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1. Global fertility in 204 countries and territories, 1950–2021, with forecasts to 2100: a comprehensive demographic analysis for the Global Burden of Disease Study 2021

Author

Bhattacharjee, NV, Schumacher, AE, Aali, A, Abate, YH, Abbasgholizadeh, R, Abbasian, M, Abbasi-Kangevari, M, Abbastabar, H, ElHafeez, SA, Abd-Elsalam, S, Abdollahi, M, Abdollahifar, MA, Abdoun, M, Abdullahi, A, Abebe, M, Abebe, SS, Abiodun, O, Abolhassani, H, Abolmaali, M, Abouzid, M, Aboye, GB, Abreu, LG, Abrha, WA, Abrigo, MRM, Abtahi, D, Abualruz, H, Abubakar, B, Abu-Gharbieh, E, Abu-Rmeileh, NME, Adal, TGG, Adane, MM, Adeagbo, OAA, Adedoyin, RA, Adekanmbi, V, Aden, B, Adepoju, AV, Adetokunboh, OO, Adetunji, JB, Adeyinka, DA, Adeyomoye, OI, Adnani, QES, Adra, S, Afolabi, RF, Afyouni, S, Afzal, MS, Afzal, S, Aghamiri, S, Agodi, A, Agyemang-Duah, W, Ahinkorah, BO, Ahlstrom, AJ, Ahmad, A, Ahmad, D, Ahmad, F, Ahmad, MM, Ahmad, S, Ahmad, T, Ahmed, A, Ahmed, H, Ahmed, LA, Ahmed, MS, Ahmed, SA, Ajami, M, Aji, B, Akalu, GT, Akbarialiabad, H ; https://orcid.org/0000-0003-2018-6378, Akinyemi, RO, Akkaif, MA, Akkala, S, Al Hamad, H, Al Hasan, SM, Qadire, MA, AL-Ahdal, TMA, Alalalmeh, SO, Alalwan, TA, Al-Aly, Z, Alam, K, Al-Amer, RM, Alanezi, FM, Alanzi, TM, Albakri, A, Albashtawy, M, AlBataineh, MT, Alemi, H, Alemi, S, Alemu, YM, Al-Eyadhy, A, Al-Gheethi, AAS, Alhabib, KF, Alhajri, N, Alhalaiqa, FAN, Alhassan, RK, Ali, A, Ali, BA, Ali, L, Ali, MU, Ali, R, Ali, SSS, Alif, SM, Xu, Luna ; https://orcid.org/0000-0003-4787-6547, Peprah, Prince ; https://orcid.org/0000-0002-3816-2713, Biswas, Raaj Kishore ; https://orcid.org/0000-0003-4294-6323, Okeke, Sylvester ; https://orcid.org/0000-0001-9211-1813, Mitchell, Philip ; https://orcid.org/0000-0002-7954-5235, Dai-Keller, Zhaoli ; https://orcid.org/0000-0003-0809-5692, Bhattacharjee, NV, Schumacher, AE, Aali, A, Abate, YH, Abbasgholizadeh, R, Abbasian, M, Abbasi-Kangevari, M, Abbastabar, H, ElHafeez, SA, Abd-Elsalam, S, Abdollahi, M, Abdollahifar, MA, Abdoun, M, Abdullahi, A, Abebe, M, Abebe, SS, Abiodun, O, Abolhassani, H, Abolmaali, M, Abouzid, M, Aboye, GB, Abreu, LG, Abrha, WA, Abrigo, MRM, Abtahi, D, Abualruz, H, Abubakar, B, Abu-Gharbieh, E, Abu-Rmeileh, NME, Adal, TGG, Adane, MM, Adeagbo, OAA, Adedoyin, RA, Adekanmbi, V, Aden, B, Adepoju, AV, Adetokunboh, OO, Adetunji, JB, Adeyinka, DA, Adeyomoye, OI, Adnani, QES, Adra, S, Afolabi, RF, Afyouni, S, Afzal, MS, Afzal, S, Aghamiri, S, Agodi, A, Agyemang-Duah, W, Ahinkorah, BO, Ahlstrom, AJ, Ahmad, A, Ahmad, D, Ahmad, F, Ahmad, MM, Ahmad, S, Ahmad, T, Ahmed, A, Ahmed, H, Ahmed, LA, Ahmed, MS, Ahmed, SA, Ajami, M, Aji, B, Akalu, GT, Akbarialiabad, H ; https://orcid.org/0000-0003-2018-6378, Akinyemi, RO, Akkaif, MA, Akkala, S, Al Hamad, H, Al Hasan, SM, Qadire, MA, AL-Ahdal, TMA, Alalalmeh, SO, Alalwan, TA, Al-Aly, Z, Alam, K, Al-Amer, RM, Alanezi, FM, Alanzi, TM, Albakri, A, Albashtawy, M, AlBataineh, MT, Alemi, H, Alemi, S, Alemu, YM, Al-Eyadhy, A, Al-Gheethi, AAS, Alhabib, KF, Alhajri, N, Alhalaiqa, FAN, Alhassan, RK, Ali, A, Ali, BA, Ali, L, Ali, MU, Ali, R, Ali, SSS, Alif, SM, Xu, Luna ; https://orcid.org/0000-0003-4787-6547, Peprah, Prince ; https://orcid.org/0000-0002-3816-2713, Biswas, Raaj Kishore ; https://orcid.org/0000-0003-4294-6323, Okeke, Sylvester ; https://orcid.org/0000-0001-9211-1813, Mitchell, Philip ; https://orcid.org/0000-0002-7954-5235, and Dai-Keller, Zhaoli ; https://orcid.org/0000-0003-0809-5692

Abstract

Background: Accurate assessments of current and future fertility—including overall trends and changing population age structures across countries and regions—are essential to help plan for the profound social, economic, environmental, and geopolitical challenges that these changes will bring. Estimates and projections of fertility are necessary to inform policies involving resource and health-care needs, labour supply, education, gender equality, and family planning and support. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 produced up-to-date and comprehensive demographic assessments of key fertility indicators at global, regional, and national levels from 1950 to 2021 and forecast fertility metrics to 2100 based on a reference scenario and key policy-dependent alternative scenarios. Methods: To estimate fertility indicators from 1950 to 2021, mixed-effects regression models and spatiotemporal Gaussian process regression were used to synthesise data from 8709 country-years of vital and sample registrations, 1455 surveys and censuses, and 150 other sources, and to generate age-specific fertility rates (ASFRs) for 5-year age groups from age 10 years to 54 years. ASFRs were summed across age groups to produce estimates of total fertility rate (TFR). Livebirths were calculated by multiplying ASFR and age-specific female population, then summing across ages 10–54 years. To forecast future fertility up to 2100, our Institute for Health Metrics and Evaluation (IHME) forecasting model was based on projections of completed cohort fertility at age 50 years (CCF50; the average number of children born over time to females from a specified birth cohort), which yields more stable and accurate measures of fertility than directly modelling TFR. CCF50 was modelled using an ensemble approach in which three sub-models (with two, three, and four covariates variously consisting of female educational attainment, contraceptive met need, population density in

