Search

Background: One of the main factors contributing to maternal morbidity and mortality is induced abortion. The WHO estimates that over 44 million induced abortions take place annually around the world. The majority of these abortions—about 50%—are unsafe, significantly increasing maternal morbidity and contributing to 13% of maternal deaths. Thus, this review aimed to estimate the pooled prevalence of induced abortion and its associated factors in Africa. Methods: To find literature on the prevalence of induced abortion and its associated factors, a thorough search of the internet databases such as PubMed/MEDLINE, African Journals Online, and Google Scholar was conducted. The data were extracted using a structured method of data collection. Software called STATA 14 was used to do the analysis. funnel plot and Egger regression test were used to evaluate potential publication bias. I2 statistics and Cochrane's Q were used to measure the heterogeneity at a p-value < 0.05. Results: 976 studies were found through a thorough search of electronic databases. Finally, 46 full-text abstract papers were included in this study. The estimated pooled prevalence of induced abortion was 16% (95% CI: 13%-19%). According to the sub-group analysis, most studies were conducted in Ethiopia, and the pooled prevalence was 19% (95% CI: 10%–30%). Similarly, the subgroup analysis by year of study showed that the prevalence of induced abortion was 39% (95% CI: 17%–64%) among studies conducted in 2019. Conclusion: The results of this study thus imply that the pooled prevalence of induced abortion is higher than that of earlier studies that were published in some nations. the data from this study are needed to support reproductive and adolescent health programmers and policymakers and to formulate recommendations for future clinical practice and guidelines. [ABSTRACT FROM AUTHOR]

Since 2016, fall armyworm (FAW) has threatened sub-Saharan 'Africa's fragile food systems and economic performance. Yet, there is limited evidence on this transboundary pest's economic and food security impacts in the region. Additionally, the health and environmental consequences of the insecticides being used to control FAW have not been studied. This paper presents evidence on the impacts of FAW on maize production, food security, and human and environmental health. We use a combination of an agroecology-based community survey and nationally representative data from an agricultural household survey to achieve our objectives. The results indicate that the pest causes an average annual loss of 36% in maize production, reducing 0.67 million tonnes of maize (0.225 million tonnes per year) between 2017 and 2019. The total economic loss is US$ 200 million, or 0.08% of the gross domestic product. The lost production could have met the per capita maize consumption of 4 million people. We also find that insecticides to control FAW have more significant toxic effects on the environment than on humans. This paper highlights governments and development partners need to invest in sustainable FAW control strategies to reduce maize production loss, improve food security, and protect human and environmental health. [ABSTRACT FROM AUTHOR]

Background: Geospatial data are important in monitoring many aspects of healthcare development. Geographically linking health facility data with population data is an important area of public health research. Examining healthcare problems spatially and hierarchically assists with efficient resource allocation and the monitoring and evaluation of service efficacy at different levels. This paper explored methodological issues associated with geographic data linkage, and the spatial and multilevel analyses that could be considered in analysing maternal health service data. Methods: The 2016 Ethiopia Demographic and Health Survey and the 2014 Ethiopia Service Provision Assessment data were used. Two geographic data linking methods were used to link these two datasets. Administrative boundary link was used to link a sample of health facilities data with population survey data for analysing three areas of maternal health service use. Euclidean buffer link was used for a census of hospitals to analyse caesarean delivery use in Ethiopia. The Global Moran’s I and the Getis-Ord Gi* statistics need to be carried out for identifying hot spots of maternal health service use in ArcGIS software. In addition to this, since the two datasets contain hierarchical data, a multilevel analysis was carried out to identify key determinants of maternal health service use in Ethiopia. Results: Administrative boundary link gave more types of health facilities and more maternal health services as compared to the Euclidean buffer link. Administrative boundary link is the method of choice in case of sampled health facilities. However, for a census of health facilities, the Euclidean buffer link is the appropriate choice as this provides cluster level service environment estimates, which the administrative boundary link does not. Applying a False Discovery Rate correction enables the identification of true spatial clusters of maternal health service use. Conclusions: A service environment link minimizes the methodological issues associated with geographic data linkage. A False Discovery Rate correction needs to be used to account for multiple and dependent testing while carrying out local spatial statistics. Examining maternal health service use both spatially and hierarchically has tremendous importance for identifying geographic areas that need special emphasis and for intervention purposes. [ABSTRACT FROM AUTHOR]

