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Background: Childhood tuberculosis (TB) was poorly studied in Ethiopia. This study aimed to describe the epidemiology of childhood TB and identify predictors of death among children on TB treatment. Methods: This is a retrospective cohort study of children aged 16 and younger who were treated for TB between 2014 and 2022. Data were extracted from TB registers of 32 healthcare facilities in central Ethiopia. Phone interview was also conducted to measure variables without a space and not recorded in the registers. Frequency tables and a graph were used to describe the epidemiology of childhood TB. To perform survival analysis, we used a Cox proportional hazards model, which was then challenged with an extended Cox model. Results: We enrolled 640 children with TB, 80 (12.5%) of whom were under the age of two. Five hundred and fifty-seven (87.0%) of the enrolled children had not had known household TB contact. Thirty-six (5.6%) children died while being treated for TB. Nine (25%) of those who died were under the age of two. HIV infection (aHR = 4.2; 95% CI = 1.9–9.3), under nutrition (aHR = 4.2; 95% CI = 2.2-10.48), being under 10 years old (aHR = 4.1; 95% CI = 1.7–9.7), and relapsed TB (aHR = 3.7; 95% CI = 1.1–13.1) were all independent predictors of death. Children who were found to be still undernourished two months after starting TB treatment also had a higher risk of death (aHR = 5.64, 95% CI = 2.42–13.14) than normally nourished children. Conclusions: The majority of children had no known pulmonary TB household contact implying that they contracted TB from the community. The death rate among children on TB treatment was unacceptably high, with children under the age of two being disproportionately impacted. HIV infection, baseline as well as persistent under nutrition, age < 10 years, and relapsed TB all increased the risk of death in children undergoing TB treatment. [ABSTRACT FROM AUTHOR]

Background: Despite anaemia is the leading cause of child morbidity and mortality in Africa including Ethiopia, there is inadequate evidence on modelling anaemia related factors among under five years old children in Ethiopia. Therefore, this study is aimed to assess factors that affect the anaemia status among under five years old children and estimate the proportion of overall child-level variation in anaemia status that is attributable to various factors in three regions of Ethiopia, namely Amhara, Oromiya and Southern Nation Nationalities People (SNNP). Methods: This is a cross-sectional study, and the data was extracted from the 2011 Ethiopia National Malaria Indicator Survey which is a national representative survey in the country. A sample of 4,356 under five years old children were obtained from three regions. Based on child hemoglobin level, anaemia status was classified as non-anaemia (>11.0g/dL), mild anaemia (8.0-11.0g/dL), moderate anaemia (5.0-8.0g/dL) and severe anaemia (<5.0g/dL). Various multilevel proportional odds models with random Kebele effects were adopted taking into account the survey design weights. All the models were fitted with the PROC GLIMMIX in SAS. The Brant test for parallel lines assumption was done using the brant() function from brant package in R environment. Results: The prevalence of anaemia status of under five years children varies among the three study regions, where the prevalence of severe child anaemia status was higher in Oromiya region as compared to Amhara and SNNP regions. The results of this study indicate that age (OR = 0.686; 95% CI: 0.632, 0.743), malaria RDT positive (OR = 4.578; 95% 2.804, 7.473), household had used mosquito nets while sleeping (OR = 0.793; 95%: 0.651, 0.967), household wealth status and median altitude (OR = 0.999; 95%: 0.9987, 0.9993), were significantly related to the prevalence of child anaemia infection. The percentage of Kebele-level variance explained by the region and median altitude, and child / household (Level 1) characteristics was 32.1 %. Hence, large part of the Kebele-level variance (67.9%) remain unexplained. Conclusions: The weighted multilevel proportional odds with random Kebele effects model used in this paper identified four child/household and one Kebele level risk factors of anaemia infection. Therefore, the public health policy makers should focus to those significant factors. The results also show regional variation in child anaemia prevalence, thus special attention should be given to those children living in regions with high anaemia prevalence. [ABSTRACT FROM AUTHOR]

