hoz, Mohammed Shannawaz, Luis Camera, Nevine El Nahas, Paul S. F. Yip, Miguel A Barboza, Ibrahim Abdollahpour, Augustine Mwangi Gatotoh, Gurudatta Naik, Kebede Deribe, Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Value, Affordability and Sustainability (VALUE), Microbes in Health and Disease (MHD), Instituto de Saúde Pública da Universidade do Porto, IRAS OH Epidemiology Chemical Agents, Local Burden of Disease WaSH Collaborator, Violante FS, Public Health, Department of Earth Observation Science, UT-I-ITC-ACQUAL, Faculty of Geo-Information Science and Earth Observation, GeoHealth, HUS Comprehensive Cancer Center, Clinicum, University of Helsinki, Department of Oncology, Yisma, Engida, and Local Burden of Disease WaSH Collaborators

Subjects
Drinking water access, Sanitation, Universal design, Geographic Mapping, Socioeconomic Factor, DISEASE, 0302 clinical medicine, RA0421, Hygiene, 11. Sustainability, Global health, 030212 general & internal medicine, media_common, 2. Zero hunger, Public health, lcsh:Public aspects of medicine, 1. No poverty, General Medicine, 3142 Public health care science, environmental and occupational health, 6. Clean water, Low-income countries, 3. Good health, A990 Medicine and Dentistry not elsewhere classified, CHILD GROWTH, TERRITORIES, HYGIENE, Human, 0605 Microbiology, Diarrhea, AFRICA, medicine.medical_specialty, media_common.quotation_subject, 030231 tropical medicine, Local Burden of Disease WaSH Collaborators, Developing country, Article, Geographical inequalities, 1117 Public Health and Health Services, 12. Responsible consumption, Developing Countrie, 03 medical and health sciences, NUTRITIONAL INTERVENTIONS, Environmental health, medicine, SYSTEMATIC ANALYSIS, Humans, QUALITY, Sanitation/statistics & numerical data, Open defecation, Improved sanitation, hand washing, Developing Countries, Models, Statistical, Middle-income countries, Drinking Water, lcsh:RA1-1270, Bayes Theorem, GLOBAL BURDEN, diarrheal disease, DIARRHEA, Diarrhea/epidemiology, Local Burden of Disease WaSH Collaborator, Socioeconomic Factors, 0605 Microbiology, 1117 Public Health and Health Services, ITC-ISI-JOURNAL-ARTICLE, Business, Human medicine, Sanitation facilities, ITC-GOLD
Abstract

Background: Universal access to safe drinking water and sanitation facilities is an essential human right, recognised in the Sustainable Development Goals as crucial for preventing disease and improving human wellbeing. Comprehensive, high-resolution estimates are important to inform progress towards achieving this goal. We aimed to produce highresolution geospatial estimates of access to drinking water and sanitation facilities. Methods: We used a Bayesian geostatistical model and data from 600 sources across more than 88 low-income and middle-income countries (LMICs) to estimate access to drinking water and sanitation facilities on continuous continent-wide surfaces from 2000 to 2017, and aggregated results to policy-relevant administrative units. We estimated mutually exclusive and collectively exhaustive subcategories of facilities for drinking water (piped water on or off premises, other improved facilities, unimproved, and surface water) and sanitation facilities (septic or sewer sanitation, other improved, unimproved, and open defecation) with use of ordinal regression. We also estimated the number of diarrhoeal deaths in children younger than 5 years attributed to unsafe facilities and estimated deaths that were averted by increased access to safe facilities in 2017, and analysed geographical inequality in access within LMICs. Findings: Across LMICs, access to both piped water and improved water overall increased between 2000 and 2017, with progress varying spatially. For piped water, the safest water facility type, access increased from 40·0% (95% uncertainty interval [UI] 39·4–40·7) to 50·3% (50·0–50·5), but was lowest in sub-Saharan Africa, where access to piped water was mostly concentrated in urban centres. Access to both sewer or septic sanitation and improved sanitation overall also increased across all LMICs during the study period. For sewer or septic sanitation, access was 46·3% (95% UI 46·1–46·5) in 2017, compared with 28·7% (28·5–29·0) in 2000. Although some units improved access to the safest drinking water or sanitation facilities since 2000, a large absolute number of people continued to not have access in several units with high access to such facilities (>80%) in 2017. More than 253 000 people did not have access to sewer or septic sanitation facilities in the city of Harare, Zimbabwe, despite 88·6% (95% UI 87·2–89·7) access overall. Many units were able to transition from the least safe facilities in 2000 to safe facilities by 2017; for units in which populations primarily practised open defecation in 2000, 686 (95% UI 664–711) of the 1830 (1797–1863) units transitioned to the use of improved sanitation. Geographical disparities in access to improved water across units decreased in 76·1% (95% UI 71·6–80·7) of countries from 2000 to 2017, and in 53·9% (50·6–59·6) of countries for access to improved sanitation, but remained evident subnationally in most countries in 2017. Interpretation: Our estimates, combined with geospatial trends in diarrhoeal burden, identify where efforts to increase access to safe drinking water and sanitation facilities are most needed. By highlighting areas with successful approaches or in need of targeted interventions, our estimates can enable precision public health to effectively progress towards universal access to safe water and sanitation. This work was primarily supported by a grant from the Gates Foundation (OPP1132415). LGA has received support from Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (Finance Code 001), Conselho Nacional de Desenvolvimento Científico e Tecnológico and Fundação de Amparo à Pesquisa do Estado de Minas Gerais. OOA acknowledges the Department of Science and Innovation, National Research Foundation, and DSI/NRF Centre of Excellence for Epidemiological Modelling and Analysis, Stellenbosch, South Africa. SMAl acknowledges the Department of Health Policy and Management, Faculty of Public Health, Kuwait University and International Centre for Casemix and Clinical Coding, Faculty of Medicine, National University of Malaysia for the approval and support to participate in this research project. HTA acknowledges Aksum University. MAu and CH are partly supported by a grant from the Romanian National Authority for Scientific Research and Innovation, CNDS-UEFISCDI, project number PN-III-P4-ID-PCCF-2016-0084. AAz acknowledges funding from the Gates Foundation (OPP1171700). ABad is supported by the Public Health Agency of Canada. TWB was supported by the Alexander von Humboldt Foundation through the Alexander von Humboldt Professor award, funded by the German Federal Ministry of Education and Research; the EU; the Wellcome Trust; and from National Institute of Child Health and Human Development of National Institutes of Health (NIH; R01-HD084233), National Institute on Aging of NIH (P01AG041710), National Institute of Allergy and Infectious Diseases of NIH (R01-AI124389 and R01-AI112339), as well as Fogarty International Center of NIH (D43-TW009775). DABen was supported by the National Institute for Health Research (NIHR) Oxford Biomedical Research Centre. The views expressed are those of the authors and not necessarily those of the National Health Service, the NIHR, or the UK Department of Health and Social Care. GBB is supported by Sistema Nacional de Investigación (SNI) de la Secretaría Nacional de Ciencia, Tecnología e Innovación (SENACYT) of Panamá. FCar acknowledges UID/ MULTI/04378/2019 and UID/QUI/50006/2019 support with funding from FCT/Ministério da Ciência, Tecnologia e Ensino Superior through national funds. VMC acknowledges her grant (SFRH/BHD/110001/2015), received by Portuguese national funds through Fundação para a Ciência e Tecnologia (FCT), IP, under the Norma Transitória DL57/2016/CP1334/CT0006. JDN acknowledges support from the Alexander von Humboldt Foundation. DBD acknowledges support from the Gates Foundation. KD is supported by a Wellcome Trust grant (number 201900/Z/16/Z) as part of his International Intermediate Fellowship. AGo acknowledges Sistema Nacional de Investigadores de Panamá (SNI), Secretaría Nacional de Ciencia, Tecnología e Innovación (SENACYT). CH is partly supported by a grant co-funded by European Fund for Regional Development through the Operational Program for Competitiveness (project ID P_40_382). SMSI is funded by a Fellowship from National Heart Foundation of Australia and Deakin University. MJ and the Serbian part of this GBD contribution was co-funded through grant OI175014 of the Ministry of Education Science and Technological Development of the Republic of Serbia. JK is a recipient of the 2020 Benjamin V Cohen Peace Fellowship from Ball State University Center for Peace and Conflict Studies. YJK’s work was supported by the Research Management Centre, Xiamen University Malaysia, grants number XMUMRF/2018-C2/ ITCM/0001. KKr is supported by a DST PURSE grant and UGC Center of Advanced Study awarded to the Department of Anthropology, Panjab University, Chandigarh, India. BL acknowledges support from the NIHR Oxford Biomedical Research Centre and the British Heart Foundation Centre of Research Excellence, Oxford. PTNM acknowledges the Council for the Development of Social Science Research in Africa. ANA acknowledges Debre Markos University for its support in-terms of office and internet access while reviewing this paper. AMSam received a fellowship from the Egyptian Fulbright Mission programme. MMS-M acknowledges the support of the Ministry of Education, Science and Technological Development of the Republic of Serbia (contract number 175087). AShi acknowledges the support of Health Data Research UK. MRS acknowledges the Clinical Research Development Center of Imam Reza Hospital, Kermanshah university of Medical sciences for their wise advice. JBS is part of Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. RT-S was supported in part by grant PI17/00719 from Instituto de Salud Carlos III–FEDER. BU acknowledges Manipal Academy of Higher Education, Manipal. TWij acknowledges the Migraine Foundation Australia and the Department of Medicine, Faculty of Medicine, University of Rajarata, Saliyapura, Anuradhapuraya, Sri Lanka. CSW was supported by the South African Medical Research Council. SBZ received a scholarship from the Australian Government research training program in support of his academic career.