Published
2024

2. Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

Author

Brauer, M, Roth, GA, Aravkin, AY, Zheng, P, Abate, KH, Abate, YH, Abbafati, C, Abbasgholizadeh, R, Abbasi, MA, Abbasian, M, Abbasifard, M, Abbasi-Kangevari, M, Abd ElHafeez, S, Abd-Elsalam, S, Abdi, P, Abdollahi, M, Abdoun, M, Abdulah, DM, Abdullahi, A, Abebe, M, Abedi, A, Abegaz, TM, Zuñiga, RAA, Abiodun, O, Abiso, TL, Aboagye, RG ; https://orcid.org/0000-0002-3498-2909, Abolhassani, H, Abouzid, M, Aboye, GB, Abreu, LG, Abualruz, H, Abubakar, B, Abu-Gharbieh, E, Abukhadijah, HJJ, Aburuz, S, Abu-Zaid, A, Adane, MM, Addo, IY, Addolorato, G, Adedoyin, RA, Adekanmbi, V, Aden, B, Adetunji, JB, Adeyeoluwa, TE, Adha, R, Adibi, A, Adnani, QES, Adzigbli, LA, Afolabi, AA, Afolabi, RF, Afshin, A, Afyouni, S, Afzal, MS, Afzal, S, Agampodi, SB, Agbozo, F, Aghamiri, S, Agodi, A, Agrawal, A, Agyemang-Duah, W, Ahinkorah, BO, Ahmad, A, Ahmad, D, Ahmad, F, Ahmad, N, Ahmad, S, Ahmad, T, Ahmed, A, Ahmed, LA, Ahmed, MB, Ahmed, S, Ahmed, SA, Ajami, M, Akalu, GT, Akara, EM, Akbarialiabad, H ; https://orcid.org/0000-0003-2018-6378, Akhlaghi, S, Akinosoglou, K, Akinyemiju, T, Akkaif, MA, Akkala, S, Akombi-Inyang, B, Al Awaidy, S, Al Hasan, SM, Alahdab, F, AL-Ahdal, TMA, Alalalmeh, SO, Alalwan, TA, Al-Aly, Z, Alam, K, Alam, N, Alanezi, FM, Alanzi, TM, Albakri, A, AlBataineh, MT, Aldhaleei, WA, Aldridge, RW, Maulik, Pallab Kumar ; https://orcid.org/0000-0001-6835-6175, Godinho, Myron ; https://orcid.org/0000-0002-0081-2506, Biswas, Raaj Kishore ; https://orcid.org/0000-0003-4294-6323, Sachdev, Perminder ; https://orcid.org/0000-0002-9595-3220, Mitchell, Philip ; https://orcid.org/0000-0002-7954-5235, Dai-Keller, Zhaoli ; https://orcid.org/0000-0003-0809-5692, Huda, Md Nazmul ; https://orcid.org/0000-0001-7048-1266, Boufous, Soufiane ; https://orcid.org/0000-0002-5686-1729, Xu, Luna ; https://orcid.org/0000-0003-4787-6547, Peprah, Prince ; https://orcid.org/0000-0002-3816-2713, Degenhardt, Louisa ; https://orcid.org/0000-0002-8513-2218, Schutte, Alta ; https://orcid.org/0000-0001-9217-4937, Pesudovs, Konrad ; https://orcid.org/0000-0002-6322-9369, Okeke, Sylvester ; https://orcid.org/0000-0001-9211-1813, Si, Yafei ; https://orcid.org/0000-0001-9334-8230, Brauer, M, Roth, GA, Aravkin, AY, Zheng, P, Abate, KH, Abate, YH, Abbafati, C, Abbasgholizadeh, R, Abbasi, MA, Abbasian, M, Abbasifard, M, Abbasi-Kangevari, M, Abd ElHafeez, S, Abd-Elsalam, S, Abdi, P, Abdollahi, M, Abdoun, M, Abdulah, DM, Abdullahi, A, Abebe, M, Abedi, A, Abegaz, TM, Zuñiga, RAA, Abiodun, O, Abiso, TL, Aboagye, RG ; https://orcid.org/0000-0002-3498-2909, Abolhassani, H, Abouzid, M, Aboye, GB, Abreu, LG, Abualruz, H, Abubakar, B, Abu-Gharbieh, E, Abukhadijah, HJJ, Aburuz, S, Abu-Zaid, A, Adane, MM, Addo, IY, Addolorato, G, Adedoyin, RA, Adekanmbi, V, Aden, B, Adetunji, JB, Adeyeoluwa, TE, Adha, R, Adibi, A, Adnani, QES, Adzigbli, LA, Afolabi, AA, Afolabi, RF, Afshin, A, Afyouni, S, Afzal, MS, Afzal, S, Agampodi, SB, Agbozo, F, Aghamiri, S, Agodi, A, Agrawal, A, Agyemang-Duah, W, Ahinkorah, BO, Ahmad, A, Ahmad, D, Ahmad, F, Ahmad, N, Ahmad, S, Ahmad, T, Ahmed, A, Ahmed, LA, Ahmed, MB, Ahmed, S, Ahmed, SA, Ajami, M, Akalu, GT, Akara, EM, Akbarialiabad, H ; https://orcid.org/0000-0003-2018-6378, Akhlaghi, S, Akinosoglou, K, Akinyemiju, T, Akkaif, MA, Akkala, S, Akombi-Inyang, B, Al Awaidy, S, Al Hasan, SM, Alahdab, F, AL-Ahdal, TMA, Alalalmeh, SO, Alalwan, TA, Al-Aly, Z, Alam, K, Alam, N, Alanezi, FM, Alanzi, TM, Albakri, A, AlBataineh, MT, Aldhaleei, WA, Aldridge, RW, Maulik, Pallab Kumar ; https://orcid.org/0000-0001-6835-6175, Godinho, Myron ; https://orcid.org/0000-0002-0081-2506, Biswas, Raaj Kishore ; https://orcid.org/0000-0003-4294-6323, Sachdev, Perminder ; https://orcid.org/0000-0002-9595-3220, Mitchell, Philip ; https://orcid.org/0000-0002-7954-5235, Dai-Keller, Zhaoli ; https://orcid.org/0000-0003-0809-5692, Huda, Md Nazmul ; https://orcid.org/0000-0001-7048-1266, Boufous, Soufiane ; https://orcid.org/0000-0002-5686-1729, Xu, Luna ; https://orcid.org/0000-0003-4787-6547, Peprah, Prince ; https://orcid.org/0000-0002-3816-2713, Degenhardt, Louisa ; https://orcid.org/0000-0002-8513-2218, Schutte, Alta ; https://orcid.org/0000-0001-9217-4937, Pesudovs, Konrad ; https://orcid.org/0000-0002-6322-9369, Okeke, Sylvester ; https://orcid.org/0000-0001-9211-1813, and Si, Yafei ; https://orcid.org/0000-0001-9334-8230

Abstract

Background: Understanding the health consequences associated with exposure to risk factors is necessary to inform public health policy and practice. To systematically quantify the contributions of risk factor exposures to specific health outcomes, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 aims to provide comprehensive estimates of exposure levels, relative health risks, and attributable burden of disease for 88 risk factors in 204 countries and territories and 811 subnational locations, from 1990 to 2021. Methods: The GBD 2021 risk factor analysis used data from 54 561 total distinct sources to produce epidemiological estimates for 88 risk factors and their associated health outcomes for a total of 631 risk–outcome pairs. Pairs were included on the basis of data-driven determination of a risk–outcome association. Age-sex-location-year-specific estimates were generated at global, regional, and national levels. Our approach followed the comparative risk assessment framework predicated on a causal web of hierarchically organised, potentially combinative, modifiable risks. Relative risks (RRs) of a given outcome occurring as a function of risk factor exposure were estimated separately for each risk–outcome pair, and summary exposure values (SEVs), representing risk-weighted exposure prevalence, and theoretical minimum risk exposure levels (TMRELs) were estimated for each risk factor. These estimates were used to calculate the population attributable fraction (PAF; ie, the proportional change in health risk that would occur if exposure to a risk factor were reduced to the TMREL). The product of PAFs and disease burden associated with a given outcome, measured in disability-adjusted life-years (DALYs), yielded measures of attributable burden (ie, the proportion of total disease burden attributable to a particular risk factor or combination of risk factors). Adjustments for mediation were applied to account for relationships involving risk

Published
2024

3. Forecasting the effects of smoking prevalence scenarios on years of life lost and life expectancy from 2022 to 2050: a systematic analysis for the Global Burden of Disease Study 2021