Background: Human Immunodeficiency Virus (HIV) continues to be the major cause of childhood deaths, particularly in the sub-Saharan African region. In Ethiopia, though several primary studies have been conducted on the incidence of HIV-related child mortality, the pooled incidence density mortality rate among HIV-positive children is unknown. Therefore, this systematic review and meta-analysis aimed to estimate the pooled incidence density mortality rate among HIV-positive children and identify its associated factors in Ethiopia., Methods: We browsed PubMed, HINARI, Science Direct, Google Scholar, African Journals Online, and cross-references using different search terms to identify articles. Quality appraisal was done using the Joanna Briggs Institute checklist. Meta-package was used to estimate the pooled incidence of mortality and hazard ratio (HR) of predictors. Heterogeneity was tested using the I-square statistics. Publication bias was tested using a funnel plot visual inspection and Egger's test. Data was presented using forest plots and tables. The random effect model was used to compute the pooled estimate., Results: The overall pooled incidence density mortality rate among HIV-positive children was 2.52 (95% CI: 1.82, 3.47) per 100 child years. Advanced HIV disease (hazard ratio (HR): 3.45, 95% CI (Confidence Interval): 2.64, 4.51), tuberculosis co-infection (HR: 3.19, 95% CI: 2.08, 4.88), stunting (3.22, 95% CI: 2.46, 4.22), underweight (HR: 2.71, 95% CI: 1.72, 4.26), wasting (HR: 4.14, 95% CI: 2.27, 7.58), didn't receive Isoniazid preventive therapy (HR: 3.33, 95% CI: 2.22, 4.99), anemia (HR: 3.03, 95% CI: 2.52, 3.64), fair or poor antiretroviral therapy adherence (HR: 4.14, 95% CI: 3.28, 5.28) and didn't receive cotrimoxazole preventive therapy (HR: 3.82, 95% CI: 2.49, 5.86) were factors associated with a higher hazard of HIV related child mortality., Conclusions: The overall pooled incidence density mortality rate among HIV-positive children was high in Ethiopia as compared to the national strategy target. Therefore, counseling on antiretroviral therapy adherence should be strengthened. Regular monitoring of hemoglobin levels and assessment of nutritional status should be done for all children living with HIV. Moreover, healthcare professionals should follow the national HIV treatment guidelines and provide cotrimoxazole preventive therapy and Isoniazid preventive therapy up on the guidelines for children living with HIV., Registration: Registered in PROSPERO with ID: CRD42023486902., (© 2024. The Author(s).)

Background: Malnutrition among children under five years of age is a major public health issue in many low and middle-income constrained countries. According to WHO, 5.3 million under-five children die every year and about 45% of these deaths are linked to malnutrition. While it is clear that poverty and lack of food are important factors in children's malnutrition, less is known about the ways in which local conceptions of malnutrition affect parents' treatment choices. In Ethiopia, child malnutrition is a severe public health problem and a common cause of child death, and this paper explores the local views of malnutrition and how these shape people's health-seeking behaviour.Methods: The study was conducted in eastern Ethiopia from December 2017 to January 2019, conducting interviews and focus group discussions to explore different views and treatment options malnutrition. The study used grounded theory because it allows new and unexpected themes to arise from the data. Researchers' assumptions on local terminologies of child malnutrition are also controlled as a principle of ground theory.Results: Child malnutrition was not only perceived to be related to lack of food but was understood in a wider local conceptualization of health and illness. Parents often relied on healers because they are long-standing members of the community, possess indigenous knowledge, and cost less than other options. Because health professionals and the community perceive and speak of health very differently, people often do not seek support from health services. The misalignments between how health professionals and healers diagnose and treat malnourished children have implications on the possibilities to implement change to reduce malnutrition.Conclusions: Through an exploration of people's own terminology and understandings of what a malnourished child is, as well as the underlying reasons for their illness, this paper explores how people understand malnutrition symptoms and why many tend to rely on healers rather than seeking care from health centres. [ABSTRACT FROM AUTHOR]

Background: Children in resource-limited countries are more likely to die from treatable conditions than those in higher resource settings due to a lack of the right essential medicine at the right time. Globally millions of children die every year from conditions that could be treatable with existing medicines before they reach their fifth birthday. This study aimed in assessing the availability and affordability of essential medicine for children in selected health facilities of southern nations, nationalities, and peoples' regions (SNNPR), Ethiopia.Method: A medicine outlets-based cross-sectional study was conducted to assess the availability, affordability, and prices of the 30 selected essential medicines (EMs) for children in 30 public and 30 private medicine outlets in SNNPR from March 29 to May 5, 2019, applying WHO and Health Action International (HAI) tools. Availability was expressed as the percentage of sampled medicine outlets per sector that the surveyed medicine was found on the day of data collection. The amount of daily wages required for the lowest-paid government unskilled worker (LPGW) to buy one standard treatment of an acute condition or treatment for a chronic condition for a month was used to measure affordability and median price ratio for the price of EMs.the Results: Availability varied by sector, type of medication, and level of health facilities. The average availability of EM was 57.67% for the public sector and 53.67% for the private sector. Ceftriaxone, SOR, zinc sulfate, and cotrimoxazole were the most widely available types of medications in the two sectors. The median price ratios (MPR) for the cheapest drugs LP were 1.26 and 2.24 times higher than their International Reference Price (IRP) in the public and private sectors respectively. Eighty-two percent of LP medicines in the public and 91 % of LP medicines in the private sectors used in the treatments of prevalent common conditions in the region were unaffordable as they cost a day's or more wages for the LPGW.Conclusion: Availability, affordability, and price are determinant pre-requisite for EMs access. According to the current work, although fair availability was achieved, the observed high price affected affordability and hence access to EMs. [ABSTRACT FROM AUTHOR]