Published
2020
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41. Author correction: Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017

Author

SAVITA LASRADO, Fakher Rahim, Saeid Safari, Hassan Magdy Abd El Razek, Baye Dagnew, Farshad Pourmalek, Ali Rostami, Daniel Ketema, Aletta Schutte, Nasir Salam, Nicole Davis Weaver, Agus Sudaryanto, Martin Ayanore, Nataliya Foigt, Masoud Moradi, Susanna Dunachie, Ziad El-Khatib, Zahra Kamiab, Ashish Badiye, Vijay Kumar Chattu, Maryam Khazaee-Pool, Dabere Nigatu, Jalal Arabloo, Garumma Feyissa, Khalil Eskandari, Kewal Krishan, Bolajoko Olusanya, Gebremicheal Gebreslassie Kasahun, Takahiro Tabuchi, Gebrekiros Meles, Babak Moazen, Jaifred Christian Lopez, Ivy Shiue, Keyvan Pakshir, Tomasz Miazgowski, Surendra Karki, Shivakumar KM, Yasir Waheed, Hamideh Salimzadeh, Ali Akbar Fazaeli, Akram Pourshams, Manoochehr Karami, Yasser El-Sherbiny, Tinuke Olagunju, Vafa Rahimi-Movaghar, Ali Yadollahpour, Assefa Desalew, Ali Shalash, Preeti Dhillon, Ali Asadi-Pooya, Venkatesh Maled, Mihajlo Jakovljevic, John Ji, RAJESH SAGAR, GK Mini, Sebastian Vollmer, Ayman Grada, Boris Bikbov, Neda Izadi, Muhammad Aziz Rahman, Victor Adekanmbi, Reza Mohammadpourhodki, Rahman Shiri, Turki Alanzi, Afsaneh Arzani, Om Prakash Kurmi, Rajat Das Gupta, Masoumeh Sadeghi, Irfan Ullah, Phetole Mahasha, Neeti Kapoor, Hamed Zandian, Bruno Sunguya, Khalid Altirkawi, João Fernandes, Simon Hay, Ana Isabel Ribeiro, Krittika Bhattacharyya, Parastoo Ansari, Gebre Teklemariam Demoz, Hossein Samadi Kafil, Sojib Bin Zaman, Joan B Soriano, Sandra B Munro, Josip Car, Collins Chansa, Navid Rabiee, Sharath Burugina Nagaraja, Palash Banik, Maha El Tantawi, Muawiyyah Babale Sufiyan, Rupak Desai, Davide Rasella, Nicola Bragazzi, Borhan Mansouri, Keivan Ahmadi, Yogesh Sabde, Sergio Ivan Prada Rios, Amir Hasanzadeh, Chinwe Juliana Iwu-Jaja, Syed Amir Gilani, Seyed Sina Naghibi Irvani, Lucero Cahuana-Hurtado, Arya Haj-mirzaian, Reza Heidari-Soureshjani, Rajaa Al-Raddadi, Hagazi Gebre Meles, Muhammad Shahdaat Bin Sayeed, Peng Jia, Mostafa Dianatinasab, Ireneous Soyiri, Jennifer Ross, Erkin Mirrakhimov, Ali Koolivand, Diego Augusto Santos Silva, Olufemi Ajumobi, Muhammad Usman, Hesham Al-Mekhlafi, Enayatollah Homaie Rad, Farhad Moradpour, Fatemeh Rajati, Norberto Perico, Francis Zotor, Omid Shafaat, Joel Francis, Muktar Omer, Hedayat Abbastabar, Mohammad Aghaali, Mulat Tirfie Bayih, Sorin Hostiuc, Era Upadhyay, Daniel Diaz, Mustafa Younis, Ambrish Singh, Mohammad Zamani, Mehran Asadi-Aliabadi, Andre Pascal Kengne, Mohammad Sadegh Rezai, Bruce Duncan, Javad Nazari, Vahid Yazdi-Feyzabadi, Anemaw Asrat, Biagio Simonetti, Neda Milevska Kostova, Mariya Titova, Mohammad Rabiee, Hassan Abolhassani, Morteza Shamsizadeh, Shyam Sundar Budhathoki, Zelalem Nigussie Azene, Pallab Kumar Maulik, Rafael Tabares-Seisdedos, Maha Atout, ANDRE RENZAHO, Fatemeh Amiri, Nelsensius Klau Fauk, Yousef Khader, Mohammad Saud Khan, Davood Anvari, Shymaa Enany, Ahad Bakhtiari, Farnam Mohebi, Yuan-Pang Wang, Naser Kamyari, Tewodros Wonde, Dadi Marami, Arash Ziapour, Azmeraw T. Amare, Nima Rezaei, S.mohammad Sajadi, Vahid Rashedi, Ayesha Humayun, Jacob Olusanya, Yousef Moradi, Reta Tsegaye, Dr. Dereje Bayissa Demissie, Vivekanand Jha, Behnam Nabavizadeh, Vivek Kumar, Andrew Olagunju, Mehran Shams-beyranvand, Farshad Farzadfar, Hagos Tasew, Ninuk Hariyani, Nelson Alvis-Guzmán, Girmay Teklay, Jan-Walter De Neve, Bereket Duko Adema, Jagadish Rao Padubidri, Md Nuruzzaman Khan, Abbas Yadegar, Anurag Agrawal, Vera Marisa Costa, Francisco Rogerlândio Martins-Melo, ORISH EBERE ORISAKWE, Khem Pokhrel, Amir Kasaeian, Artem Fomenkov, Birkneh Tilahun Tadesse, Georgy Lebedev, Razique Anwer, Dimas Ria Angga Pribadi, Alex Yeshaneh, Nuno Taveira, Deepesh Lad, Claudiu Herteliu, Ali Bijani, Zahiruddin Quazi Syed, Elena Varavikova, Antonio Maria Borzì, Phuc Huyen Do, Demelash Elemineh, Abel Fekadu Dadi, Taweewat Wiangkham, Ted Miller, Zubair Kabir, Duduzile Ndwandwe, Habtamu Kasaye, Mario Herrero, Nauman Khalid, Adnan Kisa, Sergey Soshnikov, Alberto Ortiz Arduan, Paul Doku, Saravanan Muthupandian, Bing-Fang Hwang, Meghnath Dhimal, Hamidreza Komaki, Ritesh Menezes, Kedir Abegaz, Claudio Davila, Dinesh Bhandari, Mohamad-Hani Temsah, André Faro, Navid Manafi, Hamidreza Haririan, Nazli Khatib, Wahengbam Bigyananda Meitei, RAVI PRAKASH JHA, Mahdi Mirzaei, Abdallah Samy, Priya Rathi, Alireza Esteghamati, Hailay Gesesew, Eduarda Fernandes, Ghasem Azarian, Shafiu Mohammed, Tauseef Ahmad, Derrick Bennett, Stefan Lorkowski, Yunquan Zhang, Karzan Mohammad, Carlos Castañeda-Orjuela, Mohd Anisul Karim, Tissa Wijeratne, Ahmed I. Hasaballah, Somayeh Bohlouli, Mohammed Madadin, and Mohd Shannawaz

Subjects
Immunology, General Medicine, Medical and Health Sciences, General Biochemistry, Genetics and Molecular Biology, Geography, Childhood Overweight, Low and middle income countries, Environmental health, medicine, medicine.symptom, Wasting, LBD Double Burden of Malnutrition Collaborators, 11 Medical and Health Sciences
Abstract

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Published
2020

42. Mapping geographical inequalities in childhood diarrhoeal morbidity and mortality in low-income and middle-income countries, 2000-17: analysis for the Global Burden of Disease Study 2017