Introduction: Severe malaria often results in childhood disability. The prevalence of disability related to severe malaria is significant and is estimated to affect up to 53% of severe malaria survivors. In contrast, information is sparse about how healthcare providers in Africa think about or provide rehabilitation support in acute and post-acute phases respectively. Understanding the perceptions and behaviors of healthcare providers treating malaria could help inform malaria-related disability research, policy, and practice, aimed at the providers themselves. This study explored the perceptions and behaviors of healthcare providers towards rehabilitation for children with severe malaria-related disability. The Theoretical Domains Framework was used to describe the findings relative to wider literature on health provider behavior change. Methods: A qualitative descriptive approach was used to interview thirteen healthcare providers recruited purposively based on their clinical professions, roles, and settings. Data were analyzed using directed content analysis. We decided on the most prominent theoretical domains considering the frequency of specific perceptions and behaviors across the participants, the frequency of perceptions and behaviors in each domain, and evidence of strong perceptions and behaviors. Results: Nine out of fourteen theoretical domains were identified. These domains were: Beliefs about consequences, environmental context and resources, goals, knowledge, skills, optimism, reinforcement, social influences, and social or professional role and identity. Healthcare providers' beliefs about their roles in screening for disability or referring to rehabilitation were less positive. Conclusions: The findings of this study suggest the need for interventions to support healthcare providers in acute phases (prevention and control of severe malaria) and post-acute phases (disability screening, referral, and rehabilitation care). Recommended interventions should focus on developing clinical guidelines, training clinicians, addressing institutional factors, and modifying external social influences such as socio-cultural factors. [ABSTRACT FROM AUTHOR]

Many tropical wet forests are species-rich and have relatively even species frequency distributions. But, dominance by a single canopy species can also occur in tropical wet climates and can remain stable for centuries. These are uncommon globally, with the African wet tropics supporting more such communities than the Neotropics or Southeast Asia. Differences in regional evolutionary histories are implied by biogeography: most of Africa's monodominance-forming species are Amherstieae-tribe legumes; monodominance in Neotropical forests occur among diverse taxonomic groups, often legumes, but rarely Amherstieae, and monodominance in Southeast Asian forests occurs mostly among Dipterocarpaceae species. African monodominant forests have been characterized ecologically and taxonomically, but their deep-time history is unknown despite their significant presence and bottom-up ecological influence on diversity. Herein we describe fossil leaflets of Englerodendron mulugetanum sp. nov., an extinct species of the extant genus Englerodendron (Berlinia Clade, Amherstieae, Detarioideae) from the 21.73 Ma Mush Valley site in Ethiopia. We also document a detailed study of associated legume pollen, which originate from a single taxon sharing characters with more than one extant descendant. Taxonomically, the pollen is most comparable to that from some extant Englerodendron species and supports a likely affiliation with the Englerodendron macrofossils. The Mush Valley site provides the first fossil evidence of a monodominant tropical forest in Africa as represented by leaflets and pollen. Previous studies documented >2400 leaves and leaflets from localities at six stratigraphic levels spanning 50,000–60,000 years of nearly continuous deposition within seven meters of section; all but the basal level contain ≥ 50% E. mulugetanum leaflets. Modern leaf litter studies in African mixed vs. monodominant forests indicates the likelihood of monodominance in the forests that surrounded the Mush paleolake, particularly after the basal level. Thus, we provide an early case for monodominance within the Amherstieae legumes in Africa. [ABSTRACT FROM AUTHOR]