Background: Globally, neonatal and child mortality remains still high. Under-five mortality accounts for four-fifth of child and young adolescent deaths. In Ethiopia, though there has been a remarkable progress over the past years, under-five mortality is still high. Evidence from population-based longitudinal studies on under-five mortality is limited. Thus, this study aims to investigate the magnitude, trend, and causes of under-five mortality in the Kilite-Awlaelo Health Demographic Surveillance System, Northern Ethiopia.Methods: Kilite-Awlaelo health and demographic surveillance system was established in 2009 in the northern part of Ethiopia. Population-based longitudinal study design was carried out through extracting data for nine consecutive years (2009-2017). After smoothing the data revealed a visually decreasing trend. Linear, quadratic, exponential, and autoregressive time-series models were checked. Accordingly, the exponential trend model provided the best fit with the lowest standard error of estimate, lowest sum square error and highest adjusted R2 value. Cause-specific mortality was determined by cross tabulating cause of death with specific age death.Results: The overall under-five mortality rate was 35.62 per 1000 livebirths. The under-five mortality rate of rural and urban residents was 37.58 and 12.99 deaths per 1000 livebirths respectively. The exponential trend model showed the under-five mortality rate was declining exponentially. Bacterial sepsis 67(20.6%), prematurity 37(11.08%), intestinal infection disease 30(8.98%), acute lower respiratory infections 26(7.78%), and birth asphyxia 24(7.19%) were the major causes of under-five mortality.Conclusion: The overall under-five mortality rate for the surveillance period was comparatively lower. A statistically significant difference in under-five mortality rate was observed between urban and rural residents. A statistically significant declining trend in the under-five mortality rate was observed. Bacterial sepsis, prematurity, intestinal infection disease, acute lower respiratory infections, and birth asphyxia were the major causes of under-five mortality. We recommend the huge discrepancy in under-five mortality rate between urban and rural dwellers could be narrowed to some level by increasing healthcare access for rural residents. [ABSTRACT FROM AUTHOR]

Background: Immunization is a cost-effective public health strategy. Immunization averts nearly three million deaths annually but immunization coverage is low in some countries and some regions within countries. The aim of this systematic review and meta-analysis is to assess pooled immunization coverage in Ethiopia.Method: A systematic search was done from PubMed, Google Scholar, EMBASE, HINARI, and SCOPUS, WHO's Institutional Repository for Information Sharing (IRIS), African Journals Online databases, grey literature and reviewing reference lists of already identified articles. A checklist from the Joanna Briggs Institute was used for appraisal. The I2 was used to assess heterogeneity among studies. Funnel plot were used to assess publication bias. A random effect model was used to estimate the pooled prevalence of immunization among 12-23 month old children using STATA 13 software.Result: Twenty eight articles were included in the meta-analysis with a total sample size of 20,048 children (12-23 months old). The pooled prevalence of immunization among 12-23 month old children in Ethiopia was found to be 47% (95%, CI: 46.0, 47.0). A subgroup analysis by region indicated the lowest proportion of immunized children in the Afar region, 21% (95%, CI: 18.0, 24.0) and the highest in the Amhara region, 89% (95%, CI: 85.0, 92.0).Conclusion: Nearly 50% of 12-23 month old children in Ethiopia were fully vaccinated according to this systematic review and meta-analysis this indicates that the coverage, is still low with a clear disparity among regions. Our finding suggests the need for mobile and outreach immunization services for hard to reach areas, especially pastoral and semi-pastoral regions. In addition, more research may be needed to get more representative data for all regions.Prospero Registration Number: CRD42020166787. [ABSTRACT FROM AUTHOR]