Author

Manisha Dubey, Fatemeh Rajati, Mehran Shams-Beyranvand, Amir Khater, Reza Shirkoohi, Segun Emmanuel Ibitoye, David C. Schwebel, Milena Ilic, Kebede Embaye Gezae, Ali Akbar Fazaeli, Ronny Westerman, Taye Abuhay Zewale, Ravi Mehrotra, Sezer Kisa, Junaid Khan, Jost B. Jonas, Dian Kusuma, Marcel Ausloos, Getnet Gedefaw, Hamed Zandian, Edward J Mills, Aparna Lal, Atalay Goshu Muluneh, Leeberk Raja Inbaraj, Edgar Denova-Gutiérrez, Jacqueline Elizabeth Alcalde Rabanal, Yousef Veisani, Sharath Burugina Nagaraja, Christopher Troeger, Ismael R. Campos-Nonato, Kidane Tadesse Gebremariam, Maysaa El Sayed Zaki, Oliver J. Brady, David Laith Rawaf, Tamer H. Farag, Simin Mouodi, Hafiz Ansar Rasul Suleria, Saleh Salehi Zahabi, Soumyadeep Bhaumik, Samad Azari, Getinet Ayano, Faris Lami, Raaj Kishore Biswas, Maryam Adabi, Alaa Badawi, Saravanan Muthupandian, Amir Hasanzadeh, Martin Amogre Ayanore, Maziar Moradi-Lakeh, Mohamad-Hani Temsah, Kavumpurathu Raman Thankappan, Bineyam Taye, Nader Jafari Balalami, Hamid Yimam Hassen, Karzan Abdulmuhsin Mohammad, Paul H. Lee, Emerito Jose A. Faraon, Kewal Krishan, Muhammad Ali, Ehsan Sadeghi, Richard C. Franklin, Dara K. Mohammad, Naznin Hossain, Lal B. Rawal, Alyssa N. Sbarra, Behnam Heidari, Dietrich Rothenbacher, Hagos Tasew Atalay, Eric L. Ding, Noushin Mohammadifard, Nihal Thomas, Man Mohan Mehndiratta, Sanghamitra Pati, Addisu Melese, Niranjan Kissoon, Farzad Manafi, Carl Abelardo T. Antonio, Morteza Abdullatif Khafaie, Meysam Behzadifar, Mohammad Reza Sobhiyeh, Frank B. Osei, Koku Sisay Tamirat, Yahya Salimi, Pranab Chatterjee, Gebreamlak Gebremedhn Gebremeskel, Olatunji O. Adetokunboh, Benjamin K. Mayala, Bhaskaran Unnikrishnan, Zahid A Butt, Olufemi Ajumobi, Fiseha Wadilo Wada, Shafiu Mohammed, Charles Shey Shey Wiysonge, Félix Carvalho, Masresha Tessema Anegago, Yun Jin Kim, Ai-Min Wu, Ketema Bizuwork Gebremedhin, Paulina A. Lindstedt, Ana-Laura Manda, Aziz Eftekhari, Rakhi Dandona, Mehdi Fazlzadeh, Nicole Davis Weaver, Muluken Bekele Sorrie, Marwa Rashad Salem, Kassawmar Angaw Bogale, Dongyu Zhang, Saeed Safari, Vivekanand Jha, Keivan Ahmadi, Turki Alanzi, Amir Jalali, Hamidreza Haririan, Chukwudi A Nnaji, Kebadnew Mulatu Mihretie, Lucas Guimarães Abreu, Gessessew Bugssa Hailu, Surendra Karki, Kirsten E. Wiens, Boikhutso Tlou, Soraya Siabani, Muluken Azage Yenesew, Asnakew Achaw Ayele, Ayalew Jejaw Zeleke, Osayomwanbo Osarenotor, Susanna Dunachie, Marcos Roberto Tovani-Palone, Daniel Bekele Ketema, Tissa Wijeratne, Dessalegn Ajema Berbada, André Karch, Ebrahim Babaee, Akram Pourshams, Seyyed Meysam Mousavi, Bal Govind Chauhan, Giuseppe Remuzzi, Vera Marisa Costa, Mehdi Yaseri, Tahereh Pashaei, Benn Sartorius, Helen Derara Diro, Anelisa Jaca, Mostafa Hosseini, Nikolay Ivanovich Briko, Franz Castro, Cuong Tat Nguyen, Chalachew Genet Akal, Natalie Maria Cormier, Ghulam Mustafa, Sonia Lewycka, Achala Upendra Jayatilleke, David L. Smith, Ibrahim A Khalil, Genet Melak Alamene, George C Patton, Andem Effiong, Gebrekiros Gebremichael Meles, Collins Chansa, Tsegaye Lolaso Lenjebo, Van C. Lansingh, Chabila C Mapoma, Olayinka Stephen Ilesanmi, Aso Mohammad Darwesh, Aubrey J. Levine, Miliva Mozaffor, Till Bärnighausen, Ali Rostami, André Faro, Rushdia Ahmed, Colm McAlinden, Duduzile Ndwandwe, Neeraj Bedi, Irfan Ullah, Winfried März, Rajeev Gupta, Masood Ali Shaikh, Catalina Liliana Andrei, Ali Kazemi Karyani, Shaimaa I. El-Jaafary, Abbas Mosapour, Javad Nazari, Obinna Onwujekwe, Narinder Pal Singh, Dabere Nigatu, Tanuj Kanchan, Jagdish Khubchandani, Aklilu Endalamfaw, Hajer Elkout, Michelle L. Bell, Beyene Meressa Adhena, Evanson Z. Sambala, Nelson Alvis-Guzman, Nefsu Awoke, Mohammad Ali Sahraian, Muki Shey, Christiane Dolecek, Kedir Hussein Abegaz, Syed Ather Hussain, Birhan Tamene Alemnew, Arash Etemadi, Anwar E. Ahmed, Vinay Nangia, Sachin R Atre, Roghiyeh Faridnia, Robert C. Reiner, Rajat Das Gupta, Aniruddha Deshpande, Sanjay Zodpey, Birhanu Geta, Amaha Kahsay, Muktar Beshir Ahmed, Kiana Ramezanzadeh, Jacek Jerzy Jozwiak, Chi Linh Hoang, Bahram Armoon, Manfred Accrombessi, Christopher J L Murray, Ebrahim M Yimer, Rashmi Gupta, Ahmed Omar Bali, Dadi Marami, Arash Tehrani-Banihashemi, Getnet Mengistu, Govinda Prasad Dhungana, Fereshteh Ansari, Dina Nur Anggraini Ningrum, Mu'awiyyah Babale Sufiyan, Harish Chander Gugnani, Ali S. Akanda, Satar Rezaei, Wondimeneh Shibabaw Shiferaw, Irina Filip, Mohammad Fareed, Hagos Degefa Hidru, Morteza Shamsizadeh, Mojtaba Hoseini-Ghahfarokhi, Yared A Asmare Aynalem, Gelin Xu, Zubair Kabir, Khalid A Altirkawi, Beatriz Paulina Ayala Quintanilla, Kenean Getaneh Tlaye, Devasahayam J. Christopher, Malede Mequanent Sisay, Yibeltal Alemu Bekele, Mika Shigematsu, Bryan L. Sykes, Quique Bassat, Jemal Abdu Mohammed, Seyed Mostafa Mir, Moslem Soofi, Nuruzzaman Khan, Ensiyeh Jenabi, Seyed-Mohammad Fereshtehnejad, Alireza Esteghamati, Paramjit Gill, Nathaniel J Henry, Meghnath Dhimal, Hosein Shabaninejad, Trang Huyen Nguyen, Amjad Mohamadi-Bolbanabad, Eugenio Traini, Mohammad Zamani, Arianna Maever L. Amit, Mehran Alijanzadeh, Florian Fischer, Rafael Moreira Claro, Pushpendra Kumar, Shai Linn, Lucas Earl, Haileab Fekadu Wolde, Getenet Dessie, Doris D. V. Ortega-Altamirano, John S. Ji, Moritz U. G. Kraemer, Saeed Amini, Ziad A. Memish, Aisha Elsharkawy, Ken Lee Chin, Mustafa Z. Younis, Daniel Diaz, Hebat Allah Salah A. Yousof, Seifadin Ahmed Shallo, Tomohide Yamada, Adrian Pana, Salman Rawaf, Amir Almasi-Hashiani, Platon D. Lopukhov, Alireza Rafiei, Dragos Virgil Davitoiu, Hossein Poustchi, Ayele Geleto Bali, Francesco Saverio Violante, Leonardo Roever, Giovanni Damiani, Maha El Tantawi, Nuworza Kugbey, Hadi Pourjafar, Michael R.M. Abrigo, Dinh-Toi Chu, Farkhonde Salehi, Phetole Walter Mahasha, Farnam Mohebi, Sathish Thirunavukkarasu, Dharmesh Kumar Lal, Senbagam Duraisamy, Demelash Woldeyohannes Handiso, Eleonora Dubljanin, Takeshi Fukumoto, Biruck Desalegn Yirsaw, Fakher Rahim, Jasvinder A. Singh, Jai K Das, Savita Lasrado, Ana Isabel Ribeiro, Santosh Varughese, Adnan Kisa, Laurie B. Marczak, Amira Shaheen, Peter Njenga Keiyoro, Nader Jahanmehr, Yuming Guo, Arash Ziapour, Alex Yeshaneh, Ninuk Hariyani, Seyed Sina Naghibi Irvani, Sameer Vali Gopalani, Joel M. Francis, Asmamaw Demis, Ahamarshan Jayaraman Nagarajan, Praveen Hoogar, Nicola Luigi Bragazzi, Yunquan Zhang, Yousef Mohammad, Iman El Sayed, Vafa Rahimi-Movaghar, Anbissa Muleta Senbeta, Subramanian Senthilkumaran, Marzieh Nojomi, Tewodros Eshete Wonde, Sameh Magdeldin, Anton Sokhan, Nauman Khalid, Nima Hafezi-Nejad, Ben Lacey, Luca Ronfani, James Albright, Senthilkumar Balakrishnan, Ejaz Ahmad Khan, Khanh Bao Tran, Guoqing Hu, Yousef Khader, Parvaneh Mirabi, Boris Bikbov, Feleke Mekonnen Demeke, Assefa Desalew, Yasir Waheed, Berhe Etsay Tesfay, Julio Cesar Campuzano Rincon, Ernoiz Antriyandarti, Brian J. Hall, James A Platts-Mills, Gbenga A. Kayode, Jan-Walter De Neve, Maria Jesus Rios-Blancas, Navid Manafi, Ravi Prakash Jha, Yilma Chisha Dea Geramo, Hamideh Salimzadeh, Fisaha Haile Tesfay, Abdullah Al Mamun, Ali Bijani, Hedley Quintana, Shanshan Li, Kebreab Paulos, Joan B. Soriano, Victor Adekanmbi, Oladimeji Adebayo, David Teye Doku, Brijesh Sathian, Bakhtiar Piroozi, MohammadBagher Shamsi, Netsanet Fentahun, Shymaa Enany, Ayman Grada, Salvatore Rubino, Kenji Shibuya, Norberto Perico, Sergio I. Prada, Andrea Farioli, Gebremicheal Gebreslassie Kasahun, Mohsen Afarideh, Maciej Banach, Andrey Nikolaevich Briko, Mohsen Asadi-Lari, Rakesh Lodha, David M. Pigott, Bárbara Niegia Garcia de Goulart, Hadi Hassankhani, Daniel Adane Endalew, Siamak Sabour, Yoshan Moodley, Preeti Dhillon, Dilaram Acharya, Anas M. Saad, Ibrahim Abdelmageed Ginawi, Theo Vos, Tuomo J. Meretoja, Ireneous N. Soyiri, Hasan Yusefzadeh, Mohammad Rabiee, Ajay Patle, Rahman Shiri, Girmay Teklay Weldesamuel, Sivan Yegnanarayana Iyer Saraswathy, Mekdes Tigistu Yilma, Davide Guido, Chuanhua Yu, Abdallah M. Samy, Ali Talha Khalil, Ashish Awasthi, Pascual R. Valdez, Nelson G.M. Gomes, Nejimu Biza Zepro, Taweewat Wiangkham, Anthony Masaka, Afsaneh Arzani, Ayesha Humayun, Michael Tamene Haile, Huyen Phuc Do, Krittika Bhattacharyya, Maryam Khayamzadeh, Seth Christopher Yaw Appiah, Mehdi Ahmadi, Farah Daoud, QuynhAnh P Nguyen, Suleman Atique, Sheikh Mohammed Shariful Islam, Indang Trihandini, Mario Poljak, Bartosz Miazgowski, Huda Basaleem, Rafael Alves Guimares, Mina Anjomshoa, Peng Jia, Yafeng Wang, Erkin M. Mirrakhimov, Seyed Hossein Yahyazadeh Jabbari, Itamar S. Santos, Alireza Khatony, Desalegn Tadese Mengistu, Samath D Dharmaratne, S. Mohammad Sajadi, Francisco Rogerlândio Martins-Melo, Shankar M Bakkannavar, Konrad Pesudovs, Tina Beyranvand, Liliana Preotescu, Leticia Avila-Burgos, Enrico Rubagotti, Amira Hamed Darwish, Mahdi Safdarian, Ali Yadollahpour, Vijay Kumar Chattu, Moses K. Muriithi, Azmeraw T. Amare, Si Si, Joshua Longbottom, Somayeh Bohlouli, Khaled Khatab, Masoud Behzadifar, Anusha Ganapati Bhat, G Anil Kumar, Margaret Kosek, Mona M. Khater, Reta Tsegaye Gayesa, Ghobad Moradi, Srinivas Goli, Ruth W Kimokoti, Jalal Arabloo, Kimberly B. Johnson, Andrew T Olagunju, Mowafa Househ, In-Hwan Oh, Arya Haj-Mirzaian, Desta Haftu Hayelom, Jae Il Shin, Ahmed Abdelalim, Catherine A. Welgan, Veincent Christian Filipino Pepito, Andre Rodrigues Duraes, Yuan-Pang Wang, Rosario Cárdenas, Mohammad Khazaei, Sebastian Vollmer, Xiu-Ju Zhao, Mihajlo Jakovljevic, Degu Abate, Ali S. Shalash, Davide Rasella, Melese Abate Reta, Hedayat Abbastabar, Manu Raj Mathur, Aliasghar Ahmad Kiadaliri, Ritesh G. Menezes, Molly K. Miller-Petrie, Beriwan Abdulqadir Ali, Ahmed I. Hasaballah, Joseph Frostad, Eirini Skiadaresi, Aleksandra Barac, Simon I. Hay, Deborah Carvalho Malta, Brigette F. Blacker, Carlo La Vecchia, Eduarda Fernandes, Chandrashekhar T Sreeramareddy, Zewdie Aderaw Alemu, Foad Abd-Allah, Elias Merdassa Roro, Agus Sudaryanto, Fariba Ghassemi, Behzad Karami Matin, Mohsen Naghavi, Maarten J. Postma, Chhabi Lal Ranabhat, Maheswar Satpathy, Mahesh P A, Carlos Miguel Rios González, Pallab K. Maulik, Amir Kasaeian, Ali H. Mokdad, Alemayehu Toma Mena, Tamirat Tesfaye Dasa, Abdur Razzaque Sarker, Andre M. N. Renzaho, Muhammad Aziz Rahman, Ali Kabir, Josephine W. Ngunjiri, Aberash Abay Tassew, Kala M. Mehta, Ionut Negoi, Hosni Salem, Hesham M. Al-Mekhlafi, Sharareh Eskandarieh, Rufus A. Adedoyin, Saleem M Rana, Engida Yisma, Sahel Valadan Tahbaz, Hossein Farzam, Krishna K. Aryal, Lalit Dandona, Masoud Moradi, Juan Sanabria, Gebre Teklemariam Demoz, Naser Mohammad Gholi Mezerji, Shirin Djalalinia, Suraj Bhattarai, Ammas Siraj Mohammed, Claudiu Herteliu, Dawit Zewdu Wondafrash, Mohsen Bayati, Arvin Haj-Mirzaian, Gulfaraz Khan, Mostafa Leili, Nasir Salam, Ehsan Khodamoradi, Jean Jacques Noubiap, Vahid Alipour, Mohammad Ali Mansournia, Rajesh Sagar, Jagadish Rao Padubidri, Manasi Kumar, Mehdi Sharif, Fatemeh Heydarpour, Navid Rabiee, Gvs Murthy, Hamed Kalani, Mayowa O. Owolabi, Claudio Alberto Davila, Oluchi Okpala, Shivakumar K.M. Kondlahalli, Mathew M. Baumann, Bereket Duko Adema, Lorenzo Monasta, Paul S. F. Yip, Mohammad Hossein Khosravi, Rizwan Suliankatchi Abdulkader, Ibrahim Abdollahpour, Dhirendra N Sinha, Farid Najafi, Kebede Deribe, Paula Moraga, Mehedi Hasan, Mohammad Moradi-Joo, Melkamu Merid Mengesha, Temesgen Yihunie Akalu, Vishnu Renjith, Syed Mohamed Aljunid, Zemenu Tadesse Tessema, Amir Radfar, Nuno Taveira, Masoud Foroutan, Demelash Abewa Elemineh, Chinwe Juliana Iwu, Kamarul Imran Musa, Getaneh Alemu Abebe, Farshad Pourmalek, Olatunde Aremu, Mohammad Reza Salahshoor, Derrick A Bennett, Ahmad Daryani, Alebachew Fasil Ashagre, Apurba Shil, Narayan Bahadur Mahotra, Nelson J. Alvis-Zakzuk, Lauren E. Schaeffer, Alexandre C. Pereira, Mehdi Naderi, Mehdi Hosseinzadeh, Rovshan Khalilov, Ai Koyanagi, Salman Khazaei, Jennifer Rickard, Ali Almasi, Sandra B. Munro, Carlos Zambrana-Torrelio, Naohiro Yonemoto, Ahmad Ghashghaee, Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Value, Affordability and Sustainability (VALUE), Microbes in Health and Disease (MHD), Instituto de Saúde Pública da Universidade do Porto, Local Burden Dis Diarrhoea, Department of Earth Observation Science, UT-I-ITC-ACQUAL, Faculty of Geo-Information Science and Earth Observation, GeoHealth, Reiner, Robert C, Wiens, Kirsten E, Deshpande, Aniruddha, Baumann, Mathew M, Adema, Bereket Duko, Yirsaw, Biruck Desalegn, Yisma, Engida, Hay, Simon I, Local Burden of Disease Diarrhoea Collaborators, Tampere University, Health Sciences, University of Helsinki, Institute for Molecular Medicine Finland, Clinicum, HUS Comprehensive Cancer Center, Local Burden of Disease Diarrhoea Collaborator, and Violante FS