Author

Bryazka, D, Reitsma, MB, Abate, YH, Abd Al Magied, AHA, Abdelkader, A, Abdollahi, A, Abdoun, M, Abdulkader, RS, Abeldaño Zuñiga, RA, Abhilash, ES, Abiodun, OO, Andrei, CL, Zhang, L, Zhong, CC, Zhou, SC, Zhu, B, Zielińska, M, Zoghi, G, Zyoud, SH, Vollset, SE, Gakidou, E, Andrei, T, Ansari, MT, Anuoluwa, IA, Anvari, S, Anwar, SL, Anyasodor, AE, Arabloo, J, Arafa, EA, Aravkin, AY, Abiodun, O, Areda, D, Aregawi, BB, Aremu, O, Artamonov, AA, Asgedom, AA, Asghari-Jafarabadi, M, Ashemo, MY, Ashraf, T, Astell-Burt, T, Athari, SS, Aboagye, RG, Atorkey, P, Atreya, A, Aujayeb, A, Awotidebe, AW, Ayano, G, Aychiluhm, SB, Azadnajafabad, S, Azzam, AY, Babu, GR, Bahrami Taghanaki, P, Abreu, LG, Bahramian, S, Bai, R, Bakkannavar, SM, Balakrishnan, S, Bam, K, Banach, M, Bandyopadhyay, S, Baran, MF, Barchitta, M, Bardhan, M, Abtahi, D, Barker-Collo, SL, Barrow, A, Bashiru, HA, Basiru, A, Bastan, M-M, Basu, S, Batra, K, Bayati, M, Behnoush, AH, Abualruz, H, Bell, SL, Belo, L, Beneke, AA, Bennett, DA, Bensenor, IM, Beran, A, Bermudez, ANC, Beyene, HB, Bhagat, DS, Bhagavathula, AS, Abubakar, B, Bhala, N, Bhardwaj, N, Bhardwaj, P, Bhaskar, S, Bhat, AN, Bhattacharjee, NV, Bhattacharjee, P, Bhatti, JS, Bilgin, C, Biswas, A, Abu-Rmeileh, NME, Biswas, B, Boachie, MK, Bogale, EK, Bora Basara, B, Borhany, H, Bosoka, SA, Bouaoud, S, Boyko, EJ, Brenner, H, Brunoni, AR, Aburuz, S, Bugiardini, R, Bulamu, NB, Bustanji, Y, Butt, ZA, Caetano dos Santos, FL, Calina, D, Cao, C, Cao, F, Capodici, A, Cárdenas, R, Abu-Zaid, A, Carreras, G, Castaldelli-Maia, JM, Cattaruzza, MS, Caye, A, Cegolon, L, Cenko, E, Cerrai, S, Chakraborty, S, Chandika, RM, Chandrasekar, EK, Adane, MM, Chattu, VK, Chaudhary, AA, Chaurasia, A, Chen, A-T, Chen, G, Chen, H, Chen, MX, Chen, S, Cheng, KJG, Chi, G, Adebiyi, AO, Chichagi, F, Chimoriya, R, Chirinos-Caceres, JL, Chitheer, A, Chong, B, Chong, CL, Chong, YY, Chopra, H, Choudhari, SG, Chu, D-T, Adegboye, OA, Chukwu, IS, Chung, S-C, Chutiyami, M, Conde, J, Corlateanu, A, Criqui, MH, Cruz-Martins, N, da Silva, AG, Dadras, O, Dai, S, Adekanmbi, V, Dai, X, Damiani, G, Dandona, L, Dandona, R, Darcho, SD, Darvishi Cheshmeh Soltani, R, Das, S, Dash, NR, Davletov, K, Debele, AT, Adewuyi, HO, Debopadhaya, S, Demant, D, Desai, HD, Devegowda, D, Dewan, SMR, Dhali, A, Dhane, AS, Dhulipala, VR, Do, TC, Dodangeh, M, Adnani, QES, Doegah, PT, Dohare, S, Dongarwar, D, D'Oria, M, Doshi, OP, Doshi, RP, Dowou, RK, Dsouza, AC, Dsouza, HL, Dsouza, VS, Adzigbli, LA, Duncan, BB, Duraes, AR, Dziedzic, AM, E'mar, AR, Ebrahimi, A, Ebrahimi, N, Ebrahimi Kalan, M, Edvardsson, D, Edvardsson, K, Efendi, F, Afaghi, S, Effendi, DE, Eghbali, F, Ekholuenetale, M, El Arab, RA, El Bayoumy, IF, El Sayed, I, Elbarazi, I, Elhadi, M, El-Huneidi, W, Elmonem, MA, Afolabi, AA, ELNahas, G, Elsohaby, I, Eltaha, C, Eltahir, ME, Emamverdi, M, Emeto, TI, Erku, DA, Etaee, F, Ezenwankwo, EF, Fabin, N, Afzal, MS, Fagbamigbe, AF, Fagbule, OF, Faghani, S, Fahim, A, Fakhradiyev, IR, Falzone, L, Farooque, U, Fatehizadeh, A, Fatima, Z, Fauk, NK, Afzal, S, Fazylov, T, Feizkhah, A, Fekadu, G, Feng, X, Ferrara, P, Ferreira, N, Feyisa, BR, Filippidis, FT, Fischer, F, Flor, LS, Agodi, A, Foigt, NA, Fortuna Rodrigues, C, Foschi, M, G, S, Gaal, PA, Gadanya, MA, Gaidhane, AM, Gajdács, M, Gallus, S, Gandhi, AP, Agyemang-Duah, W, Ganesan, B, Gautam, P, Gautam, RK, Gebregergis, MW, Gebrehiwot, M, Gebremeskel, TG, Getacher, L, Ghadirian, F, Ghazy, RM, Gholamrezanezhad, A, Ahinkorah, BO, Ghorbani, M, Ghozy, S, Gil, AU, Gil, GF, Gnedovskaya, EV, Goel, S, Goharinezhad, S, Goldust, M, Golechha, M, Goleij, P, Ahlstrom, AJ, Golinelli, D, Gorini, G, Gouravani, M, Grada, A, Grivna, M, Grover, S, Guan, S-Y, Gubari, MIM, Guha, A, Guicciardi, S, Ahmad, A, Gulati, S, Gunawardane, DA, Gunturu, S, Guo, Z, Gupta, AK, Gupta, B, Gupta, I, Gupta, M, Gupta, R, Gupta, S, Ahmad, D, Gupta, VB, Gupta, V, Gupta, VK, Hadei, M, Hadi, NR, Hajj Ali, A, Halboub, ES, Hamdy, NM, Hamidi, S, Hammoud, A, Ahmad, MM, Hankey, GJ, Hargono, A, Haro, JM, Hasaballah, AI, Hasan, F, Hasan, MK, Hasnain, MS, Hassan, A, Hassan, II, Hassan, S, Ahmad, S, Hay, SI, Heibati, B, Heidari, M, Hemmati, M, Hendrie, D, Herteliu, C, Heyi, DZ, Hezam, K, Hiraike, Y, Hoan, NQ, Holla, R, Horita, N, Hossain, MM, Hossain, S, Hosseinzadeh, H, Hostiuc, M, Hostiuc, S, Huang, J, Humayun, A, Hussain, J, Ahmadi, A, Hwang, B-F, Ibitoye, SE, Ikeda, N, Ikiroma, A, Ilesanmi, OS, Ilic, IM, Ilic, MD, Immurana, M, Inbaraj, LR, Iqhrammullah, M, Ahmed, A, Irham, LM, Islam, MR, Islam, SMS, Islami, F, Isola, G, Itumalla, R, Iwagami, M, Iyer, M, J, V, Jaafari, J, Jacob, L, Jafarzadeh, A, Jaggi, K, Jahanmehr, N, Jain, A, Jain, N, Jairoun, AA, Jaka, S, Jakovljevic, M, Jalilzadeh Yengejeh, R, Ahmed, H, Jamshidi, E, Janodia, MD, Jawaid, T, Jayapal, SK, Jayaram, S, Jayasinghe, RD, Jebai, R, Jee, SH, Jeswani, BM, Jiang, H, Ahmed, MB, Jokar, M, Jonas, JB, Joo, T, Joseph, N, Joshua, CE, Jozwiak, JJ, Jürisson, M, K, V, Kabir, A, Kabir, Z, Ahmed, S, Kadashetti, V, Kamarajah, SK, Kanaan, M, Kanmodi, KK, Kant, S, Kantar, RS, Karakasis, P, Karaye, IM, Karimi, SE, Karimi, Y, Ajami, M, Karimi Behnagh, A, Karkhah, S, Karki, P, Kashoo, FZ, Katikireddi, SV, Kaur, H, Kaur, N, Kazemian, S, Kazmi, TH, Keiyoro, PN, Akkaif, MA, Kesse-Guyot, E, Khader, YS, Khajuria, H, Khalaji, A, Khalilian, A, Khan, A, Khan, M, Khan, MJ, Khan, MAB, Khanmohammadi, S, Akter, E, Khatab, K, Khatatbeh, H, Khatatbeh, MM, Khater, AM, Kheirallah, KA, Khokhar, M, Khormali, M, Khosla, AA, Khosravi, S, Kim, K, Al Awaidy, S, Kim, MS, Kim, YJ, Kisa, A, Kolahi, A-A, Komaki, S, Kondlahalli, SKMM, Korja, M, Korzh, O, Kosen, S, Kostev, K, Al Hasan, SM, Krishan, K, Kuate Defo, B, Kuddus, M, Kujan, O, Kulimbet, M, Kumar, A, Kumar, GA, Kumar, N, Kumar, R, Kumar, V, Al-Ajlouni, Y, Kundu, A, Kundu, S, Kunutsor, SK, Kurmi, OP, Kusuma, D, Kyei-Arthur, F, Kytö, V, La Vecchia, C, Lahariya, C, Lai, DTC, Al-Aly, Z, Lai, H, Lalloo, R, Lallukka, T, Larijani, B, Lasrado, S, Lau, J, Lauriola, P, Le, TTT, Leasher, JL, Lee, M, Alam, K, Lee, SW, Lee, W-C, Lee, YH, Leong, E, Lerango, TL, Li, A, Li, W, Ligade, VS, Lim, SS, Lin, J, Alam, Z, Lindstedt, PA, Liu, G, Llanaj, E, López-Gil, JF, Lotufo, PA, Lucchetti, G, Lugo, A, Lusk, JB, M