Wheat rusts are the key biological constraint to wheat production in Ethiopia—one of Africa's largest wheat producing countries. The fungal diseases cause economic losses and threaten livelihoods of smallholder farmers. While it is known that wheat rust epidemics have occurred in Ethiopia, to date no systematic long-term analysis of past outbreaks has been available. We present results from one of the most comprehensive surveillance campaigns of wheat rusts in Africa. More than 13,000 fields have been surveyed during the last 13 years. Using a combination of spatial data-analysis and visualization, statistical tools, and empirical modelling, we identify trends in the distribution of wheat stem rust (Sr), stripe rust (Yr) and leaf rust (Lr). Results show very high infection levels (mean incidence for Yr: 44%; Sr: 34%; Lr: 18%). These recurrent rust outbreaks lead to substantial economic losses, which we estimate to be of the order of 10s of millions of US-D annually. On the widely adopted wheat variety, Digalu, there is a marked increase in disease prevalence following the incursion of new rust races into Ethiopia, which indicates a pronounced boom-and-bust cycle of major gene resistance. Using spatial analyses, we identify hotspots of disease risk for all three rusts, show a linear correlation between altitude and disease prevalence, and find a pronounced north-south trend in stem rust prevalence. Temporal analyses show a sigmoidal increase in disease levels during the wheat season and strong inter-annual variations. While a simple logistic curve performs satisfactorily in predicting stem rust in some years, it cannot account for the complex outbreak patterns in other years and fails to predict the occurrence of stripe and leaf rust. The empirical insights into wheat rust epidemiology in Ethiopia presented here provide a basis for improving future surveillance and to inform the development of mechanistic models to predict disease spread. [ABSTRACT FROM AUTHOR]

Introduction: Some studies in developing countries have shown that infant mortality is highly associated with maternal education, implying that maternal education might play an important role in the reduction of infant mortality. However, other research has shown that lower levels of maternal education does not have any significant contribution to infant survival. In this systematic review, we focus on the effect of different levels of maternal education on infant mortality in Ethiopia. Methods: MEDLINE, EMBASE, CINAHL, Scopus, and Maternity and Infant Care databases were searched between November 15, 2017 and February 20, 2018. All articles published until February 20, 2018 were included in the study. The data extraction was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA 2009) guidelines. An I2 test was used to assess heterogeneity and a funnel plot was used to check publication bias. Findings: We retrieved 441 records after removing duplications. During screening, 31 articles were fully accessed for data extraction. Finally, five articles were included for analysis. The overall pooled estimate indicated that attending primary education was associated with a 28% reduction in the odds of infant mortality compared to those infants born to mothers who were illiterate, OR: 0.72 (95% CI = 0.66, 0.78). Another pooled estimate indicated that attending secondary education and above was associated with a 45% reduction in the odds of infant mortality compared to those infants born to mothers who were illiterate, OR: 0.55 (95% CI = 0.47, 0.64). Conclusion: From this study, understanding the long-term impact of maternal education may contribute to reduce infant mortality. Therefore, policy makers should give more attention in promoting the role of women through removing institutional and cultural barriers, which hinder women from access to education in order to reduce infant mortality in Ethiopia. [ABSTRACT FROM AUTHOR]

This study assessed households’ resilience to climate change-induced shocks in Dinki watershed, northcentral highlands of Ethiopia. The data were collected through a cross-sectional survey conducted on 288 households, three focus group discussions, and 15 key informant interviews. The Climate Resilience Index (CRI) based on the three resilience capacities (absorptive, adaptive and transformative) frame was used to measure households’ resilience to climate change-induced shocks on an agro-ecological unit of analysis. A principal component analysis (PCA) and multiple regression analysis were used to identify determinant factors and indicators to households’ resilience, respectively. Findings indicate that the indexed scores of major components clearly differentiated the study communities in terms of their agro-ecological zones. Specifically, the absorptive capacity (0.495) was the leading contributing factor to resilience followed by adaptive (0.449) and transformative (0.387) capacities. Likewise, the Midland was relatively more resilient with a mean index value of 0.461. Both the PCA and multiple regression analysis indicated that access to and use of livelihood resources, such as farmlands and livestock holdings, diversity of income sources, infrastructure and social capital were determinants of households’ resilience. In general, it might be due to their exposure to recurrent shocks coupled with limited adaptive capacities including underdeveloped public services, poor livelihood diversification practices, among others, the study communities showed minimal resilience capacity with a mean score of 0.44. Thus, in addition to short-term buffering strategies, intervention priority focusing on both adaptive and transformative capacities, particularly focusing on most vulnerable localities and constrained livelihood strategies, would contribute to ensuring long-term resilience in the study communities. [ABSTRACT FROM AUTHOR]