Subjects
Low income countries, medicine.medical_treatment, 030204 cardiovascular system & hematology, Global Health, THERAPY, Global Burden of Disease, 0302 clinical medicine, Prevalence, Global health, Medicine, WATER, 030212 general & internal medicine, Children, 11 Medical and Health Sciences, Incidence, Mortality rate, Incidence (epidemiology), 1. No poverty, General Medicine, 3142 Public health care science, environmental and occupational health, Diarrhoea, 3. Good health, Child, Preschool, Middle income countries, A990 Medicine and Dentistry not elsewhere classified, TERRITORIES, Life Sciences & Biomedicine, Infants, Diarrhea, AFRICA, medicine.medical_specialty, Childhood deaths, RJ, sanitation, Developing country, Childhood diarrhoeal morbidity, ITC-HYBRID, 03 medical and health sciences, Medicine, General & Internal, General & Internal Medicine, Environmental health, SYSTEMATIC ANALYSIS, Life Science, Humans, Healthcare Disparities, Oral rehydration therapy, Risk factor, hand washing, Developing Countries, Disease burden, Global Nutrition, Wereldvoeding, Science & Technology, SEX-SPECIFIC MORTALITY, business.industry, CHOLERA, Public health, Bayes Theorem, diarrheal disease, Local Burden of Disease Diarrhoea Collaborators, ITC-ISI-JOURNAL-ARTICLE, NA, Human medicine, Diarrea, business
Abstract

Background: Across low-income and middle-income countries (LMICs), one in ten deaths in children younger than 5 years is attributable to diarrhoea. The substantial between-country variation in both diarrhoea incidence and mortality is attributable to interventions that protect children, prevent infection, and treat disease. Identifying subnational regions with the highest burden and mapping associated risk factors can aid in reducing preventable childhood diarrhoea. Methods: We used Bayesian model-based geostatistics and a geolocated dataset comprising 15 072 746 children younger than 5 years from 466 surveys in 94 LMICs, in combination with findings of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017, to estimate posterior distributions of diarrhoea prevalence, incidence, and mortality from 2000 to 2017. From these data, we estimated the burden of diarrhoea at varying subnational levels (termed units) by spatially aggregating draws, and we investigated the drivers of subnational patterns by creating aggregated risk factor estimates. Findings: The greatest declines in diarrhoeal mortality were seen in south and southeast Asia and South America, where 54·0% (95% uncertainty interval [UI] 38·1-65·8), 17·4% (7·7-28·4), and 59·5% (34·2-86·9) of units, respectively, recorded decreases in deaths from diarrhoea greater than 10%. Although children in much of Africa remain at high risk of death due to diarrhoea, regions with the most deaths were outside Africa, with the highest mortality units located in Pakistan. Indonesia showed the greatest within-country geographical inequality; some regions had mortality rates nearly four times the average country rate. Reductions in mortality were correlated to improvements in water, sanitation, and hygiene (WASH) or reductions in child growth failure (CGF). Similarly, most high-risk areas had poor WASH, high CGF, or low oral rehydration therapy coverage. Interpretation: By co-analysing geospatial trends in diarrhoeal burden and its key risk factors, we could assess candidate drivers of subnational death reduction. Further, by doing a counterfactual analysis of the remaining disease burden using key risk factors, we identified potential intervention strategies for vulnerable populations. In view of the demands for limited resources in LMICs, accurately quantifying the burden of diarrhoea and its drivers is important for precision public health. This work was primarily supported by a grant from the Bill & Melinda Gates Foundation (OPP1132415). S Aljunid reports additional funding from the International Centre for Casemix and Clinical Coding, Faculty of Medicine, National University of Malaysia and Department of Health Policy and Management, Faculty of Public Health, Kuwait University for the approval and support to participate in this research project outside of the study. A Awasthi is supported by the Department of Science and Technology, Government of India, New Delhi, through the INSPIRE Faculty Program outside of the study. A Badawi reports additional funding from the Public Health Agency of Canada outside of the study. A Barac reports additional funding from the Project of Ministry of Education, Science and Technology of the Republic of Serbia (no III45005) outside of the study. T Bärnighausen reports additional funding by the Alexander von Humboldt Foundation through the Alexander von Humboldt Professor award, funded by the German Federal Ministry of Education and Research outside of the study. F Carvalho and E Fernandez report additional funding from the Portuguese national funds (UID/MULTI/04378/2019 and UID/QUI/50006/2019) outside of the study. V M Costa reports additional funding from Fundação da Ciência e Tecnologia (FCT) for her grant (SFRH/BPD/110001/2015), which was funded by national funds through FCT – Fundação para a Ciência e a Tecnologia, IP, under the Norma Transitória – DL57/2016/CP1334/CT0006 outside of the study. J De Neve reports additional funding from the Alexander von Humboldt Foundation outside of the study. K Deribe reports additional funding from the Wellcome Trust (grant number 201900) as part of his International Intermediate Fellowship outside of the study. D Endalew and M Moradi report additional funding from Wolkite University. M Ausloos, C Herteliu, and A Pana report additional funding from the Romanian National Authority for Scientific Research and Innovation, CNDS-UEFISCDI (project number PN-III-P4-ID-PCCF-2016-0084) outside of the study. C Herteliu reports additional funding from the European Fund for Regional Development through Operational Program for Competitiveness (Project ID P_40_382) and the European Fund for Regional Development, through InterReg Romania-Hungary (project code EMS ROHU 217) outside of the study. P Hoogar reports additional funding from the Centre for Holistic Development and Research (CHDR), Kalaghatagi and The Department of Studies in Anthropology, Karnatak University, D S Islam reports additional funding from the National Heart Foundation of Australia and the Institute for Physical Activity and Nutrition, Deakin University outside of the study. A Khatony reports additional funding from the Clinical Research Development Center of Imam Reza Hospital in Kermanshah outside of the study. J Khubchandani reports additional funding from Merck Research Laboratories outside of the study. K Krishan reports additional funding from the UGC Center of Advanced Study (CAS II) awarded to the Department of Anthropology, Panjab University, Chandigarh, India outside of the study. M Kumar reports additional funding from the Fogarty Foundation/NIH through a K43 award (TW010716-01A1) outside of the study. B Lacey reports additional funding from the National Institute for Health Research Oxford Biomedical Research Centre and the British Heart Foundation Centre of Research Excellence (Oxford, UK) outside of the study. A M Samy reports additional funding from the Egyptian Fulbright Mission Program (EFMP) outside of the study. S Seyedmousavi reports additional funding from the Intramural Program of National Institute of Health Clinical Center, Bethesda, MD, USA outside of the study. M Shey reports additional funding from the Wellcome Trust Kenji Shibuya reports additional funding from Japan's Ministry of Health, Labour and Welfare and Japan's Ministry of Education, Culture, Sport, Science and Technology outside of the study. M Sobhiyeh reports additional funding from the Clinical Research Development Center of Imam Reza Hospital, Kermanshah University of Medical Sciences outside of the study. J Soriano reports additional funding from Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain outside of the study. N Taveira reports additional funding from the LIFE study (RIA2016MC-1615) of the European and Developing Countries Clinical Trials Partnership (EDCTP) program supported by the European Union outside of the study. B Unnikrishnan reports additional funding from the Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India outside of the study. T Wijeratne reports additional funding from the Department of Medicine, Faculty of Medicine, University of Rajarata, Saliyapura, Sri Lanka outside of the study. C S Wiysonge reports additional funding from the South African Medical Research Council and the National Research Foundation of South Africa outside of the study.