Background: Though the socio-economic situation of the Ethiopian household is improving along with the decrease in under-five child mortality. But, under-five mortality is still one of the major problems. Identification of the risk factors change over time which mismatches with the diminishing rate of under-five mortality is important to address the problems.Methods: The survey data used for this research was taken from three different Ethiopian Demographic and Health Surveys (2000, 2005 and 2011). This data was used to identify the effect of time varying under-five mortality risk factors. The Cox proportional hazard model was adapted for the analysis.Results: The effect of respondent's current age, age at first birth and educational level on the under-five mortality rate significantly diminishes in the recent surveys. On the other hand, the effect of the number of births in the last 5 years increases more in 2011 than in the earlier two surveys. Similarly, number of household members in the house and the number of under-five children in the house demonstrated a difference through years. Regarding total children ever born, child death is more for the year 2000 followed by 2005 and 2011.Conclusion: Based on the study, our findings confirmed that under-five mortality is a serious problem in the country. The analysis displayed that the hazard of under-five mortality has a decreasing pattern in years. The result for regions showed that there was an increase in years for some of the regions. This research work gives necessary information to device improved teaching for family planning and children health care to change the child mortality circumstance in the country. Our study suggests that the impact of demographic characteristics and socio-economic factors on child mortality should account for their integral changes over time. [ABSTRACT FROM AUTHOR]

Background: Undernutrition remains the major public health concern in Ethiopia and continues as the underlying cause of child mortality. However, there is a scarcity of information on the magnitude and determinant factors of undernutrition. Therefore, this study aimed to assess the prevalence of undernutrition and associated factors among children aged 6-59 months in East Belesa District, northwest Ethiopia.Methods: A community-based cross-sectional study was conducted from April to May, 2014. A multistage stratified sampling technique was used to select 633 study participants. A structured interviewer-administered questionnaire was used to collect data. In order to identify factors associated with undernutrition (stunting and wasting) a multivariate logistic regression analysis was employed. The Adjusted Odds Ratio (AOR) with a 95 % Confidence Interval (CI) was computed to show the strength of the association. In the multivariate analysis, variables with a p-value of <0.05 were considered as statistically significant.Results: In this study, about 57.7 and 16 % of the children were stunted and wasted, respectively. The odds of stunting were higher in children born to mothers who gave their first birth before 15 years of age (AOR = 2.4; 95 % CI: 1.19, 5.09) and gave prelacteal feeding to their child (AOR = 1.83; 95 % CI: 1.28, 2.61). However, lower odds of stunting were observed among children aged 36-47 months (AOR = 0.41; 95 % CI: 0.22, 0.78) and had higher family monthly income, Et. Br. 750-1000, (AOR = 0.61; 95 % CI: 0.39, 0.92). Moreover, the odds of wasting were higher among children who received butter as prelacteal food (AOR = 2.32; 95 % CI:1.82, 5.31).Conclusion: Child undernutrition is a critical public health problem in the study area. Advanced age of children (36-47 months) and higher family monthly income were inversely associated with stunting. However, higher odds of stunting were observed among children whose mothers delivered their first child before 15 years of age, and gave their children prelacteal feeding. Thus, delaying the first pregnancy and reducing prelacteal feeding is of a paramount significance in reducing the burden of undernutrition. [ABSTRACT FROM AUTHOR]

Background: The prevention of child mortality through immunization is one of the most cost-effective and widely applied public health interventions. In Ethiopia, the Expanded Program on Immunization (EPI) schedule is rarely completed as planned and the full immunization rate is only 24%. The objective of this study was to identify determinant factors of incomplete childhood immunization in Arbegona district, Sidama zone, southern Ethiopia.Methods: A community based unmatched case-control study was undertaken among randomly selected children aged 12 to 23 months and with a total sample size of 548 (183 cases and 365 controls). A multi-stage sampling technique was used to get representative cases and controls. Data was collected using a structured questionnaire and analyzed using SPSS version 16 statistical software. Bivariate and multiple logistic regression analyses were done to identify independent factors for incomplete immunization status of children. Qualitative data were also generated and analyzed using thematic framework.Results: The incomplete immunization status of children was significantly associated with young mothers (AOR = 9.54; 95% CI = 5.03, 18.09), being born second to fourth (AOR = 3.64; 95% CI = 1.63, 8.14) and being born fifth or later in the family (AOR = 5.27; 95% CI = 2.20, 12.64) as compared to being born first, a mother's lack of knowledge about immunization benefits (AOR = 5.51; 95% CI = 1.52, 19.94) and a mother's negative perception of vaccine side effects (AOR = 1.92; 95% CI = 1.01, 3.70). The qualitative finding revealed that the migration of mothers and unavailability of vaccines on appointed immunization dates were the major reasons for partial immunization of children.Conclusion: To reduce the number of children with incomplete immunization status, the Arbegona district needs to consider specific planning for mothers with these risk profiles. A focus on strengthening health communication activities to raise immunization awareness and address concerns of vaccine side effects at community level is also needed. This could be achieved through integrating the immunization service to other elements of primary health care. [ABSTRACT FROM AUTHOR]