Background: The increase in the frequency of extreme events due to climate change poses a serious challenge to achieving the Sustainable Development Goal 2 of ending hunger by 2030. While evidence exists on the impact of drought on under-five children, its effect during late childhood and early adolescence remains less investigated. Objective: This study estimates the impact of concurrent and long-term exposure to drought on linear growth during late childhood and early adolescence. Methods: Four rounds (2002–2013) of data from the young lives Cohort Study dataset (n = 2000) was used. The associations of concurrent and long-term exposure to drought and Height-for-age z-score was analysed using structural equation modelling techniques. The study also explored the mediating role of interim period growth in the association of early exposure to drought and undernutrition at later age and the role of the Productive Safety Net Program in buffering the impact of drought on child nutrition. Results: Results show that both concurrent and long-term exposure to drought was negatively associated with Height-for-age z-score (p < 0.001). Exposure to drought at age 5, 8, and 12 years is associated with lower Height-for-age z- score at age 5, 8, and 12 years respectively. Exposure to drought at age 5 years was also negatively associated with Height-for-age z-score at age 12 years (p < 0.001). This association was mainly indirect (89%) and mediated through reduced child growth in subsequent years. Participation in productive safety net program by drought-affected children reduces but does not completely offset the negative effects of drought on Height-for-age z-score (p < 0.1). Moreover, girls were more likely to suffer poor growth than boys. Conclusion: Drought exposure after the 1,000 days window could have a lasting impact on child growth. Given the importance of this period for child physical and mental development, children beyond the 1,000 days window should also be a focus of disaster relief programs. [ABSTRACT FROM AUTHOR]

Introduction: Despite the government’s efforts to decentralize and expand health institutions to promote facility-based child delivery, home delivery and maternal mortality are still widespread problems in Ethiopia. Most mothers continue to give birth at home. This study aims at identifying the socio-cultural practices, perceived benefit or need, and accessibility factors influencing women’s choice of health facilities for delivery services in Gida Ayana Woreda, western Ethiopia. Methods: We conducted a cross-sectional survey to assess women’s use of delivery care services in Gida Ayana Woreda, from November 2016 to January 2017; 459 women who were selected randomly participated in the study. We evaluated the socio-cultural, perceived benefit or need, and economic and physical accessibility factors in women’s choice of delivery care and used adjusted logistic regression analysis to examine significant predictors of delivery site use decisions. Results: Over half (56.6%) of the women self-reported using institutional delivery care; 80.9% gave birth at a health center. A socio-cultural variable, maternal education, significantly influenced women’s choice of health facility for delivery care services (AOR 3.4; 95% CI 2.0–5.9). Mothers’ knowledge level of obstetric complications and experience of complications during the last birth were the two perceived benefits or need factors associated with higher odds of receiving delivery care from decentralized local facilities. Utilization of health centers for maternal delivery care was significantly higher than of health posts (AOR 5.0; 95% CI 2.4–10.2). Availability of motorized transportation during labor to nearby delivery site was a significant predictor of institutional delivery. Conclusion: This study demonstrates the under-utilization of decentralized health facilities for maternal delivery care services in Gida Ayana Woreda, which was significantly influenced by socio-cultural, perceived need, and accessibility factors of women during childbirth. This suggests the need for tailored intervention to improve childbirth services use for mothers in this kind of rural settings. [ABSTRACT FROM AUTHOR]