Published
2020

43. Childhood hearing impairment and its associated factors in sub-Saharan Africa in the 21st century: A systematic review and meta-analysis

Author

Tilayie Feto Gelano, Agumasie Semahegn, Assefa Desalew, Biftu Geda, and Tilahun Ali

Subjects
sub-Saharan Africa, lcsh:R5-920, Sub saharan, business.industry, systematic reviews, Developing country, General Medicine, Hearing impairment, meta-analysis, 03 medical and health sciences, 0302 clinical medicine, Systematic review, children, Meta-analysis, Environmental health, Medicine, 030212 general & internal medicine, Systematic Review, lcsh:Medicine (General), 030223 otorhinolaryngology, business
Abstract

Background:Childhood hearing impairment is still a significant cause of disability in the 21st century in developing countries. Particularly, the burden is more severe in sub-Saharan Africa, where the majority of children with hearing problems is living. Thre are great variations and inconsistencies of available findings conducted in sub-Saharan Africa. Hence, the aim of this review was to determine the pooled prevalence of childhood hearing impairment and its associated factors in sub-Saharan Africa.Methods:Studies were searched from main databases (PubMed, CINAHL, and African Journals Online), Google Scholar, and other relevant sources using electronic and manual techniques. All observational studies, written in English and conducted among participants (aged less than 18 years) from 2000 to 2018, were eligible. Heterogeneity between included studies was assessed using I2, and publication bias was explored using visual inspection of the funnel plot. Statistical analysis was carried out to determine pooled prevalence using Stata version 14. In addition, subgroup analysis was carried out for the normality criteria of hearing thresholds and characteristics of the study populations.Results:The pooled prevalence of hearing impairment was 10% (95% confidence interval (CI): 9%–11%). The magnitude of hearing impairment varies with the normality criterion used. The most commonly used threshold was 25 and 30 dB hearing level. The prevalence of hearing impairment based on normality criterion (>20 dB, >25 dB, >30 dB, and >35 dB) were 17%, 19%, 2%, and 1%, respectively. While in the questionnaire-based evaluation, the prevalence was 6% (95% CI: 3%–9%). In addition, based on population characteristics, the prevalence of hearing impairment for school or community-based children was 6% (95% CI: 5%–7%) while the prevalence for children with comorbidities was 23% (95% CI: 15%–31%). Chronic suppurative otitis media, impacted cerumen, advanced stage of human immunodeficiency virus, tuberculosis infection, and age of the children were associated with hearing impairment in sub-Saharan Africa.Conclusion:Hearing impairment in children and adolescents in sub-Saharan Africa was high, and associated with preventable and treatable risk factors.

Published
2020

44. Cause and predictors of neonatal mortality among neonates admitted to neonatal intensive care units in public hospitals in eastern Ethiopia: A facility-based prospective follow-up study

Author

Assefa Desalew, Yitagesu Sintayehu, Nardos Teferi, Firehiwot Amare, Bifitu Geda, Teshager Worku, Kebebush Abera, and Abiyot Asefaw

Abstract

Background: The first month is the most crucial period for child survival. Neonatal mortality continues to remain high with little improvement over the years in Sub-Saharan Africa, including Ethiopia. This region shows the least progress in reducing neonatal mortality and continues to be a significant public health issue. In this study setting, the causes and predictors of neonatal death in the neonatal intensive care units are not well documented. Hence, this study aimed to determine the causes and predictors of neonatal mortality among infants admitted to neonatal intensive care units in eastern Ethiopia. Methods: A facility-based prospective follow-up study was conducted among neonates admitted to neonatal intensive care units in public hospitals in eastern Ethiopia from November 1 to December 30, 2018. Data were collected using a pre-tested structured questionnaire and a follow-up checklist. The main outcomes and causes of death were set by pediatricians and medical residents. Epi-Data 3.1 and Statistical Package for Social Sciences Version 25 software were used for data entry and analysis, respectively. Multivariable logistic regression was used to identify the predictors of facility-based neonatal mortality.Results: The proportion of facility-based neonatal mortality was 20%(95% CI:16.7-23.8%). The causes of death were complications of preterm birth (28.58%), birth asphyxia (22.45%), neonatal infection (18.36%), meconium aspiration syndrome (9.18%), respiratory distress syndrome (7.14%), and congenital malformation (4.08%). Low birth weight, preterm births, length of stay in the neonatal intensive care unit, low 5 minutes APGAR score, hyperthermia, and initiation of feeding were predictors of neonatal death among infants admitted to the neonatal intensive care units in public hospitals in eastern Ethiopia.Conclusions: The proportion of facility-based neonatal deaths was unacceptably high. The main causes of death were preventable and treatable. Hence, improving the timing and quality of antenatal care is essential for early detection, anticipating high-risk newborns, and timely interventions. Furthermore, early initiation of feeding and better referral linkage to tertiary health facilities could lead to a reduction in neonatal death in this setting.

Published
2020
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45. Determinants of birth asphyxia among newborns in Ethiopia: A systematic review and meta-analysis

Author

Assefa, Desalew, Agumasie, Semahgn, and Gezahegn, Tesfaye

Subjects
newborn, Birth asphyxia, Review Article, Ethiopia, determinant
Abstract

Objective: The aim of this systematic review and meta-analysis was to estimate the pooled magnitude of birth asphyxia and its determinants in Ethiopia. Methods: The databases, including PubMed, Medline, CINAHL, EMBASE, and other relevant sources, were used to search relevant articles. Both published and unpublished studies, written in English and carried out in Ethiopia, were included in the study. Quality of evidence was assessed by the relevant of the Joanna Briggs Institute tool. RevMan v5.3 statistical software was used to undertake the meta-analysis using a Mantel-Haenszel random-effects model. Heterogeneity was evaluated using the Cochran Q test, and I2 statistics was considered to assess its level. The outcome was measured using a 95% confidence interval (CI). Results: The pooled prevalence of birth asphyxia was 22.8% (95% CI: 13–36.8%]. Illiterate mothers (adjusted odds ratio [AOR]; 1.96, 95% CI: 1.44–2.67), antepartum hemorrhage (APH) (AOR; 3.43, 95% CI: 1.74–6.77), cesarean section (AOR; 3.66, 95% CI: 1.35–9.91), instrumental delivery (AOR; 2.74, 95% CI: 1.48–5.08), duration of labor (AOR; 3.09, 95% CI: 1.60–5.99), pregnancy induced hypertension (AOR; 4.35, 95% CI: 2.98–6.36), induction of labor (AOR; 3.69, 95% CI: 2.26–6.01), parity (AOR; 1.29, 95% CI: 1.03–1.62), low birth weight (LBW) (AOR; 5.17, 95% CI: 2.62–10.22), preterm (AOR; 3.98, 95% CI: 3.00–5.29), non-cephalic presentation (AOR; 4.33, 95% CI: 1.97–9.51), and meconium staining (AOR; 4.59, 95% CI: 1.40–15.08) were significantly associated with birth asphyxia. Conclusion: The magnitude of birth asphyxia was very high. Maternal education, APH, mode of delivery, prolonged labor, induction, LBW, preterm, meconium-staining, and non-cephalic presentation were determinants of birth asphyxia. Hence, to reduce birth asphyxia and associated neonatal mortality, attention should be directed to improve the quality of intrapartum service and timely communication between the delivery team. In addition, intervention strategies aimed at reducing birth asphyxia should target the identified determinants.

Published
2020

46. Cause and predictors of neonatal mortality among neonates admitted to the Neonatal Intensive Care Units of public Hospitals in eastern Ethiopia: Facilities based prospective follow-up study

Author

Assefa Desalew, Yitagesu Sintayehu, Nardos Teferi, Firehiwot Amare, Bifitu Geda, Teshager Worku, Kebebush Abera, and Abiyot Asefaw

Abstract

Background The first month is the most crucial period for child survival. Neonatal mortality continues to remain high with little improvement over the years in Sub-Saharan Africa including Ethiopia. This region shows the least progress to reducing neonatal mortality and it continues to be a significant public health issue. The facilities-based causes and predictors of neonatal death in the neonatal intensive care unit are not well documented in this study setting. Hence, the aim of this study was to determine the causes and predictors of neonatal mortality among infants admitted to the neonatal intensive care units in Eastern Ethiopia. Methods Facilities-based prospective follow-up study was conducted among neonates admitted to the neonatal intensive care units of public hospitals in Eastern Ethiopia from November to December 2018. Data were collected using a pre-tested, structured questionnaire and a follow-up checklist. The main outcomes and causes of death were set by pediatricians and medical residents. Epi-Data 3.1 and Statistical Package for Social Sciences Version 25 software were used for data entry and analysis respectively. Multivariable logistic regression was used to find out the predictors of facilities-based neonatal mortality. Results The proportion of facilities-based neonatal mortality was 20%(95% CI: 16.7-23.8%) The causes of death were complications of preterm birth 28.58%, birth asphyxia 22.45%, infection 18.36%, meconium aspiration syndrome 9.18%, respiratory distress syndrome 7.14% and congenital malformation 4.08%. Low birth weight, preterm births, length of stay in NICU, low 5 minute Apgar score, hyperthermia and initiation of feeding were predictors of neonatal death among infants admitted to the neonatal intensive care units in public hospitals, Eastern Ethiopia. Conclusion The proportion of facilities-based neonatal deaths was unacceptably high. The main causes of death were preventable and treatable. Hence, improving timing and quality of ANC is essential for early detection, anticipating high-risk newborns and timely interventions. Furthermore, early initiation of feeding and a better referral linkage to tertiary facilities could lead to a reduction of neonatal death in this setting.