Amin, HI, Ma, ZF, Aldhaleei, WA, Machoy, M, Madadizadeh, F, Mahmoudi, E, Makram, AM, Makram, OM, Malhotra, K, Malik, AA, Malta, DC, Mamun, AA, Mansouri, P, Algammal, AM, Mansournia, MA, Manu, E, Marateb, HR, Martinez-Raga, J, Martorell, M, Marzo, RR, Mathangasinghe, Y, Mathews, E, Mathur, M, Mathur, N, Al-Gheethi, AAS, Mattiello, R, Maugeri, A, McKee, M, Mechili, EA, Mehrotra, R, Mekene Meto, T, Mekonnen, BD, Meles, HN, Mendoza, W, Menezes, RG, Alhabib, KF, Meo, SA, Meretoja, A, Meretoja, TJ, Mestrovic, T, Meyers, CCA, Michalek, IM, Miller, TR, Minervini, G, Mirghafourvand, M, Mirrakhimov, EM, Alhalaiqa, FN, Mishra, V, Misra, S, Mithra, P, Mohamed, AI, Mohamed, J, Mohamed, MFH, Mohamed, NS, Mohammad, AM, Mohammad-Alizadeh-Charandabi, S, Mohammadzadeh, I, 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Nargus, S, Nascimento, GG, Nashwan, AJ, Natto, ZS, Nauman, J, Naveed, M, Nawsherwan, Nayak, BP, Nayak, VC, Ali, SS, Nazri-Panjaki, A, Nduaguba, SO, Negoi, RI, Nejad Shahrokh Abadi, R, Nejadghaderi, SA, Nejjari, C, Neupane, S, Ng, M, Ngunjiri, JW, Nguyen, DH, Ali, W, Nguyen, HTH, Nguyen, HQ, Nguyen, PT, Nguyen, VT, Nigatu, YT, Nikolouzakis, TK, Nikoobar, A, Nikravangolsefid, N, Niranjan, V, Alif, SM, Nnaji, CA, Nnyanzi, LA, Noman, EA, Nomura, S, Noor, STA, Noreen, M, Nozari, M, Nugen, F, Nzoputam, CI, Nzoputam, OJ, Aljunid, SM, Oancea, B, Obamiro, KO, Odetokun, IA, Odo, DBO, Odukoya, OO, Oduro, MS, Oguta, JO, Oh, I-H, Okati-Aliabad, H, Okeke, SR, Alla, F, Okekunle, AP, Okonji, OC, Olagunju, AT, Olasupo, OO, Olatubi, MI, Oliveira, GMM, Olorukooba, AA, Omer, GL, Ong, SK, Opejin, AO, Allebeck, P, Ordak, M, Orish, VN, Ortiz-Prado, E, Osuagwu, UL, Otstavnov, SS, Ouyahia, A, P A, MP, Padron-Monedero, A, Padubidri, JR, Pak, A, Almahmeed, W, Palma-Alvarez, RF, Pan, H-F, Panagiotakos, D, Panda-Jonas, S, Pandey, A, Panos, LD, Pantazopoulos, I, Pantea Stoian, A, Papadopoulou, P, Pardhan, S, Al-Marwani, S, Parija, PP, Parikh, RR, Park, E-K, Park, S, Parsons, N, Passera, R, Patel, J, Patel, SK, Patil, S, Patwary, H, Al-Maweri, S, Pawar, S, Peprah, P, Pereira, G, Perianayagam, A, Pestell, RG, Petermann-Rocha, FE, Pham, T, Philip, AK, Phillips, MR, Poddighe, D, Alomari, MA, Polibin, RV, Poluru, R, Porru, F, Pourshams, A, Pradhan, J, Pradhan, PMS, Prasad, M, Prashant, A, Prates, EJS, Pribadi, DRA, Alqahtani, JS, Purohit, BM, Puvvula, J, Qattea, I, Radhakrishnan, V, Raggi, C, Raghav, P, Rahim, F, Rahimi-Movaghar, A, Rahman, MM, Rahman, M, Alqutaibi, AY, Rahman, MA, Rahmani, S, Rahmanian, M, Rahmanian, N, Rajendran, V, Rajpoot, PL, Rajput, P, Ram, P, Ramadan, MM, Ramadan, M, Al-Raddadi, RMM, Rana, K, Rana, RK, Ranabhat, CL, Rao, SJ, Rashedi, S, Rashid, AM, Rashidi, M-M, Rasouli-Saravani, A, Rathish, D, Rauniyar, SK, Alrousan, SM, Rautalin, I, Ravikumar, N, Rawaf, S, Reddy, MMRK, Redwan, EMM, Rezaei, N, Rezaeian, M, Riad, A, Rodrigues, M, Rodrigues da Silva, TPR, Alsakarneh, S, Rodriguez, JAB, Roever, L, Root, KT, Roshandel, G, Ross, AG, Rout, HS, Roy, B, Roy, N, Roy, S, Ruela, GDA, Alshahrani, NZ, S N, C, Sabet, CJ, Sabour, S, Sadarangani, KP, Saddik, BA, Sadeghi, M, Saeb, MR, Saeed, U, Saeedi, P, Safi, SZ, Altaany, Z, Sagoe, D, Saheb Sharif-Askari, F, Sahebkar, A, Sahoo, SS, Sajib, MRUZ, Sajid, MR, Salaroli, LB, Saleh, MA, Salem, MZY, Salihu, D, Altaf, A, Samodra, YL, Samy, AM, Sanabria, J, Santric-Milicevic, MM, Sao Jose, BP, Saqib, MAN, Sarasmita, MA, Saravanan, A, Saravi, B, Sarikhani, Y, Alvis-Guzman, N, Sarkar, T, Sarode, GS, Sarode, SC, Sartorius, B, Sathian, B, Sathyanarayan, A, Satpathy, M, Sawhney, M, Saylan, M, Schaarschmidt, BM, Al-Wardat, M, Schaub, MP, Schlaich, MP, Schmidt, MI, Schuermans, A, Schumacher, AE, Selvaraj, S, Semreen, MH, Senthilkumaran, S, Sepanlou, SG, Sethi, Y, Al-Worafi, YM, Seyedi, SA, Seylani, A, Shafie, M, Shafiee, A, Shahbandi, A, Shahid, S, Shahsavari, HR, Shahwan, MJ, Shaikh, A, Shaikh, MA, Aly, H, Shalash, AS, Shamim, MA, Shamsi, A, Shamsutdinova, A, Shanawaz, M, Shankar, A, Shannawaz, M, Sharath, M, Sharifan, A, Sharma, M, Aly, S, Sharma, U, Sharma, V, Sheikh, A, Sheikhy, A, Shetty, M, Shetty, PH, Shetty, PK, Shiferaw, D, Shimels, T, Shiri, R, Alyahya, MSI, Shittu, A, Shiue, I, Shivarov, V, Shorofi, SA, Shrestha, S, Siddig, EE, Silva, JP, Singh, A, Singh, B, Singh, H, Alzoubi, KH, Singh, JA, Singh, P, Singh, S, Singh, V, Sitas, F, Smith, AE, Soboka, M, Solanki, R, Solmi, M, Al-Zyoud, WA, Soraneh, S, Soriano, JB, Soyiri, IN, Spartalis, M, Sreeramareddy, CT, Stachteas, P, Stein, DJ, Steiropoulos, P, Stevanović, A, Straif, K, Amani, R, Suleman, M, Sulo, G, Sun, Z, Suresh, V, Swain, CK, Szarpak, L, T Y, SS, Tabaee Damavandi, P, Tabatabaei Malazy, O, Tabatabaeizadeh, S-A, Amin, TT, Tabche, C, Tadakamadla, J, Tadakamadla, SK, Taiba, J, Talaat, IM, Talukder, A, Tampa, M, Tamuzi, JLJL, Tan, K-K, Tareke, M, Amiri, S, Tarigan, IU, Teimoori, M, Temsah, M-H, Temsah, RMH, Teramoto, M, Terefa, DR, Thangaraju, P, Thankappan, KR, Thapar, R, Thayakaran, R, Amu, H, Thomas, NK, Ticoalu, JHV, Tiwari, K, Topor-Madry, R, Tovani-Palone, MR, Trabelsi, K, Tran, AT, Tran, NH, Tran, TH, Tran Minh Duc, N, Amul, GGH, Trihandini, I, Tripathy, JP, Truyen, TTTT, Tsermpini, EE, Tualeka, AR, Udoakang, AJ, Udoh, A, Ullah, A, Ullah, S, Umair, M, Amusa, GA, Unim, B, Unnikrishnan, B, Usman, JS, Vahdati, S, Vaithinathan, AG, Van den Eynde, J, Vardavas, C, Vasankari, TJ, Vaziri, S, Vellingiri, B, Anand, T, Venketasubramanian, N, Verma, M, Villeneuve, PJ, Vinayak, M, Violante, FS, Vladimirov, SK, Volovat, SR, Wadood, A, Waheed, Y, Walde, MT, Anderlini, D, Wang, S, Wang, Y, Waqas, M, Wickramasinghe, ND, Willeit, P, Wojewodzic, MW, Wolde, AA, Wonde, TE, Xiao, H, Xu, S, Anderson, DB, Yadav, MK, Yamagishi, K, Yang, D, Yang, L, Yano, Y, Yarahmadi, A, Yesodharan, R, Yezli, S, Yi, X, Yiğit, A, Anderson, JA, Yin, D, Yon, DK, Yonemoto, N, Yoon, S-J, Yu, C, Yuan, C-W, Zakham, F, Zeariya, MGM, Zhang, H, and Zhang, J