Background: Community-based health insurance (CBHI) scheme is an emerging strategy for providing financial protection against health-related poverty. It is being piloted in the Sheko district, but community satisfaction with the scheme has not yet studied. Therefore, this study aimed to assess the level of household’s satisfaction to CBHI scheme and associated factors in a piloted Sheko district; southwest Ethiopia. Methods: A community-based cross-sectional study was conducted in Sheko district from March to April 2018. Data was collected on 528 households by using simple random sampling method. Trained data collectors gathered the data using a pre-tested and structured questionnaire. Descriptive statistics, bivariate and multivariable logistic regression analyses were performed. To determine the independent predictors of household’s satisfaction to CBHI, a cut point of p values < 0.05 were used. Results: This study showed that more than half (54.7%) of the households were satisfied with the CBHI scheme. Satisfaction to CBHI was positively associated with adequate knowledge of CBHI benefit packages (AOR = 2.29, 95% CI = 1.55–3.38), type of health facility visit (AOR = 1.93, 95% CI = 1.09–3.39), laboratory service provision (AOR = 2.07, 95% CI = 1.15–373) and length of enrollment (AOR = 1.53, 95% CI = 1.01–2.32). Conclusions: Household’s satisfaction to CBHI scheme was moderate. Modifiable factors, including adequate knowledge of CBHI benefit packages, type of health facility visit, laboratory service provision, and length of enrollment were independent determinants of satisfaction. In order to augment enrollee’s satisfaction to CBHI, efforts should be given to improving their knowledge of CBHI benefit packages through education and information campaigns. Furthermore, due consideration should also be given to improving the quality of health services. [ABSTRACT FROM AUTHOR]

Introduction: Routine cervical screening has been shown to greatly reduce both the number of new cervical cancers diagnosed each year and the number of deaths resulting from the disease. Nevertheless, cervical screening knowledge and screening uptake is very low in developing countries. In Ethiopia, the coverage of cervical cancer screening is only 1%. In this study, we aimed to assess cervical cancer screening knowledge and barriers for screening uptake among women in Addis Ababa Ethiopia. Methods: A facility-based cross-sectional study was conducted from February to March 2015 in Addis Ababa, Ethiopia. A total of 520 women were selected by a multi-stage sampling procedure. Interview based questioner was used to collect the data. Descriptive statistics was used to describe the socio-demographic and clinical profiles of the women. Multivariate logistic regression using adjusted odds ratio (AOR) and 95% confidence interval (CI) was used to identify independent predictors for cervical screening knowledge. A p-value of <0.05 was set to determine level of statistical significance. Results: Among all women, 42.7% had heard of cervical cancer screening and 144 (27.7%) women had adequate knowledge of cervical cancer screening. The mean (±SD) age of women was 27.7 (±5.49) years. In total, a quarter (25%) of eligible women had experience of cervical cancer screening. Not being married (adjusted odds ratio (AOR) = 1.8, 1.1–3.3), having an awareness of cervical cancer (AOR = 5.0, 2.7–9.1) and receiving information from health professionals (AOR = 1.9, 1.1–3.2) were the predictors for good cervical cancer screening knowledge. An absence of symptoms (57%), a lack of knowledge about screening (56.3%) and the lack of a screening service in their living area (42.2%) were the perceived barriers for screening uptake. Conclusions: Cervical screening knowledge was low among women and less than half had heard of screening. Women also had low experience of screening. The lack of a screening service, the absence of symptoms and not knowing about screening were the perceived reasons for the low uptake. Hence, awareness campaigns and education should be undertaken by health professionals. Access and availability of screening service is also essential to improve screening uptake. [ABSTRACT FROM AUTHOR]

Complex projectiles—propulsion via mechanical aid—are considered an important technological innovation, with possible relevance for the successful Out-of-Africa dispersal of our species. Conclusive evidence for the beginning of this technology, however, is lacking from the early Late Pleistocene (ca. 130 to 70 thousand years ago; ka). Given the extremely limited applicability of relatively robust methods for validating stone-tipped projectile use, such as through fracture propagation velocity, converging lines of circumstantial evidence remain the best way to examine early complex projectiles. We assess here suggestions for an early Late Pleistocene origin of complex projectiles in Africa. Results from both previous and present independent approaches suggest a trajectory in which complex projectiles were likely adopted during the early Late Pleistocene in eastern Africa. At Aduma (Middle Awash, Ethiopia), morphometric, hafting, and impact damage patterns in several lithic point assemblages suggest a shift from simple spear technologies (thrusting and/or hand-cast) to complex projectiles. Broadly dated to 80–100 ka, lithic points from later phases of the Aduma succession represent a particularly strong candidate for projectile armatures most comparable to ethnographically known spearthrower darts, lending support for previous suggestions and warranting further investigations. [ABSTRACT FROM AUTHOR]