Background: Malnutrition remains to be one of the most common causes of morbidity and mortality among children in developing countries. The prevalence of wasting in Ethiopia remained about 10 % for the past ten years. Mortality rate of children with severe acute malnutrition treated in inpatient set ups has remained unacceptably high.Methods: A retrospective cohort study was conducted in Southern Ethiopia. The study population were children with severe acute malnutrition aged from 6 to 59 months who have been managed at Karat and Fasha stabilization centers between September 30, 2013, and Sep. 29, 2014. The total sample size was 420 and pretested questionnaire was used. Kaplan Meier analysis was used to estimate time to nutritional recovery and Cox proportional-hazard regression analysis was carried out to determine independent predictors.Results: Nutritional recovery rate was 3.61 per 100 person day observations. Median nutritional recovery time was 22 and 29 days for edematous malnourished and severely wasted children respectively. The independent predictors of nutritional recovery rate were: stabilization center (AHR = 1.4, 95 % CI: 1.1-1.7), malnutrition status (AHR = 1.8, 95 % CI: 1.3-2.4), weight (AHR = 1.5, 95 % CI: 1.2-1.9), mid- upper arm circumference (AHR = 1.4, 95 % CI: 1.1-1.9), inpatient complications (AHR = 2.2, 95 % CI: 1.4-3.5) and did not lose edema within four days of inpatient treatment (AHR = 2.3, 95 % CI: 1.1-4.8).Conclusions: The findings of this study confirm the probability of surviving gets slimmer with inpatient complications and staying longer in stabilization centers. So, to prevent complications and enhance recovery rate due emphasis should be given in improving early detection and treatment of severely malnourished children in Ethiopia. [ABSTRACT FROM AUTHOR]

Background: The risk of a child dying before reaching five years of age is highest in Sub-Saharan African countries. But Child mortality rates have shown substantial decline in Ethiopia. It is important to identify factors affecting under-five mortality. Methods: A structured additive logistic regression model which accounts the spatial correlation was adopted to estimate under-five mortality risk factors. The 2011 Ethiopian Demographic and Health Survey data was used for this study. Results: The analysis showed that the risk of under-five mortality increases as the family size approaches seven and keeps increasing. With respect to socio-economic factors, the greater the household wealth, the lower the mortality. Moreover, for older mothers, the chance of their child to dying before reaching five is diminishes. Conclusion: The model enables simultaneous modeling of possible nonlinear effects of covariates, spatial correlation and heterogeneity. Our findings are relevant because the identified risk factors can be used to provide priority areas for intervention activities by the government to combat under-five mortality in Ethiopia. [ABSTRACT FROM AUTHOR]

Background Worldwide diarrheal disease is the second leading cause of death in under-five year's children. In Ethiopia diarrhoea kills half million under-five children every year second to pneumonia. Poor sanitation, unsafe water supply and inadequate personal hygiene are responsible for 90% of diarrhoea occurrence; these can be easily improved by health promotion and education. The Ethiopian government introduced a new initiative health extension programme in 2002/03 as a means of providing a comprehensive, universal, equitable and affordable health service. As a strategy of the programme; households have been graduated as model families after training and implementing the intervention packages. Therefore the aim of the study was to assess risk factor of diarrheal disease in under-five children among health extension model and non-model families. Method A community based comparative cross-sectional study design was employed in 2012 at Sheko district. Multi-stage sampling technique was employed to select 275 model and 550 non-model households that had at least one under-five children. Data was collected using structured questioner and/or checklist by trained data collectors. A summery descriptive, binary and multivariate logistic regression was computed to describe the functional independent predictors of childhood diarrhoea. Result The two weeks diarrhoea prevalence in under-five children among health extension model and non-model households were 6.4% and 25.5%, respectively. The independent predictors of childhood diarrhoea revealed in the study were being mothers can't read and write [OR: 1.74, 95% CI: (1.03, 2.91)], monthly family income earn less than 650 Birr [OR: 1.75, 95% CI: (1.06, 2.88)], mothers hand washing not practice at critical time [OR: 2.21, 95%CI: (1.41, 3.46)], not soap use for hand washing [OR: 7.40, 95% CI: (2.61, 20.96)], improper refuse disposal [OR:3.19,95%CI: (1.89, 5.38)] and being non-model families for the health extension programme [OR: 4.50, 95% CI: (2.52, 8.03]. Conclusion The level of diarrheal disease variation was well explained by maternal education, income, personal hygiene, waste disposal system and the effect of health extension programme. Thus encouraging families to being model families for the programme and enhancing community based behavioural change communication that emphasize on personal hygiene and sanitation should be strengthening to reduce childhood diarrhoea. [ABSTRACT FROM AUTHOR]