Published
2020
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47. sj-pdf-1-smo-10.1177_2050312120973480 – Supplemental material for Pregnant women’s satisfaction with antenatal care services and its associated factors at public health facilities in the Harari region, Eastern Ethiopia

Author

Birhanu, Simon, Melake Demena, Yohannes Baye, Assefa Desalew, Bedru Dawud, and Gudina Egata

Subjects
FOS: Veterinary sciences, 111199 Nutrition and Dietetics not elsewhere classified, Cardiology, 170199 Psychology not elsewhere classified, 111799 Public Health and Health Services not elsewhere classified, 110604 Sports Medicine, FOS: Health sciences, 110306 Endocrinology, 110308 Geriatrics and Gerontology, 111099 Nursing not elsewhere classified, 111708 Health and Community Services, 160807 Sociological Methodology and Research Methods, 111702 Aged Health Care, 111403 Paediatrics, 110904 Neurology and Neuromuscular Diseases, 110203 Respiratory Diseases, 110315 Otorhinolaryngology, 70706 Veterinary Medicine, FOS: Clinical medicine, 110319 Psychiatry (incl. Psychotherapy), FOS: Sociology, FOS: Psychology, 110599 Dentistry not elsewhere classified, 110323 Surgery, 110305 Emergency Medicine, 111599 Pharmacology and Pharmaceutical Sciences not elsewhere classified, 111299 Oncology and Carcinogenesis not elsewhere classified, 110314 Orthopaedics
Abstract

Supplemental material, sj-pdf-1-smo-10.1177_2050312120973480 for Pregnant women’s satisfaction with antenatal care services and its associated factors at public health facilities in the Harari region, Eastern Ethiopia by Simon Birhanu, Melake Demena, Yohannes Baye, Assefa Desalew, Bedru Dawud and Gudina Egata in SAGE Open Medicine

Published
2020
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48. Additional_file_2 – Supplemental material for Incomplete Vaccination and Its Predictors among Children in Ethiopia: A Systematic Review and Meta-Analysis

Author

Assefa Desalew, Agumasie Semahegn, Birhanu, Simon, and Gezahegn Tesfaye

Subjects
111099 Nursing not elsewhere classified, FOS: Clinical medicine, FOS: Health sciences, 111403 Paediatrics, 110904 Neurology and Neuromuscular Diseases
Abstract

Supplemental material, Additional_file_2 for Incomplete Vaccination and Its Predictors among Children in Ethiopia: A Systematic Review and Meta-Analysis by Assefa Desalew, Agumasie Semahegn, Simon Birhanu and Gezahegn Tesfaye in Global Pediatric Health

Published
2020
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49. Mapping geographical inequalities in oral rehydration therapy coverage in low-income and middle-income countries, 2000-17