Background: The need for increased attention to surgical safety in low- and middle-income countries invited organizations worldwide to support improvements in surgical care. However, little is written about issues in instrument sterilization in low- and middle-income countries including Ethiopia. Objective: The study aims to identify the impact of a sterile processing course, with a training-of-trainers component and workplace mentoring on surgical instrument cleaning and sterilization practices at 12 hospitals in Ethiopia. Method: A mixed-methods research design that incorporates both qualitative and quantitative research approaches to address issues in sterile processing was used for this study. The quantitative data (test results) were validated by qualitative data (hospital assessments, including observations and participant feedback). Twelve hospitals were involved in the training, including two university teaching hospitals from two regions of Ethiopia. In each of the two regions 30 sterile processing staff were invited to participate in a three-day course including theory and skills training; 12–15 of these individuals were invited to remain for a two-day training of trainers course. The collected quantitative data were analysed using a paired t-test by SPSS software, whereas comparative analysis was employed for the qualitative data. Results: Process, structural, and knowledge changes were identified following program implementation. Knowledge test results indicated an increase of greater than 20% in participant sterile processing knowledge. Changes in process included improved flow of instruments from dirty to clean, greater attention to detail during the cleaning and decontamination steps, more focused inspection of instruments and careful packaging, as well as changes to how instruments were stored. Those trained to be trainers had taught over 250 additional staff. Conclusions: Increased attention to and knowledge in sterile processing practices and care of instruments with a short, one-week course provides evidence that a small amount of resources applied to a largely under-resourced area of healthcare can result in decreased risks to patients and staff. Providing education in sterile processing and ensuring staff have the ability to disseminate their learnings to other health care providers results in decreasing risks of hospital associated infections in patients. [ABSTRACT FROM AUTHOR]

Introduction: Tuberculous lymphadenitis is the most frequent form of extra-pulmonary TB (EPTB) and accounts for a considerable proportion of all EPTB cases. We conducted a systematic review of articles that described the epidemiological features of TBLN in Africa. Methods: Any article that characterized TBLN cases with respect to demographic, exposure and clinical features were included. Article search was restricted to African countries and those published in English language irrespective of publication year. The articles were retrieved from the electronic database of PubMed, Scopus, Cochrane library and Lens.org. Random effect pooled prevalence with 95% CI was computed based on Dersimonian and Laird method. To stabilize the variance, Freeman-Tukey double arcsine root transformation was done. The data were analyzed using Stata 14. Results: Of the total 833 articles retrieved, twenty-eight articles from 12 African countries fulfilled the eligibility criteria. A total of 6746 TBLN cases were identified. The majority of the cases, 4762 (70.6%) were from Ethiopia. Over 77% and 88% of identified TBLN were cervical in type and naïve to TB drugs. Among the total number of TBLN cases, 53% were female, 68% were in the age range of 15–44 years, 52% had a history of livestock exposure, 46% had a history of consuming raw milk/meat and 24% had history of BCG vaccination. The proportion of TBLN/HIV co-infection was much lower in Ethiopia (21%) than in other African countries (73%) and the overall African estimate (52%). Fever was recorded in 45%, night sweating in 55%, weight loss in 62% and cough for longer than two weeks in 32% of the TBLN cases. Conclusions: TBLN was more common in females than in males. The high prevalence of TBLN in Ethiopia did not show directional correlation with HIV. Population based prospective studies are warranted to better define the risk factors of TBLN in Africa. [ABSTRACT FROM AUTHOR]