Background: Improving child survival through various health interventions has been one of the main preoccupations of public health programs in developing nations. However, efforts to understand the child death determinants and determine whether the health interventions are really contributing to the reduction of mortality were not satisfactory. The purpose of this study is to identify determinants and causes of child mortality. Methods: The study was conducted in the town of Jimma, Ethiopia, using a case control study design. Cases were identified through enumeration of all children and deaths prior to interview of the study subjects. Controls were under five children of the same age (+/-2 months) residing in the nearest household. Data was entered into EPI -info 6.4 software and analyzed using SPSS. Results: Seventy four cases and 222 controls were included in the study. The study found that children who never breast fed [OR = 13.74, 95%CI (3.34, 56.42]] and children with mothers having more than five children [OR = 3.34, 95%CI (1.27, 8.76)] were more likely to die than their counterparts. Vaccination reduced the risk of death [OR=.26, 95%CI (0.10, 0.67) significantly. Pneumonia was the most common immediate cause of death [29.7% (95% CI (19.66, 41.48)] followed by acute diarrhea and malaria each contributing for 23% [95%CI (13.99, 34.21)] of deaths. Conclusion: Immunization, breastfeeding and low parity mothers were independently found to be protective from childhood death. Strengthening the child survival initiatives, namely universal child immunization, family planning and breast feeding - is strongly recommended. [ABSTRACT FROM AUTHOR]

Background: Ethiopia is one of the most densely populated countries in Africa with an estimated population of 77.1 million in mid-2007. Uncontrolled fertility has adversely influenced the socioeconomic, demographic and environmental situations of the country. It is one of the largest and poorest countries that, even in the midst of crisis, has maintained high levels of fertility. This study was aimed at investigating the most important factors influencing fertility behavior in Northwest Ethiopia. Methods: A comparative cross-sectional study which included 2424 women aged 25 years and above was undertaken in the Amhara region of Northwest Ethiopia. The study subjects were grouped into high fertile and low fertile categories. There were 1011 and 1413 women in the high and low fertile groups, respectively. A multi-stage cluster sampling stratified by place of residence was employed to select the required study subjects. Both bivariate and multivariate logistic regression techniques were used to analyze the data. Results: Among the 25 variables considered in this study, only 9 of them were found significantly and independently associated with the level of fertility. Women with at least secondary education were at a lower risk of high fertility with OR = 0.37 (95% CI: 0.21 to 0.64) compared to those with no formal education. However, women with primary education did not show any significant difference when compared with the same baseline group. Age at first marriage was inversely associated with the number of children ever born alive. Place of residence, household expenditure, number of children who have died, attitude towards using contraceptives, women's knowledge on the safe period, and current marital status were the other variables that showed significant associations with the level of fertility. Conclusion: Female education beyond the primary level, reduced infant and child mortality, delayed marriage and correct knowledge on the safe period during the menstrual cycle were amongst the main factors that had a bearing on high fertility. [ABSTRACT FROM AUTHOR]

Background: Though Ethiopia achieved the fourth Millennium Development Goal, commit to reducing under five child mortalities by the year 2015, but perinatal mortality has remained a major public health problem in Ethiopia, and the Tigray region is experiencing a high perinatal mortality rate. This study aimed to assess the risk factors attributed to perinatal death in the Tigray region.Methods: A retrospective cross-sectional study was used. The information collected from 2738 children born five years preceding the survey was considered. Variables such as maternal social and demographic characteristics, child demographic characteristics, health and environmental factors were considered as risk factors of perinatal death. The study used descriptive statistics, and logistic regression model to identify significant correlates of perinatal mortality.Results: The data showed that from total children included in the study, 4.1% are early neonatal deaths, and 2.1% are stillbirth. Overall the prevalence of experiencing perinatal mortality was 6.2% the Tigray region. The logistic analysis revealed, factors small birth interval (less than 15 months) (AOR = 7.902; 95% CI: (4.526-13.795)) and 16-26 months (AOR =2.088; 95% CI: (1.292-3.375)), poor wealth index (AOR = 1.948; 95% CI: (1.011-3.754)), having no toilet facility (AOR =1.649; 95% CI: (1.093-2.488)), child sex (being male) (AOR =1.74; 95% CI: (1.234-2.454)), giving birth at older maternal age (45-49 years) (AOR = 0.293; 95% CI: (0.128-0.668)), rural residence and using the unprotected well water were significantly associated with a higher risk of perinatal death.Conclusions: The study identified sex of a child, previous birth intervals, availability of toilet facilities, wealth index, birth type, mother's age, parity, place of residence, mother's occupation and source of drinking water were the factors significantly associated with perinatal mortality. The prevalence of perinatal mortality shows that Tigray region was experiencing a high perinatal mortality rate than the national. [ABSTRACT FROM AUTHOR]