Author

Ninuk Hariyani, Benjamin Uzochukwu, Anas M. Saad, Sivan Yegnanarayana Iyer Saraswathy, Amirhossein Sahebkar, Behzad Karami Matin, Abdallah M. Samy, Roman Topor-Madry, Nelson G.M. Gomes, Afsaneh Arzani, Simin Liu, Maryam Khayamzadeh, Ejaz Ahmad Khan, Asmamaw Bizuneh Demis, Anelisa Jaca, Amir Kasaeian, Fereshteh Ansari, Abdur Razzaque Sarker, Ali Kabir, Jorge Cano, Marcos Roberto Tovani-Palone, Tufa Kolola, Josephine W. Ngunjiri, Roghiyeh Faridnia, Kedir Hussein Abegaz, Hosni Salem, Sharareh Eskandarieh, Norberto Perico, Sergio I. Prada, Fisaha Haile Tesfay, Jai K Das, Ana Isabel Ribeiro, Sameer Vali Gopalani, Dessalegn Haile, Shivakumar Km Marulasiddaiah M. KMShivakumar, Narayan Prasad, Pranab Chatterjee, Shafiu Mohammed, Ravi Prakash Jha, Xiu Ju George Zhao, Farshad Farzadfar, Ahmad Daryani, Pramesh Raj Ghimire, Abbas Mosapour, Ebrahim Babaee, Rajat Das Gupta, Jean Jacques Noubiap, Daniel Bekele Ketema, Teshome Bekele Elema I, Erkin M. Mirrakhimov, Seyed Hossein Yahyazadeh Jabbari, Muktar Beshir Ahmed, Wondimeneh Shibabaw Shiferaw, Mehran Asadi-Aliabadi, Mohamed M. Gad, Eugenio Traini, Milena Santric-Milicevic, Bakhtiar Piroozi, Mohsen Afarideh, Duduzile Ndwandwe, Ibrahim Abdollahpour, Aisha Elsharkawy, Bárbara Niegia Garcia de Goulart, Soufiane Boufous, Obinna Onwujekwe, Seyyed Meysam Mousavi, Azeem Majeed, Meghnath Dhimal, Bruno F. Sunguya, Daniel Adane Endalew, Hosein Shabaninejad, Siddhesh Zadey, Takahiro Tabuchi, Gebrekiros Gebremichael Meles, Davide Guido, Trang Huyen Nguyen, Yonatal Mesfin Tefera, Hala Elhabashy, Devasahayam J. Christopher, Malede Mequanent Sisay, Davide Rasella, Hedayat Abbastabar, Maziar Moradi-Lakeh, Anthony Masaka, Wagaye Fentahun Chanie, B. Suresh Kumar Shetty, Matiwos Soboka Daba, Tesfaye Yitna Yitna Chichiabellu, Arianna Maever L. Amit, Tomohide Yamada, Alireza Rafiei, Reinhard Busse, Abdullah Al Mamun, Genet Melak Alamene, George C Patton, Andem Effiong, Rushdia Ahmed, Jagadish Rao Padubidri, Mohamad-Hani Temsah, Nizal Sarrafzadegan I, Francesco Saverio Violante, Monika Sawhney, Eyal Oren, Kimberly B. Johnson, Benn Sartorius, Shirin Djalalinia, Mohsen Bayati, Merhawi Gebremedhin Tekle, Navid Rabiee, Javad Nazari, Krishna K. Aryal, Kavumpurathu Raman Thankappan, Yoshan Moodley, Anh Kim Dang, Mohammad Khazaei, Parvaiz A Koul, Edson Serván-Mori, Foad Abd-Allah, Seyed Mohammad Riahi, Nader Jahanmehr, Yuming Guo, Sonia Saxena, Bayu Begashaw Bekele, Hagos Degefa de Hidru I, Enayatollah Homaie Rad, Richard C. Franklin, Dara K. Mohammad, Naznin Hossain, Oliver J. Brady, Natalie Maria Cormier, Ghulam Mustafa, Samiah Alam, Guoqing Hu, Yousef Khader, Mohsen Mazidi, Hamed Kalani, Hamideh Salimzadeh, Mayowa O. Owolabi, Ali Bijani, Getu Debalkie Demissie, Tsegaye Lolaso Lenjebo, German Martinez, Elias Merdassa Roro, Hamidreza Komaki, Giovanni Damiani, Nelson Alvis-Guzman, Reza Shirkoohi, Aditya Prasad Dash, Benny Antony, Cheru Tesema Leshargie, Josip Car, Turki Alanzi, Amir Jalali, Shahin Soltani, Arvin Haj-Mirzaian, John S. Ji, Nima Hafezi-Nejad, S. Mohammad Sajadi, Khalid A Altirkawi, Shanshan Li, Hunduma Amensisa Amensisa Bojia I, Estifanos Baye, Hany Aref, Kebreab Paulos, Francisco Rogerlândio Martins-Melo, Shankar M Bakkannavar, Felix Lam, Themba G.G. Ginindza, Behnam Heidari, Chukwudi A Nnaji, Kebadnew Mulatu Mihretie, Mostafa Leili, Sohail Ahmad, Babak Moazen, Samad Azari, Feleke Gebremeskel W, Jacqueline Elizabeth Alcalde-Rabanal, Khanh Bao Tran, Okechukwu S Ogah, Bruno Ramos Nascimento, Tefera Chane Mekonnen, Irina Filip, Bogdan Oancea, Lalit Dandona, Desalegn Markos Shifti, Nasir Salam, Binyam Minuye Birihane, Mohammad Ali Mansournia, Mohammad Ebrahimi Kalan, Sheetal D. Lad, Michael R.M. Abrigo, Ken Lee Chin, Masoud Moradi, Temesgen Yihunie Akalu, Behzad Heibati, Ole Frithjof Norheim, Man Mohan Mehndiratta, Mahya Beheshti, Ali Yadollahpour, Gelin Xu, Siamak Sabour, Neda Izadi, Carlos Culquichicón, Tuomo J. Meretoja, Ireneous N. Soyiri, Jacob Olusegun Olusanya, Félix Carvalho, Hamid Yimam Hassen, Dereje Bayissa Demissie, Yun Jin Kim, Rajesh Sagar, Fakher Rahim, Catrin E. Moore, Thomas R. Hird, Amjad Mohamadi-Bolbanabad, Naser Mohammad Gholi Mezerji, Ahamarshan Jayaraman Nagarajan, Anton Sokhan, Faris Lami, Masoud Behzadifar, Ritesh G. Menezes, Amira Hamed Darwish, Mohammad Zamani, Tesleem Kayode Babalola, Navid Manafi, Charles Shey Wiysonge, Diego Augusto Santos Silva, Daniel Diaz, Eleonora Dubljanin, Soraya Nouraei Motlagh, Suraj Bhattarai, Getasew Taddesse Worku, Noore Alam, Jasvinder A. Singh, Catalina Liliana Andrei, Ali Kazemi Karyani, Robert C. Reiner, Mohammedaman Mama Hussen, Fatemeh Heydarpour, Nuruzzaman Khan I, Bach Xuan Tran, Lal B. Rawal, Bereket Duko, Joemer C. Maravilla, Rakhi Dandona, Sandra B. Munro, Jae Il Shin, Julia Moreira Pescarini, Claudiu Herteliu, Ahmed Abdelalim, Manasi Kumar, Pushpendra Kumar, Saleem Muhammad Rana, Hedley Quintana, Akram Pourshams, Franz Castro, Muhammad Aziz Rahman, Beyene Meressa Adhena, Aberash Abay Tasew, Linda Morales, Dawit Zewdu Wondafrash, Wasiq Faraz Rawasia, David Laith Rawaf, Zoubida Zaidi, Tomislav Mestrovic, Rajeev Gupta, Seyyede Masoume Athari, Peter Njenga Keiyoro, Andrea Werdecker, Santi Martini, Fatemeh Rajati, Andre Pascal Kengne, Victor Adekanmbi, Seid Tiku Mereta, Yared Asmare Aynalem, Kewal Krishan, Marzieh Nojomi, Yves Miel H Zuniga, Mohammad Reza Sobhiyeh, Frank B. Osei, Nefsu Awoke, Randah R. Hamadeh, G. K. Mini, Edris Hasanpoor, Ayele Geleto Bali, Moslem Soofi, Prabhat Lamichhane, Peter Azzopardi, Amir Khater, G Anil Kumar, Catherine A. Welgan, Abraham Getachew Kelbore, Jaifred Christian F. Lopez, Senthilkumar Balakrishnan, Mohammad Ali Sahraian, Ahmed I. Hasaballah, Virendra Singh, Arash Ziapour, Zahid A Butt, Hebat Allah Salah A. Yousof, Tewodros Eshete Wonde, Sanjay Zodpey, Amaha Kahsay, Achala Upendra Jayatilleke, Segun Emmanuel Ibitoye, Beriwan Abdulqadir Ali, Simin Mouodi, Salman Rawaf, Iqbal R. F. Elyazar, Ai-Min Wu, Seyed Sina Naghibi Irvani, Yasir Waheed, Delia Hendrie, Hadi Pourjafar, Farnam Mohebi, Naohiro Yonemoto, Ahmad Ghashghaee, Veincent Christian Filipino Pepito, Paulina A. Lindstedt, Nauman Khalid, Sezer Kisa, Chi Linh Hoang, Niranjan Kissoon, Kindie Fentahun Muchie, Valery L. Feigin, Mathew M. Baumann, Alemayehu Toma, Andre Rodrigues Duraes, Benjamin B. Massenburg, Santosh Varughese, Yuan-Pang Wang, Ingan Ukur Tarigan, Ali Kiadaliri, Hamed Zandian, Demelash Woldeyohannes Handiso, Hassan Magdy Abd El Razek, Ketema Bizuwork Gebremedhin, Hafiz Ansar Rasul Suleria, Oluchi Ezekannagha, Getinet Ayano, Bolajoko O. Olusanya, Manu Raj Mathur, Manfred Accrombessi, Christopher J L Murray, Moritz U. G. Kraemer, Saeed Amini, Ziad A. Memish, Yousef Mohammad, Luis Camera, Ernoiz Antriyandarti, Ronny Westerman, Meghdad Pirsaheb, Negar Rezaei, Ted R. Miller, Aziz Eftekhari, Nevine El Nahas, Sebastian Vollmer, Sanjay Basu, Hesham M. Al-Mekhlafi, D. R. Mahadeshwara Prasad, Rufus A. Adedoyin, Miliva Mozaffor I, Mihiretu Kebede, Preeti Dhillon, Dilaram Acharya, Iman El Sayed, Narendar Manohar, Paul S. F. Yip, Ben Lacey, Felix Akpojene Ogbo, Adrian Davis, Dinh-Toi Chu, Ranjani Somayaji, Raaj Kishore Biswas, Taddese Alemu Zerfu, Claudio Alberto Dávila-Cervantes, Sharath Burugina Nagaraja, Getachew Mullu Kassa, Mohan Bairwa, Gurudatta Naik, André Karch, Gudlavalleti V S Murthy, Avula Laxmaiah, Farid Najafi, Birhanu Geta Meharie, Lorenzo Monasta, Amit Arora, Christopher S Yilgwan, Samer Hamidi, Keivan Ahmadi, Kebede Deribe, Ehimario U. Igumbor, Engida Yisma, Henok Biresaw Netsere, Mihajlo Jakovljevic, Ali S. Shalash, Thirunavukkarasu Sathish, Sachin R Atre, Mohamed I Hegazy, Mehedi Hasan, Hamidreza Haririan, Lucas Guimarães Abreu, Nejimu Biza Zepro, Surendra Karki, Krittika Bhattacharyya, Hiroshi Yatsuya, Gbenga A. Kayode, Osayomwanbo Osarenotor, Paul H. Lee, Deepak Paudel, Hagos Tasew Atalay, Hatem S Shehata, Mohammad Fareed, Adnan Kisa, Hisham Atan Edinur, Mehran Alijanzadeh, Shafiur Rahman, Mohammad Hossein Khosravi, Anusha Ganapati Bhat, Bahram Mohajer, Narinder Pal Singh, Shai Linn, Savita Lasrado, Joseph Adel Mattar Banoub, Amir Almasi-Hashiani, Mohd Anisul Karim, Praveen Hoogar, Kerrie E. Doyle, Bedilu Girma Weji, Juan Sanabria, Olatunji O. Adetokunboh, Mohamed Hsairi, Alireza Esteghamati, Seok Jun Yoon, Paramjit Gill, Dabere Nigatu, Tariq Jamal Siddiqi, Muhammad Usman, Rafael Alves Guimarães, Zemenu Tadesse Tessema, Aziz Sheikh, Florian Fischer, Peter Memiah, Rakesh Lodha, Nihal Thomas, Karzan Abdulmuhsin Mohammad, Mohammad Sadegh Rezai, Tanuj Kanchan, Vinay Nangia, Ashraf Nabhan, Gebre Teklemariam Demoz, Eirini Skiadaresi, Aleksandra Barac, Simon I. Hay, Sadaf G. Sepanlou, Michellr L. Bell, Nicola Luigi Bragazzi, Aklilu Endalamaw, Vishnu Renjith, Chinwe Juliana Iwu, Gabrielle B. Britton, Colm McAlinden, Ayenew Negesse Abejie, Smita Pakhale, Doris V.V. Ortega-Altamirano, Noushin Mohammadifard, Deborah Carvalho Malta, Vo Dinh Bay, Kirsten E. Wiens, Hamidreza Karimi-Sari, Mustafa Z. Younis, Shaimaa I. El-Jaafary, Morenike Oluwatoyin Folayan, Phetole Walter Mahasha, Mu'awiyyah Babale Sufiyan, Harish Chander Gugnani, Mohammad Hifz Ur Rahman, Sheikh Mohammed Shariful Islam, Maarten J. Postma, Usman Iqbal, Abdu A. Adamu, Marwa R.Rashad Salem I, Fares Alahdab, Vafa Rahimi-Movaghar, Zulfiqar A. Bhutta, Masoud Foroutan, Muhammad Shahzeb Khan, In-Hwan Oh, Yahya Salimi, Takeshi Fukumoto, Chhabi Lal Ranabhat, Tiffany K. Gill, Angel Paternina-Caicedo, Walter Mendoza, Sojib Bin Zaman, Olayinka Stephen Ilesanmi, Brigette F. Blacker, Anbissa Muleta Senbeta, Subramanian Senthilkumaran, Ambrish Singh, Mehdi Fazlzadeh, Mahesh P A, Carlo La Vecchia, Alex Yeshaneh, Benjamin K. Mayala, Aniruddha Deshpande, Agus Sudaryanto, Neeraj Bedi, Morteza Shamsizadeh, Jemal Abdu Mohammed, Vahid Alipour, Haileab Fekadu Wolde, Boris Bikbov, Ahmed Abualhasan, Ali H. Mokdad, Eduarda Fernandes, Chandrashekhar T Sreeramareddy, Jacek Jerzy Jozwiak, Alessandra C. Goulart, Mahmoud Yousefifard, Masood Ali Shaikh, Roya Safari-Faramani, MohammadBagher Shamsi, Aso Mohammad Darwesh, Amir Anoushiravani, Kebede Embaye Gezae, Degena Bahrey Tadesse, Paula Moraga, Maha El Tantawi, Rosario Cárdenas, Assefa Desalew, Vivek Kumar, Mina Anjomshoa, Junaid Khan, Jagdish Khubchandani, Marcel Ausloos, Soraya Siabani, Anwar E. Ahmed, Mohammed Ibrahim Mohialdeen Gubari, Andre M. N. Renzaho, Vuong Minh Nong, Kaushik Sarkar, Bruno Piassi Sao Jose, Yafeng Wang, Mitchell T. Wallin, Edgar Denova-Gutiérrez, Mohammad Hasan Imani-Nasab, Melese Abate Reta, Kala M. Mehta, Yahya Safari, Marufa Sultana, David C. Schwebel, Roghayeh Mohammadibakhsh, Samath D Dharmaratne, Maysaa El Sayed Zaki, Shiwei Liu, Gail Davey, Milena Ilic, Yunquan Zhang, Bahram Armoon, Seyed-Mohammad Fereshtehnejad, Jost B. Jonas, Dian Kusuma, Yawukal chane Kasahun, Beatriz Paulina Ayala Quintanilla, Mohammad Moradi-Joo, Gebrehiwot G. Kassa, Maria Jesus Rios-Blancas, Serge Resnikoff, Seifadin Ahmed Shallo, Bartosz Miazgowski, Huda Basaleem, Jobert Richie Nansseu, Enrico Rubagotti, Carl Abelardo T. Antonio, Morteza Abdullatif Khafaie, Meysam Behzadifar, Maryam Adabi, Saravanan Muthupandian, Soumyadeep Bhaumik, hawariat, Carlos A Castañeda-Orjuela, Bhaskaran Unnikrishnan, Martin Amogre Ayanore, Dragos Virgil Davitoiu, Hossein Poustchi, Moses K. Muriithi, Dharmesh Kumar Lal, Ayman Grada, Rafael Tabarés-Seisdedos, Seyyed Shamsadin Athari, Ashish Pathak, Salvatore Rubino, Kenji Shibuya, Ana Laura Manda, Muluken Bekele Sorrie, Vivekanand Jha, Habtamu Kebebe Kasaye, Mohammad Hoseini, Sonali Kochhar, Van C. Lansingh, Ali Almasi, Amir Radfar, Till Bärnighausen, Marcia R. Weaver, Mowafa Househ, Arya Haj-Mirzaian, Gebremicheal Gebreslassie Kasahun, Arash Etemadi, Getahun Fentaw Mulaw, Zubair Kabir, Cuong Tat Nguyen, Chabila C Mapoma, Aubrey J. Levine, Solomon Gedlu Nigatu, Aslam Pervaiz, Muhammed Magdy Abd El Razek, Nataliya A. Foigt, Andrey Nikolaevich Briko, Sadaf Esteghamati, Chuanhua Yu, Pascual R. Valdez, Jennifer Rickard, Jennifer M. Ross, Ionut Negoi, Hailay Abrha Gesesew, Kamarul Imran Musa, Farshad Pourmalek, Kiomars Sharafi, Sangram Kishor Patel, Vera Marisa Costa, Mostafa Hosseini, Hajer Elkout, Mika Shigematsu, Bryan L. Sykes, Afarin Rahimi-Movaghar, Nuworza Kugbey, Vijay Kumar Chattu, Payman Salamati, Mona M. Khater, Reta Tsegaye Gayesa, Ehsan Sadeghi, Andrew T Olagunju, Govinda Prasad Dhungana, Dina Nur Anggraini Ningrum, Yaschilal Muche Belayneh, Leonardo Roever, Luca Ronfani, Nathaniel J. Henry, Brijesh Sathian, Hamid Sharifi, Liliana Preotescu, Joshua Longbottom, Somayeh Bohlouli, Huong Lan Thi Nguyen, Khaled Khatab, Ziyad Al-Aly, Ghobad Moradi, Ruth W Kimokoti, Jalal Arabloo, Mariam Molokhia, Maciej Banach, Hasan Yusefzadeh, Rahman Shiri, Girmay Teklay Weldesamuel, Mekdes Tigistu Yilma, Taweewat Wiangkham, Soewarta Kosen, Kovin Naidoo, Fernando de la Hoz, Mohammed Shannawaz, Berhe Etsay Tesfay I, Yogesh Sabde, Syed Mohamed Aljunid, Belay Tessema, Reza Malekzadeh, Tinuke O Olagunju, Olatunde Aremu, Mohammad Reza Salahshoor, Derrick A Bennett, Oladimeji M. Adebayo, Teshome Gebre, Narayan Bahadur Mahotra, Nelson J. Alvis-Zakzuk, Lauren E. Schaeffer, Alexandre C. Pereira, Mehdi Naderi, Mehdi Hosseinzadeh, Mehran Shams-Beyranvand, Ilais Moreno Velásquez, Rovshan Khalilov, Ai Koyanagi, Salman Khazaei, Ismael R. Campos-Nonato, Alaa Badawi, Amir Hasanzadeh, Gebreamlak Gebremedhn Gebremeskel, Gessessew Bugssa Hailu, Dessalegn Ajema Berbada, Kate E. LeGrand, Azadeh Shafieesabet, Nikolay Ivanovich Briko, Robert S. Bernstein, Irfan Ullah, Isaac Oluwafemi Dipeolu, Hadi Hassankhani, Keyghobad Ghadiri, Local Burden of Disease Diarrhoea Collaborator, Violante FS, Wiens, KE, Lindstedt, PA, Blacker, BF, Johnson, KB, Yisma, E, Ahmed, Muktar Beshir, Reiner, Robert C, Duko, Bereket, Local Burden of Disease Diarrhoea Collaborators, Microbes in Health and Disease (MHD), Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Value, Affordability and Sustainability (VALUE), Local Burden Dis Diarrhoea, Department of Earth Observation Science, UT-I-ITC-ACQUAL, Faculty of Geo-Information Science and Earth Observation, GeoHealth, HUS Comprehensive Cancer Center, Clinicum, Institute for Molecular Medicine Finland, Department of Oncology, University of Helsinki, and Instituto de Saúde Pública da Universidade do Porto