Published
2024

4. Global, regional, and national burden of hepatitis B, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Author

Sheena, BS, Hiebert, L, Han, H, Ippolito, H, Abbasi-Kangevari, M, Abbasi-Kangevari, Z, Abbastabar, H, Abdoli, A, Abubaker Ali, H, Adane, MM, Adegboye, OA, Adnani, QES, Advani, SM, Afzal, MS, Afzal, S, Aghaie Meybodi, M, Ahadinezhad, B, Ahinkorah, BO, Ahmad, S, Ahmad, T, Ahmadi, S, Ahmed, H, Ahmed, MB, Rashid, TA, Akalu, GT, Aklilu, A, Akram, T, Al Hamad, H, Alahdab, F, Alem, AZ, Alem, DT, Alhalaiqa, FAN, Alhassan, RK, Ali, L, Ali, MA, Alimohamadi, Y, Alipour, V, Alkhayyat, M, Almustanyir, S, Al-Raddadi, RM, Altawalah, H, Amini, S, Amu, H, Ancuceanu, R, Andrei, CL, Andrei, T, Anoushiravani, A, Ansar, A, Anyasodor, AE, Arabloo, J, Arab-Zozani, M, Argaw, AM, Argaw, ZG, Arshad, M, Artamonov, AA, Ashraf, T, Atlaw, D, Ausloos, F, Ausloos, M, Azadnajafabad, S, Azangou-Khyavy, M, Azari Jafari, A, Azarian, G, Bagheri, S, Bahadory, S, Baig, AA, Banach, M, Barati, N, Barrow, A, Batiha, AMM, Bejarano Ramirez, DF, Belgaumi, UI, Berhie, AY, Bhagat, DS, Bhardwaj, N, Bhardwaj, P, Bhattacharyya, K, Bhojaraja, VS, Bijani, A, Biondi, A, Bodicha, BBA, Bojia, HA, Boloor, A, Bosetti, C, Braithwaite, D, Briko, NI, Butt, ZA, Cámera, LA, Chakinala, RC, Chakraborty, PA, Charan, J, Chen, S ; https://orcid.org/0000-0002-1108-3863, Choi, JYJ, Choudhari, SG, Chowdhury, FR, Chu, DT, Chung, SC, Cortesi, PA, Cowie, BC, Culbreth, GT, Sheena, BS, Hiebert, L, Han, H, Ippolito, H, Abbasi-Kangevari, M, Abbasi-Kangevari, Z, Abbastabar, H, Abdoli, A, Abubaker Ali, H, Adane, MM, Adegboye, OA, Adnani, QES, Advani, SM, Afzal, MS, Afzal, S, Aghaie Meybodi, M, Ahadinezhad, B, Ahinkorah, BO, Ahmad, S, Ahmad, T, Ahmadi, S, Ahmed, H, Ahmed, MB, Rashid, TA, Akalu, GT, Aklilu, A, Akram, T, Al Hamad, H, Alahdab, F, Alem, AZ, Alem, DT, Alhalaiqa, FAN, Alhassan, RK, Ali, L, Ali, MA, Alimohamadi, Y, Alipour, V, Alkhayyat, M, Almustanyir, S, Al-Raddadi, RM, Altawalah, H, Amini, S, Amu, H, Ancuceanu, R, Andrei, CL, Andrei, T, Anoushiravani, A, Ansar, A, Anyasodor, AE, Arabloo, J, Arab-Zozani, M, Argaw, AM, Argaw, ZG, Arshad, M, Artamonov, AA, Ashraf, T, Atlaw, D, Ausloos, F, Ausloos, M, Azadnajafabad, S, Azangou-Khyavy, M, Azari Jafari, A, Azarian, G, Bagheri, S, Bahadory, S, Baig, AA, Banach, M, Barati, N, Barrow, A, Batiha, AMM, Bejarano Ramirez, DF, Belgaumi, UI, Berhie, AY, Bhagat, DS, Bhardwaj, N, Bhardwaj, P, Bhattacharyya, K, Bhojaraja, VS, Bijani, A, Biondi, A, Bodicha, BBA, Bojia, HA, Boloor, A, Bosetti, C, Braithwaite, D, Briko, NI, Butt, ZA, Cámera, LA, Chakinala, RC, Chakraborty, PA, Charan, J, Chen, S ; https://orcid.org/0000-0002-1108-3863, Choi, JYJ, Choudhari, SG, Chowdhury, FR, Chu, DT, Chung, SC, Cortesi, PA, Cowie, BC, and Culbreth, GT