Poor nutritional status in pregnancy expressed as low mid-upper arm circumference (MUAC) is associated with low birth weight. The study aims were to assess the nutritional status of pregnant Ethiopian women using MUAC and examine association with nutrition-specific and nutrition-sensitive factors, using baseline data of a prospective longitudinal observational birth cohort study conducted in three rural districts in the Oromia region of Ethiopia. Recruitment into the cohort was rolling over a period of nine months, and the data used for this analysis were collected while the women were between 12–32 weeks of gestation. Detailed household socio-demographics, agricultural production, women’s health, morbidity and diets, with weights, heights and MUAC, and anemia prevalence (HemoCue) were collected. The prevalence of low MUAC (< 23 cm) was 41%. Controlling for location and clustering, wealth quintile (OR = 0.88, CI = 0.82 to 0.96, p<0.01) was associated with decreased risk of low MUAC, while trimester (OR = 1.31, CI = 1.16 to 1.48, p<0.001) was associated with increased risk of low MUAC. The only significant factor amenable to nutrition-specific interventions was altitude-adjusted anemia, which was associated with increased risk of low MUAC (OR = 1.28, CI = 1.09 to 1.49, p<0.01). Significant factors amenable to nutrition-sensitive factors and associated with higher odds of low MUAC were household food insecurity (OR = 1.04, CI = 1.02 to 1.06, p<0.001), distance to the clinic in minutes (OR = 1.01, CI = 1.0 to 1.01, p<0.0001) and season of recruitment (lean versus non lean) (OR = 1.30, CI = 1.10 to 1.54, p<0.01). Literacy (OR = 0.85, CI = 0.74 to 0.98, p<0.05) and numeracy (OR = 0.75, CI = 0.62 to 0.91, p<0.01) were also significantly associated with lower odds of low MUAC. Poor nutritional status in pregnancy expressed as percent with low MUAC was high in Ethiopian women. It was associated with several nutrition-specific and -sensitive factors indicating the importance of multisectoral actions in improving outcomes within the first 1000 days. [ABSTRACT FROM AUTHOR]

Background: Comprehensive care given to people living with HIV/AIDS is improving over time; however, their concurrent cognitive illness is still ignored, under screened and treated particularly in developing countries. And this problem is also striking in Ethiopia. Therefore, the objective of this study was to assess HIV-associated neurocognitive disorders and associated factors among adult people living with HIV/AIDS. Methods: An institution based cross sectional study was conducted from April to May, 2017 at Gamo Gofa zone public Hospitals. International HIV Dementia Scale was used to screen HIV associated neurocognitive disorders. Logistic regression analysis was used to assess predictors of neurocognitive disorders. Result: A total of 684 study participants were included in this study with a response rate of 98%. Among them, 56% were females while 44% were males. The mean (±SD) age of the participants was 38.8±8.8years. The screening prevalence of HIV-associated neurocognitive disorder was 67.1% (95% CI; 63.6, 70.5). Body mass index 16 kg/m2 (AOR 4.389 (1.603–12.016)), being married (AOR 0.377 (0.213–0.666), unemployment status (AOR 3.181 (1.752–5.777) and being in WHO clinical stage T3 category/advancing stages of the disease (AOR 3.558 (1.406–9.006) were the key predictors of HIV-associated neurocognitive disorders among people living with HIV/AIDS. Conclusion: In this study the screening prevalence of HIV-associated neurocognitive disorder is higher than the earlier reports in Ethiopia and Africa. This indicates that early screening strategies and policies for cognitive health in people living with HIV/AIDS should be given a top priority. [ABSTRACT FROM AUTHOR]

Agricultural sector plays a key role towards achieving healthier diets that are deemed critical for improving health and nutritional outcomes. To what extent the current food supply systems support healthy diets remains unknown. Using annual and nationally representative data on crop and livestock production in Ethiopia, we assess the national agricultural sector from a nutrition lens and its role in supporting healthy diets in the country. We do so by converting the agricultural production into energy and nutrients for the period of 2011–2015. These data show that the national food production has increased dramatically over the 5-year period to supply more than 3,000 calories per capita in 2015. Moreover, nutrient production gaps have substantially decreased (2011–15), but deficits in energy (5%), vitamin C (16%), and calcium (9%) production remained in 2015. However, this production growth–coming primarily from the cereal sector and at the expense of other food groups–led to a decrease in production diversity as reflected by a drop in the Shannon index between 2011 and 2015. Together these findings imply that the production increases in Ethiopia would need to be sustained to feed the rapidly growing population but more emphasis should be given to diversification to support healthy and nutritionally diversified diets. [ABSTRACT FROM AUTHOR]