Subjects
RJ101, medicine.medical_treatment, CHILDREN, ZINC, 0302 clinical medicine, 030212 general & internal medicine, media_common, Geography, lcsh:Public aspects of medicine, 1. No poverty, Low income and middle income countries, General Medicine, 3142 Public health care science, environmental and occupational health, 3. Good health, Child, Preschool, A990 Medicine and Dentistry not elsewhere classified, Geographical inequalities, 0605 Microbiology, Diarrhea, AFRICA, Inequality, DEATHS, media_common.quotation_subject, 030231 tropical medicine, Developing country, Article, RS, 1117 Public Health and Health Services, 03 medical and health sciences, MORBIDITY, Environmental health, DIARRHEAL DISEASE, medicine, Humans, Oral rehydration therapy, Healthcare Disparities, Developing Countries, Models, Statistical, CHOLERA, MORTALITY, Infant, Newborn, Infant, lcsh:RA1-1270, Bayes Theorem, Middle income, GLOBAL BURDEN, Child mortality, 0605 Microbiology, 1117 Public Health and Health Services, Health Care Surveys, ITC-ISI-JOURNAL-ARTICLE, Fluid Therapy, NA, Human medicine, ITC-GOLD
Abstract

Background: Oral rehydration solution (ORS) is a form of oral rehydration therapy (ORT) for diarrhoea that has the potential to drastically reduce child mortality; yet, according to UNICEF estimates, less than half of children younger than 5 years with diarrhoea in low-income and middle-income countries (LMICs) received ORS in 2016. A variety of recommended home fluids (RHF) exist as alternative forms of ORT; however, it is unclear whether RHF prevent child mortality. Previous studies have shown considerable variation between countries in ORS and RHF use, but subnational variation is unknown. This study aims to produce high-resolution geospatial estimates of relative and absolute coverage of ORS, RHF, and ORT (use of either ORS or RHF) in LMICs. Methods: We used a Bayesian geostatistical model including 15 spatial covariates and data from 385 household surveys across 94 LMICs to estimate annual proportions of children younger than 5 years of age with diarrhoea who received ORS or RHF (or both) on continuous continent-wide surfaces in 2000-17, and aggregated results to policy-relevant administrative units. Additionally, we analysed geographical inequality in coverage across administrative units and estimated the number of diarrhoeal deaths averted by increased coverage over the study period. Uncertainty in the mean coverage estimates was calculated by taking 250 draws from the posterior joint distribution of the model and creating uncertainty intervals (UIs) with the 2·5th and 97·5th percentiles of those 250 draws. Findings: While ORS use among children with diarrhoea increased in some countries from 2000 to 2017, coverage remained below 50% in the majority (62·6%; 12 417 of 19 823) of second administrative-level units and an estimated 6 519 000 children (95% UI 5 254 000-7 733 000) with diarrhoea were not treated with any form of ORT in 2017. Increases in ORS use corresponded with declines in RHF in many locations, resulting in relatively constant overall ORT coverage from 2000 to 2017. Although ORS was uniformly distributed subnationally in some countries, within-country geographical inequalities persisted in others; 11 countries had at least a 50% difference in one of their units compared with the country mean. Increases in ORS use over time were correlated with declines in RHF use and in diarrhoeal mortality in many locations, and an estimated 52 230 diarrhoeal deaths (36 910-68 860) were averted by scaling up of ORS coverage between 2000 and 2017. Finally, we identified key subnational areas in Colombia, Nigeria, and Sudan as examples of where diarrhoeal mortality remains higher than average, while ORS coverage remains lower than average. Interpretation: To our knowledge, this study is the first to produce and map subnational estimates of ORS, RHF, and ORT coverage and attributable child diarrhoeal deaths across LMICs from 2000 to 2017, allowing for tracking progress over time. Our novel results, combined with detailed subnational estimates of diarrhoeal morbidity and mortality, can support subnational needs assessments aimed at furthering policy makers' understanding of within-country disparities. Over 50 years after the discovery that led to this simple, cheap, and life-saving therapy, large gains in reducing mortality could still be made by reducing geographical inequalities in ORS coverage. This work was primarily supported by a grant from the Bill & Melinda Gates Foundation (OPP1132415). L G Abreu has received support from Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (Finance Code 001), Conselho Nacional de Desenvolvimento Científico e Tecnológico and Fundação de Amparo à Pesquisa do Estado de Minas Gerais. O O Adetokunboh acknowledges the South African Department of Science and Innovation and the National Research Foundation. S M Aljunid acknowledges the Department of Health Policy and Management, Faculty of Public Health, Kuwait University and International Centre for Casemix and Clinical Coding, Faculty of Medicine, National University of Malaysia for the approval and support to participate in this research project. H T Atalay acknowledges Aksum University. M Ausloos and C Herteliu are partially supported by a grant of the Romanian National Authority for Scientific Research and Innovation, CNDS-UEFISCDI, project number PN-III-P4-ID-PCCF-2016-0084. P S Azzopardi was supported by an Australian National Health and Medical Research Council (NHMRC) early career fellowship. A Badawi is supported by the Public Health Agency of Canada. T W Bärnighausen was supported by the Alexander von Humboldt Foundation through the Alexander von Humboldt Professor award, funded by the German Federal Ministry of Education and Research; the EU; the Wellcome Trust; and from National Institute of Child Health and Human Development of National Institutes of Health (NIH; R01-HD084233), National Institute on Aging of NIH (P01-AG041710), National Institute of Allergy and Infectious Diseases of NIH (R01-AI124389 and R01-AI112339), as well as Fogarty International Center of NIH (D43-TW009775). G B Britton is supported by Sistema Nacional de Investigación (SNI) de la Secretaría Nacional de Ciencia, Tecnología e Innovación (SENACYT) of Panamá. A Barac is funded by the Project of Ministry of Education, Science and Technology of the Republic of Serbia (number III45005). D A Bennett was supported by the National Institute for Health Research (NIHR) Oxford Biomedical Research Centre. The views expressed are those of the authors and not necessarily those of the National Health Service, the NIHR, or the UK Department of Health and Social Care. V M Costa acknowledges her grant (SFRH/BHD/110001/2015), received by Portuguese national funds through Fundação para a Ciência e Tecnologia (FCT), IP, under the Norma Transitória DL57/2016/CP1334/CT0006. F Carvalho acknowledges UID/MULTI/04378/2019 and UID/QUI/50006/2019 support with funding from FCT/Ministério da Ciência, Tecnologia e Ensino Superior through national funds. K Deribe is supported by a Wellcome Trust grant (number 201900/Z/16/Z) as part of his International Intermediate Fellowship. C Herteliu is partially supported by a grant co-funded by European Fund for Regional Development through the Operational Program for Competitiveness (project ID P_40_382). P Hoogar thanks Centre for Bio Cultural Studies, Directorate of Research, Manipal Academy of Higher Education, Manipal and Centre for Holistic Development and Research, Kalaghatgi-Karnataka. S M S Islam is funded by a Fellowship from National Heart Foundation of Australia and Deakin University. M Jakovljevic and the Serbian part of this GBD contribution was co-funded through grant OI175014 of the Ministry of Education Science and Technological Development of the Republic of Serbia. A P Kengne is supported by the South African Medical Research Council. Y J Kim's work was supported by the Research Management Centre, Xiamen University Malaysia, grants number XMUMRF/2018-C2/ITCM/0001. K Krishan is supported by a DST PURSE grant and UGC Center of Advanced Study awarded to the Department of Anthropology, Panjab University, Chandigarh, India. M Kumar acknowledges K43 TW010716-03. B Lacey acknowledges support from the NIHR Oxford Biomedical Research Centre and the British Heart Foundation Centre of Research Excellence, Oxford. P T N Memiah acknowledges the Council for the Development of Social Science Research in Africa. M Molokhia is supported by the NIHR Biomedical Research Center at Guy's and St Thomas' National Health Service Foundation Trust and King's College London. I Moreno Velásquez is supported by the Sistema Nacional de Investigación (SENACYT, Panamá). G C Patton is funded by an NHMRC Fellowship. A M Samy received a fellowship from the Egyptian Fulbright Mission programme. M M Santric-Milicevic acknowledges the support of the Ministry of Education, Science and Technological Development of the Republic of Serbia (contract number 175087). A Sheikh acknowledges the support of Health Data Research UK. M R Sobhiyeh acknowledges the Clinical Research Development Center of Imam Reza Hospital, Kermanshah University of Medical Sciences for their wise advice. R Tabarés-Seisdedos was supported in part by grant PI17/00719 from Instituto de Salud Carlos III–FEDER. B Unnikrishnan acknowledges Manipal Academy of Higher Education, Manipal. M R Weaver was supported by the Bill & Melinda Gates Foundation grant OPP1127433. C S Wiysonge was supported by the South African Medical Research Council.

Published
2020
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50. Additional_file_1 – Supplemental material for Childhood hearing impairment and its associated factors in sub-Saharan Africa in the 21st century: A systematic review and meta-analysis

Author

Assefa Desalew, Tilayie Feto Gelano, Agumasie Semahegn, Biftu Geda, and Tilahun Ali

Subjects
FOS: Veterinary sciences, 111199 Nutrition and Dietetics not elsewhere classified, Cardiology, 170199 Psychology not elsewhere classified, 111799 Public Health and Health Services not elsewhere classified, 110604 Sports Medicine, FOS: Health sciences, 110306 Endocrinology, 110308 Geriatrics and Gerontology, 111099 Nursing not elsewhere classified, 111708 Health and Community Services, 160807 Sociological Methodology and Research Methods, 111702 Aged Health Care, 111403 Paediatrics, 110904 Neurology and Neuromuscular Diseases, 110203 Respiratory Diseases, 110315 Otorhinolaryngology, 70706 Veterinary Medicine, FOS: Clinical medicine, 110319 Psychiatry (incl. Psychotherapy), FOS: Sociology, FOS: Psychology, 110599 Dentistry not elsewhere classified, 110323 Surgery, 110305 Emergency Medicine, 111599 Pharmacology and Pharmaceutical Sciences not elsewhere classified, 111299 Oncology and Carcinogenesis not elsewhere classified, 110314 Orthopaedics
Abstract

Supplemental material, Additional_file_1 for Childhood hearing impairment and its associated factors in sub-Saharan Africa in the 21st century: A systematic review and meta-analysis by Assefa Desalew, Tilayie Feto Gelano, Agumasie Semahegn, Biftu Geda and Tilahun Ali in SAGE Open Medicine

Published
2020
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