Abstract

Background: Combating viral hepatitis is part of the UN Sustainable Development Goals (SDGs), and WHO has put forth hepatitis B elimination targets in its Global Health Sector Strategy on Viral Hepatitis (WHO-GHSS) and Interim Guidance for Country Validation of Viral Hepatitis Elimination (WHO Interim Guidance). We estimated the global, regional, and national prevalence of hepatitis B virus (HBV), as well as mortality and disability-adjusted life-years (DALYs) due to HBV, as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. This included estimates for 194 WHO member states, for which we compared our estimates to WHO elimination targets. Methods: The primary data sources were population-based serosurveys, claims and hospital discharges, cancer registries, vital registration systems, and published case series. We estimated chronic HBV infection and the burden of HBV-related diseases, defined as an aggregate of cirrhosis due to hepatitis B, liver cancer due to hepatitis B, and acute hepatitis B. We used DisMod-MR 2.1, a Bayesian mixed-effects meta-regression tool, to estimate the prevalence of chronic HBV infection, cirrhosis, and aetiological proportions of cirrhosis. We used mortality-to-incidence ratios modelled with spatiotemporal Gaussian process regression to estimate the incidence of liver cancer. We used the Cause of Death Ensemble modelling (CODEm) model, a tool that selects models and covariates on the basis of out-of-sample performance, to estimate mortality due to cirrhosis, liver cancer, and acute hepatitis B. Findings: In 2019, the estimated global, all-age prevalence of chronic HBV infection was 4·1% (95% uncertainty interval [UI] 3·7 to 4·5), corresponding to 316 million (284 to 351) infected people. There was a 31·3% (29·0 to 33·9) decline in all-age prevalence between 1990 and 2019, with a more marked decline of 76·8% (76·2 to 77·5) in prevalence in children younger than 5 years. HBV-related diseases resulted in 555 0

Published
2022

5. Utilization of insecticide-treated bed nets and associated factors among households in Pawie District, Benshangul Gumuz, Northwest Ethiopia.

Author

Merga T, Adane MM, Shibabaw T, Salah FA, Ejigu LJ, and Mulatu S

Subjects
Ethiopia epidemiology, Humans, Female, Male, Adult, Cross-Sectional Studies, Middle Aged, Adolescent, Young Adult, Surveys and Questionnaires, Health Knowledge, Attitudes, Practice, Insecticide-Treated Bednets statistics & numerical data, Family Characteristics, Malaria prevention & control, Malaria epidemiology, Mosquito Control methods
Abstract

Introduction: Insecticide-treated bed nets are often used as a physical barrier to prevent infection of malaria. In Sub-Saharan Africa, one of the most important ways of reducing the malaria burden is the utilization of insecticide-treated bed nets. However, there is no sufficient information on the utilization of insecticide-treated bed nets and their associated factors in Ethiopia., Objectives: This study aimed to assess the utilization of insecticide-treated bed nets and associated factors among households in Pawie District, Benshangul Gumuz, North West Ethiopia., Methods: A community-based cross-sectional study was conducted in the Pawie district to identify factors influencing the use of insecticide-treated nets (ITNs). Diverse household groups were engaged, and data were collected using a structured questionnaire and observational checklists by trained interviewers. The data were entered into Epi-Data version 3.1 and analyzed using SPSS version 23. Advanced statistical methods, including binary and multi-variable logistic regression, were employed to examine the factors associated with ITN utilization., Results: From the total of 633 respondents, more than two third, 438 (69.2% with 95% CI: 65.2%, 72.5%) had utilized insecticide-treated bed nets during the early morning of the interview. Approximately 297 respondents (67.8%) successfully hung their insecticide-treated nets (ITNs) properly during the early morning of observation. In this study, 406 respondents (64.1%, 95% CI: 60.5, 68.1) showed a solid understanding of insecticide-treated nets (ITNs) utilization. Key predictors for the utilization of insecticide-treated bed nets (ITNs) included age (AOR = 1.86, 95% CI: 1.11, 3.13, p = 0.019), educational status (AOR = 0.45, 95% CI: 0.26, 0.77, p = 0.008), knowledge level (AOR = 2.64, 95% CI: 1.89, 3.81, p < 0.001), and family size (AOR = 1.89, 95% CI: 1.31, 2.74, p = 0.001). All of these variables were found to be statistically significant for the utilization of insecticide-treated bed net., Conclusions: Utilization of the insecticide-treated bed nets (ITNs) remains low in the study area. To address this, it is crucial to raise public awareness and improve utilization of the insecticide-treated bed nets (ITNs) to decrease malaria transmission in the district. Ongoing health education initiatives, including demonstrations on the proper way to hang bed nets, will be essential in fostering better practices and improving community health outcomes., Competing Interests: Declarations. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Published
2024
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6. Prevalence and risk factors of cooking-related burn injury among under-five-years old children in a resource-limited setting: a community-based cross-sectional study in Northwest Ethiopia.

Author

Adane MM, Admasie A, and Shibabaw T

Subjects
Humans, Cooking methods, Cross-Sectional Studies, Ethiopia epidemiology, Prevalence, Risk Factors, Child, Preschool, Infant, Burns epidemiology, Burns etiology
Abstract

Cooking-related child burn injury causes a greater health burden in low-and-middle-income countries. Therefore, a community-based cross-sectional study was conducted among 5830 under-five-years old children in a resource-limited community in Northwest Ethiopia to determine the prevalence and risk factors of this child health problem. Data were collected by trained nurses using a questionnaire and the logistic regression analysis method was applied to identify factors linked with burn injury. Injury prevalence was 6.2% (95% CI:5.5-6.8); and this burden was linked with several risk factors such as lower literacy status of caretakers [AOR = 2.21 (95% CI:1.05-4.67)], overcrowding [AOR = 2.35(95% CI:1.25-4.43], lack of separate kitchen [AOR =2.19 (95% CI:1.56-3.07)], using traditional cookstove [AOR = 2.04 (95% CI:1.23-3.36)], and lack of child supervision [AOR = 2.27 (95% CI:1.63-3.17)]. In conclusion, children experience a high burden of burn injury. Thus, stakeholders should work to reduce child burn injury by modifying the aforementioned risk factors.

Published
2023
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7. Risk Factors of Cooking-related Burn Injury Among Under-Four Children in Northwest Ethiopia: A Community-Based Cross-Sectional Study.

Author

Adane MM, Admasie A, and Shibabaw T

Subjects
Humans, Child, Cross-Sectional Studies, Ethiopia epidemiology, Cooking, Risk Factors, Prevalence, Burns epidemiology, Burns etiology, Burns prevention & control
Abstract

Objective: To investigate the prevalence and risk factors of cooking-related child burn injury., Methods: A cross-sectional community-based study was conducted among a total of 5830 children with their respective caretakers in randomly selected 100 clusters. Data were collected through face-to-face interviews using a structured questionnaire. Logistic regression was used to identify the risk factors and adjusted odds ratios were used as measures of effect., Results: The prevalence of cooking-related child burn injury was 6.2% (95% CI: 5.5-6.8). This burden was linked with risk factors such as lower literacy of caretaker, family size, using traditional cook stove, long cooking time, and presence of extra indoor burning events as well as lack of separate kitchen, child supervision, and injury prevention awareness., Conclusion: Children experience a high burden of burn injury. Thus, stakeholders should work to reduce this burden by controlling the aforementioned risk factors.

Published
2023

8. Risk Factors of Noncompliance to Preventive Mass Drug Administration for Eliminating Lymphatic Filariasis: A Case-Control Study in Jawi District, Northwest Ethiopia.