Background: Complete childhood vaccination remains poor in Sub-Saharan Africa, despite major improvement in childhood vaccination coverage worldwide. Globally, an estimated 2.5 million children die annually from vaccine-preventable diseases. While studies are being conducted in different East African countries, there is limited evidence of complete basic childhood vaccinations and associated factors in East Africa among children aged 12-23 months. Therefore, this study aimed to investigate complete basic childhood vaccinations and associated factors among children aged 12-23 months in East Africa., Methods: Based on the Demographic and Health Surveys (DHSs) of 12 East African countries (Burundi, Ethiopia, Comoros, Uganda, Rwanda, Tanzania, Mozambique, Madagascar, Zimbabwe, Kenya, Zambia, and Malawi), secondary data analysis was performed. The study included a total weighted sample of 18,811 children aged 12-23 months. The basic childhood vaccination coverage was presented using a bar graph. Multilevel binary logistic regression analysis was fitted for identifying significantly associated factors because the DHS has a hierarchical nature. The Intra-class Correlation Coefficient (ICC), Median Odds Ratio (MOR), Proportional Change in Variance (PCV), and deviance (-2LLR) were used for checking model fitness, and for model comparison. Variable with p-value ≤0.2 in the bi-variable multilevel analysis were considered for the multivariable analysis. In the multivariable multilevel analysis, the Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) were reported to declare the significance and strength of association with full vaccination., Results: Complete basic childhood vaccination in East Africa was 69.21% (95% CI, 69.20, 69.21%). In the multivariable multilevel analysis; Mothers aged 25-34 years (AOR = 1.21, 95% CI: 1.10, 1.32), mothers aged 35 years and above (AOR = 1.50, 95% CI: 1.31, 1.71), maternal primary education (AOR = 1.26, 95% CI: 1.15, 1.38), maternal secondary education and above (AOR = 1.54, 95% CI: 1.36, 1.75), husband primary education (AOR = 1.25, 95% CI: 1.13, 1.39), husband secondary education and above (AOR = 1.24, 95% CI: 1.11, 1.40), media exposure (AOR = 1.23, 95% CI: 1.13, 1.33), birth interval of 24-48 months (AOR = 1.28, 95% CI: 1.15, 1.42), birth interval greater than 48 months (AOR = 1.35, 95% CI: 1.21, 1.50), having 1-3 ANC visit (AOR = 3.24, 95% CI: 2.78, 3.77), four and above ANC visit (AOR = 3.68, 95% CI: 3.17, 4.28), PNC visit (AOR = 1.34, 95% CI: 1.23, 1.47), health facility delivery (AOR = 1.48, 95% CI: 1.35, 1.62), large size at birth 1.09 (AOR = 1.09, 95% CI: 1.01, 1.19), being 4-6 births (AOR = 0.83, 95% CI: 0.75, 0.91), being above the sixth birth (AOR = 0.60, 95% CI: 0.52, 0.70), middle wealth index (AOR = 1.16, 95% CI: 1.06, 1.28), rich wealth index (AOR = 1.20, 95% CI: 1.09, 1.33), community poverty (AOR = 1.21, 95% CI: 1.11, 1.32) and country were significantly associated with complete childhood vaccination., Conclusions: In East Africa, full basic childhood vaccine coverage remains a major public health concern with substantial differences across countries. Complete basic childhood vaccination was significantly associated with maternal age, maternal education, husband education, media exposure, preceding birth interval, number of ANC visits, PNC visits, place of delivery, child-size at birth, parity, wealth index, country, and community poverty. Public health interventions should therefore target children born to uneducated mothers and fathers, poor families, and those who have not used maternal health services to enhance full childhood vaccination to reduce the incidence of child mortality from vaccine-preventable diseases.