Author

Mihretu F, Tsega G, Belayneh M, and Adane MM

Abstract

Background: High compliance is crucial for the success of a mass drug administration program to achieve lymphatic filariasis elimination. However, the presence of persistently noncompliant individuals might delay the elimination target. Besides, although context-based research is essential to designing effective strategies, only a few studies have focused on identifying factors that play a role in noncompliance with mass drug administration in Africa. Therefore, this study was conducted to identify the factors associated with noncompliance to prevent mass drug administration using ivermectin-with-albendazole for the elimination of lymphatic filariasis in Northwest Ethiopia., Methods: A case-control study was conducted in Jawi District, Northwest Ethiopia. All individuals who are permanently living in the study area and registered on the annual chemotherapy registration book since 2015 were included in this study. A two-proportion formula was used to estimate the required sample size and 348 cases and 348 controls were selected by identification number on the village chemotherapy registration book using a systematic sampling technique. Data were collected by face-to-face interviews using a structured questionnaire developed through an intensive literature review. Then, data were entered and cleaned by using the EPI DATA software, and analyses were conducted using SPSS version 26. Finally, a logistic regression analysis technique was applied to identify the risk factors using adjusted odds ratio as measures of effect., Results: A total of 690 (99.1%) participants, 345 cases and 345 controls, were included in the study. Younger age (AOR = 1.60; 95%CI: 1.10, 2.33), female sex (AOR = 1.56; 95%CI: 1.24, 3.93), thought of not being susceptible to the disease (AOR = 2.36, 95%CI: 1.80, 4.32), lack of disease knowledge (AOR = 1.88; 95% CI: 1.38, 3.81), fear of drug side effect (AOR = 2.45; 95% CI:1.23, 4.86), and not participating in community drug distributors selection (AOR = 2.58; 95% CI: 1.70, 3.91) were found to be the risk factors significantly associated with noncompliance., Conclusion: Noncompliance with lymphatic filariasis mass drug administration therapy was associated with specific demographic, individual, program, and drug delivery characteristics. This finding has important implications for program effectiveness and would be used to accelerate the elimination of lymphatic filariasis in the study area and other endemic settings., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2022 Fetene Mihretu et al.)

Published
2022
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9. Biomass-fuelled improved cookstove intervention to prevent household air pollution in Northwest Ethiopia: a cluster randomized controlled trial.

Author

Adane MM, Alene GD, and Mereta ST

Subjects
Cluster Analysis, Ethiopia, Air Pollutants analysis, Air Pollution, Indoor prevention & control, Biomass, Cooking methods
Abstract

Background: Household air pollution from biomass fuels burning in traditional cookstoves currently appeared as one of the most serious threats to public health with a recent burden estimate of 2.6 million premature deaths every year worldwide, ranking highest among environmental risk factors and one of the major risk factors of any type globally. Improved cookstove interventions have been widely practiced as potential solutions. However, studies on the effect of improved cookstove interventions are limited and heterogeneous which suggested the need for further research., Methods: A cluster randomized controlled trial study was conducted to assess the effect of biomass-fuelled improved cookstove intervention on the concentration of household air pollution compared with the continuation of an open burning traditional cookstove. A total of 36 clusters were randomly allocated to both arms at a 1:1 ratio, and improved cookstove intervention was delivered to all households allocated into the treatment arm. All households in the included clusters were biomass fuel users and relatively homogenous in terms of basic socio-demographic and cooking-related characteristics. Household air pollution was determined by measuring the concentration of indoor fine particulate, and the effect of the intervention was estimated using the Generalized Estimating Equation., Results: A total of 2031 household was enrolled in the study across 36 randomly selected clusters in both arms, among which data were obtained from a total of 1977 households for at least one follow-up visit which establishes the intention-to-treat population dataset for analysis. The improved cookstove intervention significantly reduces the concentration of household air pollution by about 343 μg/m 3 (Ḃ = - 343, 95% CI - 350, - 336) compared to the traditional cookstove method. The overall reduction was found to be about 46% from the baseline value of 859 (95% CI 837-881) to 465 (95% CI 458-472) in the intervention arm compared to only about 5% reduction from 850 (95% CI 828-872) to 805 (95% CI 794-817) in the control arm., Conclusions: The biomass-fuelled improved cookstove intervention significantly reduces the concentration of household air pollution compared to the traditional method. This suggests that the implementation of these cookstove technologies may be necessary to achieve household air pollution exposure reductions., Trial Registration: The trial project was retrospectively registered on August 2, 2018, at the clinical trials.gov registry database ( https://clinicaltrials.gov/ ) with the NCT03612362 registration identifier number.

Published
2021
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10. Effect of improved cookstove intervention on childhood acute lower respiratory infection in Northwest Ethiopia: a cluster-randomized controlled trial.

Author

Adane MM, Alene GD, Mereta ST, and Wanyonyi KL

Subjects
Biomass, Child, Cooking, Ethiopia, Humans, Air Pollution, Indoor adverse effects, Respiratory Tract Infections epidemiology, Respiratory Tract Infections prevention & control
Abstract

Background: Household air pollution exposure is linked with over 3.5 million premature deaths every year, ranking highest among environmental risk factors globally. Children are uniquely vulnerable and sensitive to the damaging health effects of household air pollution which includes childhood acute lower respiratory infection (ALRI). The use of improved cookstoves has been widely encouraged to reduce these health burdens. It is, however, unclear as to whether it is possible to prevent household air pollution-related disease burdens with biomass-fuelled improved cookstove intervention and the evidence regarding its child health effect still attracts wide debate. Therefore, we investigated the child health effect of improved baking stove intervention compared with the continuation of the open burning traditional baking stove., Methods: A cluster-randomized controlled trial was conducted to assess the health effect of improved baking stove intervention. A total of 100 clusters were randomly allocated to both arms at a 1:1 ratio, and a total of four follow-up visits were carried out within 1 year immediately after the delivery of the intervention to all households allocated into the intervention arm. Data were analyzed in SPSS-22, and the intervention effect was estimated using a Generalized Estimating Equations modeling approach among the intention-to-treat population., Results: A total of 5508 children were enrolled in the study across 100 randomly selected clusters in both arms, among which data were obtained from a total of 5333 participants for at least one follow-up visit which establishes the intention-to-treat population dataset. The intervention was not found to have a statistically significant effect on the longitudinal childhood ALRI with an estimated odds ratio of 0.95 (95% CI: 0.89-1.02). Nevertheless, the longitudinal change in childhood ALRI was significantly associated with age, baseline childhood ALRI, location of cooking quarter, secondary stove type and frequency of baking event measured at baseline., Conclusions: We found no evidence that an intervention comprising biomass-fuelled improved baking stove reduced the risk of childhood ALRI compared with the continuation of an open burning traditional baking stove. Therefore, effective cooking solutions are needed to avert the adverse health effect of household air pollution, particularly, childhood ALRI., Trial Registration: The trial was registered on August 2, 2018 at clinical trials.gov registry database (registration identifier number: NCT03612362).

Published
2021
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11. Facilitators and barriers to improved cookstove adoption: a community-based cross-sectional study in Northwest Ethiopia.

Author

Adane MM, Alene GD, Mereta ST, and Wanyonyi KL

Subjects
Cross-Sectional Studies, Ethiopia, Air Pollution, Indoor, Cooking methods, Environmental Health, Household Articles statistics & numerical data
Abstract

Background: Among the environmental risk factors, household air pollution exposure from traditional cooking practices is one of the biggest killers globally, which mainly impacts developing countries where many families rely on traditional cooking practices. Although improved cookstove adoption is central to tackle this public health issue, the efforts to disseminate cookstove technologies have faced challenges, and the adoption rates are reported to be very low in many developing countries including Ethiopia. Therefore, this study aimed to determine the magnitude and identify potential factors that may act as facilitators or barriers to adoption from users' point of view., Methods: As part of the wider stove trial project, a cross-sectional study was conducted among a total of 5830 households under randomly selected clusters. The required data were collected through face-to-face interviews, and a backward stepwise logistic regression analysis technique was applied to evaluate the effect of potential predictor variables on adoption using adjusted odds ratio (AOR) as measures of effect., Results: The prevalence of adoption was found to be 12.3% (95% CI 11.5-13.2), and households headed by females (AOR 1.96; 95% CI 1.24-3.10), private house ownership (AOR 4.58; 95% CI 3.89-6.19), separate cooking location (AOR 1.84; 95% CI 1.49-2.78), fuel purchasing (AOR 2.13; 95% CI 1.64-2.76), health benefit (AOR 1.76; 95% CI 1.15-2.70), optimistic social interaction (AOR 1.81; 95% CI 1.46-2.26), traditional suitability (AOR 1.58; 95% CI 1.28-1.95), stove use demonstration experience (AOR 2.47; 95% CI 1.98-3.07), cheap price (AOR 2.48; 95% CI 1.91-3.21), availability (AOR 1.81; 95% CI 1.5-1, 2.17), fuel-saving benefit (AOR 1.63; 95% CI 1.18-2.24), and more durable stove (AOR 1.71; 95% CI 1.30-2.26) of cookstove played a significant role as facilitators to adoption. In addition, lower educational level of head (AOR 0.31; 95% CI 0.23-0.42) and fuel processing requirement (AOR 0.55; 95% CI 0.44-0.70) of cookstove were found to be barriers for adoption., Conclusions: Extremely lower improved cookstove adoption was observed due to household- and setting-related, cookstove technology-related, user knowledge- and perception-related, and financial- and market development-related factors. Therefore, to gain successful adoption, implementers and policymakers should consider those important factors in the implementation of clean cooking solutions to the community.

Published
2020
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12. Prevalence and risk factors of acute lower respiratory infection among children living in biomass fuel using households: a community-based cross-sectional study in Northwest Ethiopia.

Author

Adane MM, Alene GD, Mereta ST, and Wanyonyi KL

Subjects
Acute Disease, Biomass, Child, Preschool, Cross-Sectional Studies, Ethiopia epidemiology, Family Characteristics, Female, Humans, Infant, Infant, Newborn, Male, Prevalence, Risk Factors, Air Pollution, Indoor adverse effects, Cooking methods, Respiratory Tract Infections epidemiology
Abstract

Background: Childhood acute lower respiratory infection in the form of pneumonia is recognized as the single largest cause of childhood death globally accounting for 16% of the overall deaths. Some studies also reported a higher prevalence of childhood acute respiratory infection in Ethiopia, which ranges from 16% up to 33.5%. Concerning the risk factors, there are limited community-based studies in Ethiopia in general, and in the current study region in particular. Therefore, the present study was conducted to investigate the prevalence of childhood acute respiratory infection and associated factors in Northwest Ethiopia., Methods: As part of the wider stove trial project, a cross-sectional study was conducted in May 2018 among a total of 5830 children aged less than 4 years old in randomly selected clusters. Binary logistic regression was applied to identify factors linked with childhood acute lower respiratory infection and adjusted odds ratios were used as measures of effect with a 95% confidence interval., Results: A total of 5830 children were included in the study within 100 clusters. Out of which 51.7% were male and 48.3% female. The prevalence of childhood lower acute respiratory infection was 19.2% (95% CI: 18.2-20.2) and found to decrease among children living in homes with chimney, eaves space and improved cookstove than children living in households with no chimney, eaves space and improved cookstove with estimated AOR of 0.60 (95% CI: 0.51-0.70), 0.70 (95% CI: 0.60-0.84) and 0.43 (95% CI: 0.28-0.67) respectively. It was also associated with other cooking-related factors such as cow dung fuel use [AOR = 1.54 (95% CI: 1.02-2.33)], child spending time near stove during cooking [AOR = 1.41 (95% CI: 1.06-1.88), presence of extra indoor burning events [AOR = 2.19 (95% CI: 1.41-3.40)] and with frequent cooking of meals [AOR = 1.55 (95% CI: 1.13-2.13)]., Conclusion: High prevalence of childhood acute lower respiratory infection was demonstrated by this study and it was found to be associated with household ventilation, cooking technology, and behavioral factors. Therefore, we recommend a transition in household ventilation, cooking technologies as well as in child handling and in the peculiar local extra indoor burning practices.

Published
2020
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13. Assessment of antiretroviral treatment (ART) care service provision in Tigray Region health centers, North Ethiopia.

Author

Tessema SB and Adane MM

Subjects
Adolescent, Adult, Aged, Aged, 80 and over, Cross-Sectional Studies, Ethiopia, Female, Humans, Male, Middle Aged, Surveys and Questionnaires, Young Adult, Anti-Retroviral Agents therapeutic use, Health Services statistics & numerical data, Health Services Accessibility statistics & numerical data, Patient Satisfaction statistics & numerical data, Retroviridae Infections drug therapy
Abstract

Background: Client satisfaction is a vital component and main concern intertwined with strategic decisions in service provisions. To improve efficiency of services, eliciting the opinion of users about the available services and identifying factors associated with dissatisfaction is very critical. Thus, the main objective of this study was to assess the perceived levels of clients' satisfaction with health services at ART clinic level in health centres of Tigray Region in Ethiopia., Methods: Cross sectional study was conducted from May to June 2013 in Tigray Region ART clinics. A total of 714 ART care user were included in the study using both purposive and probability sampling technique. Data was collected by using structured questionnaire and the collected data was analysed using Statistical Package for the Social Sciences (SPSS) version 16.0. Crude and Adjusted logistic regression analyses were carried out to identify the associated factors underlying perceived levels of clients' overall satisfaction. Finally, the results were presented with table as well as odds ratio (OR) and 95% confidence interval (CI)., Results: A total of 714 study participants were enrolled in this study. An overall satisfaction level of 89.6% was reported by ART care service users. Higher scores of satisfaction of services provisions were reported for courtesy and respect (95.80%) followed by privacy (93.28%). On the other hand, respondents' dissatisfaction was rated 35.32% for toilet cleanliness followed by 26.19% for availability of additional drugs. As for overall satisfaction and associated factors, adjusted logistic regression analyses showed that marital status [AOR = 2.01 (95% CI: 1.11, 3.60)], educational status [AOR = 3.13 (95% CI: 1.15, 8.53)], travel distance to reach health centre [AOR = 3.59 (95% CI: 1.23, 10.50)], toilet cleanliness [AOR = 2.22 (95% CI :1.62, 6.32)], and ART drug availability [AOR = 2.60 (95% CI :1.18, 6.52)] were found to have influence on overall ART service satisfaction status., Conclusions: This study revealed high level of client satisfaction rate and were associated with preventable and modifiable factors such as marital status, educational status, travel distance to reach health centre, toilet cleanliness and ART drug availability. Therefore, countermeasures such as increasing access to ART service, availing clean toilet and ART drugs may further increase client satisfaction level in the region.

Published
2015
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14. Assessment of water, sanitation, and hygiene practice and associated factors among people living with HIV/AIDS home based care services in Gondar city, Ethiopia.

Author

Yallew WW, Terefe MW, Herchline TE, Sharma HR, Bitew BD, Kifle MW, Tetemke DM, Tefera MA, and Adane MM

Subjects
Adult, Cross-Sectional Studies, Ethiopia, Female, Humans, Male, Qualitative Research, Risk Factors, HIV Infections therapy, Home Care Services, Hygiene standards, Sanitation standards, Water Supply standards
Abstract

Background: People living with HIV/AIDS have substantially greater need for water, sanitation, and hygiene. Encouraging hygiene education for People Living with HIV/AIDS in home based care services and additional support for the provision of water, sanitation, and hygiene services is recommended., Methods: A cross-sectional study was carried during 2009 to assess water, sanitation status and hygiene practices and associated factors among People Living with HIV/AIDS in home based care services in Gondar city of Ethiopia. A systematic random sampling was used to select study subjects from 900 Home Based Care clients of People Living HIV/AIDS in Gondar city. Data was collected from 296 People Living with HIV/AIDS from two NGO's in the city. For in-depth interview, four different categories were participated. Logistic regression and thematic framework analysis were performed for quantitative and qualitative part respectively., Results: Two hundred ninety four subjects (72.8% (214) females and 27.2% (80) males) were studied. The mean age was 35.8 ± 8.7 years. In the study, 42.9% (126) of the households have unimproved water status, 67% (197) of the households have unimproved sanitation status, and 51.7% (152) of the households have poor hygienic practice. Diarrhoea with water status; educational status and latrine availability with sanitation status; and hand washing device availability and economical reasons for the affordability of soap with hygienic practice were significantly associated. Economical reasons and hygiene education were factors that affect water, sanitation, and hygienic practice. Stigma and discrimination were minimized as a factor in the study area., Conclusions: There is high burden of water, sanitation and hygiene in people living HIV/AIDS in home based care services. Encouraging hygiene education for people living HIVAIDS in home based care services and additional support for the provision of water, sanitation, and hygiene services is recommended.

Published
2012
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