Background: Severe forms of malnutrition have drastic effects on childhood morbidity and mortality in sub-Saharan countries, including Ethiopia. Although few studies have previously estimated treatment outcomes of severe acute malnutrition (SAM) in Ethiopia, the findings were widely varied and inconsistent. This study thus aimed to pool estimates of treatment outcomes and identify predictors of mortality among children with SAM in Ethiopia.Methods: A systematic review was carried out to select 21 eligible articles from identified 1013 studies (dating from 2000 to 2018) that estimated treatment outcomes and predictors of mortality among SAM children. Databases including PubMed, CINHAL, Web of Sciences; Cochrane, Psych INFO and Google Scholar were comprehensively reviewed using medical subject headings (MESH) and a priori set criteria PRISMA guideline was used to systematically review and meta-analyze eligible studies. Details of sample size, magnitude of effect sizes, including Hazard Ratio (HRs) and standard errors were extracted. Random-effects model was used to calculate pooled estimates in Stata/se version-14. Cochran's Q, I2, and meta-bias statistics were assessed for heterogeneity and Egger's test for publication bias.Result: Twenty-one studies were included in the final analysis, which comprised 8057 under-five children with SAM in Ethiopia. The pooled estimates of treatment outcomes, in terms of death, recovery, defaulter and transfer out and non-response rates were 10.3% (95% CI: 8.3, 12.3), 70.5% (95% CI: 65.7, 72.2), 13.8% (95% CI: 10.8, 16.9) and 5.1% (95% CI: 3.3, 6.9), respectively. Diarrhea (HR: 1.5, 95% CI: 1.1, 2.2), dehydration (HR: 3.1, 95% CI: 2.3, 4.2) and anemia (HR: 2.2, 95% CI: 1.5, 3.3) were statistically significant predictors of mortality among these children. No publication bias was detected.Conclusion: Treatment outcomes in under-five children with SAM are lower than the World Health Organization (WHO) standard, where mortality is being predicted by comorbidities at admission. Children with SAM need to be treated for diarrhea, dehydration and anemia at the primary point of care to reduce mortality. [ABSTRACT FROM AUTHOR]

Background: Childhood morbidities are a major cause of mortality of children in the developing countries particularly in Ethiopia. Regardless of the noticeable improvement in the reduction of under-five death in Ethiopia, childhood diarrhea and fever are still the leading cause of death. In Ethiopia, the burden of child mortality is alarming and calls for determined efforts in combating such health problems. Therefore, this study aimed to investigate the risk factors for childhood morbidity specifically for diarrhea and fever.Methods: To gain insight into children's health issues, the 2016 Ethiopian Demographic and Health Survey data were used. Among the marginal models, alternating logistic regression that is an extension of the generalized estimating equation model was used to investigate the risk factors of childhood morbidity explicitly for diarrhea and fever.Results: The results show that the child's sex, child's age, anemia level, husband education level, mother's work status, mother's marital status, breastfeeding status and region are all chosen significant risk factors related with childhood diarrhea disease and fever disease.Conclusion: The study indicated that male children, 0-11 months aged children, 12-23 months aged children, anemic children, husband with a lower education, mothers paid employment, non-breastfed children, regions of Amhara, Afar, Dire Dawa, Benishangul, Gambela, Oromia, SNNPR, Somali and Tigray were significantly associated with higher odds of morbidity in Ethiopia. Therefore, there is a need for children morbidity interventions intended to improve child health outcomes in the country. [ABSTRACT FROM AUTHOR]

Background: Malnutrition is one of the major contributors to child mortality in Ethiopia. Currently established, child nutrition status is assessed by four anthropometric indicators. However, there are other factors affecting children's anthropometric statuses. Thus, the main objective of this paper is to explore some of the determinants of child anthropometric indicators in Ethiopia.Methods: Data from GROW (the Growing Nutrition for Mothers and Children), a survey including 1261 mothers and 1261 children was carried out in Ethiopia in 2016. Based on the data gathered, the goal of GROW is to improve the nutritional status of women of reproductive age (15-49), as well as boys and girls under 5 years of age in Ethiopia. In order to investigate the association between different factors and child anthropometric indicators, this study employs various statistical methods, such as ANOVA, T-test, and linear regressions.Results: Child's sex (confidence intervals for (wasting = - 0.782, - 0.151; stunting = - 0.936,-0.243) (underweight = - 0.530, - 0.008), child's age (confidence intervals for (wasting = - 0.020, 0.007; stunting = - 0.042,-0.011) (underweight = - 0.025, - 0.002), maternal MUAC (confidence intervals for (wasting = 0.189, 0.985; BMI-for-age = 0.077, 0.895), maternal education (stunting = 0.095, 0.897; underweight = 0.120, 0.729), and open defecation (stunting = 0.055, 0.332; underweight = 0.042, 0.257) were found to be significantly associated with anthropometric indicators. Contrary to some findings, maternal dietary diversity does not present significance in aforementioned child anthropometric indicators.Conclusion: Depending on the choice of children anthropometric indicator, different conclusions were drawn demonstrating the association between each factor to child nutritional status. Results showed child's sex, age, region, open defecation, and maternal MUAC significantly increases the risk of child anthropometric indicators. Highlighting the factors influencing child undernutrition will help inform future policies and programs designed to approach this major problem in Ethiopia. [ABSTRACT FROM AUTHOR]