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1. Medicines Wastage and Its Contributing Factors in Public Health Facilities of South Gondar Zone, Amhara Regional State, Ethiopia

Author

Guadie M, Asemahagn MA, Tefera A, Melkam W, Habteweld HA, and Derebe D

Subjects
medicines wastage, contributing factors, public health facilities, Pharmacy and materia medica, RS1-441
Abstract

Muluneh Guadie,1 Mulusew Andualem Asemahagn,2 Abekyelesh Tefera,3 Wondim Melkam,4 Habtemariam Alekaw Habteweld,5 Dagninet Derebe4 1Department of Regional Regulatory Offices, Amhara Health Bureau, Bahir Dar, Ethiopia; 2School of Public Health, Bahir Dar University, Bahir Dar, Ethiopia; 3Department of Pharmacy, GAMBY Medical and Business College, Bahir Dar, Ethiopia; 4Department of Pharmacy, Bahir Dar University, Bahir Dar, Ethiopia; 5Department of Pharmacy, Debre Berhan University, Debre Berhan, EthiopiaCorrespondence: Dagninet Derebe, Email dagninet37@yahoo.comBackground: In developing countries like Ethiopia, medicines wastage becomes a major healthcare system challenge. However, data that displayed the type, extent, and contributing factors of medicines wastage were limited.Methods: A health facility-based explanatory sequential mixed study was conducted from December 2021 to February 2022. One drug and therapeutics committee (DTC) and one store man per health facility, working during the study period were included for their perception of medicines wastage and possible causes. As key informants, 1 Chief Executive Officer (CEO) and 1pharmacy head were also included per facility. In total, 80 participants were included in this study. The quantitative data to determine the magnitude of medicine wastage were collected using a structured interviewer-administered questionnaire and analyzed using SPSS version 25.Results: The overall medicines wastage in the three consecutive years was 6.3%. The trend over the three years indicated that medicines wastage is 6.5%, 5.9%, and 6.5% in 2011, 2012, and 2013 Ethiopian Fiscal Year (EFY), respectively. The medicine wastage rate has been increasing nearly by 3% between 2011/2012 and 2012/2013. The main sources of wastage of medicines were expiry (99.3%). The perceived reasons for such medicine’s wastage were near-expiry medicines (< 6 months) being delivered to the health facilities by suppliers, poor communication and coordination with key stakeholders, and the presence of overstocked medicines due to improper forecasting of need in the facilities.Conclusion: There is an excessive rate of medicines wastage which needs immediate mitigation by exchanging nearly expired medicines with other health facilities, communicating with suppliers and even prescribers, using auditable pharmaceutical transactions and services (APTS), providing continuous training, pursuing quality and safety medicines reuse scheme, implementation of pharmacist waste-reducing activities in all stages of the pharmaceutical supply chain, reducing medication amounts in stock, and through the use of electronic stock management tools.Keywords: medicines wastage, contributing factors, public health facilities

Published
2023

2. Trends and Outcomes of Acute Poisoning in Felege Hiwot Comprehensive Specialized Hospital Medical Intensive Care Units: Retrospective Study

Author

Shumet A, Shiferaw N, Mekonnen D, and Asemahagn MA

Subjects
trends, poisoning, felege hiwot hospital, medical intensive care unit, ethiopia, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Abebe Shumet,1 Niguse Shiferaw,2 Daniel Mekonnen,3 Mulusew Andualem Asemahagn4 1Department of Internal Medicine, School of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia; 2Critical Care Nursing Unit, Felege Hiwot Specialized Hospital, Bahir Dar, Ethiopia; 3Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Dar University, Bahir Dar, Ethiopia; 4School of Public Health, College of Medicine and Health Sciences, Dar University, Bahir Dar, EthiopiaCorrespondence: Abebe Shumet Mitiku, Bahir Dar University, Bahir Dar, Ethiopia, Tel +251912064411, Email abeshumete@gmail.com; Abebe.Shumet@mail.bdu.edu.etBackground: Acute poisoning with agrochemicals, medicines and different environmental exposures continues to be a global health problems. However, with our search for reports about acute poisoning, there was no data regarding a change in trends and outcomes of acute poisoning in Ethiopia and its districts.Objective: This study was to determine the burden of poison-related health hazards, identify poisoning substances, and clinical outcomes of poisoning cases admitted to Felege Hiwot Comprehensive Specialized Hospital- Medical intensive care unit (FHCSH-MICU), Bahir Dar, Ethiopia.Methods: A retrospective hospital-based study was conducted using patient data archived from March 2019 to February 2020 at FHCSH-MICU. Collected data were analyzed using Statistical Package for Social Sciences (SPSS) software version 26 and descriptive statistics such as measures of central tendency and proportions were computed. The results were reported as text narrations, figures and tables.Results: A total 121 poisoned patients were identified from the patient registration log books. Among the total FHCSH-MICU cases registered, acute poisoning accounted for 17.0%. Of 121 poison cases, 118 (98.3%) were due to suicide attempts with the female to male ratio being 1.5:1. The majority, 65 (54.0%), of cases were in the range of 21– 30 years age. Nearly two-thirds, 75 (62.0%), of the poisoning cases died, accounting for 21.6% of all deaths in the FHCSH-MICU. The most common poisoning substance was aluminum phosphide, 92 (76%).Conclusion and Recommendations: Aluminum phosphide became the leading poisoning substance in the study area. Nearly two-thirds of the poisoning cases died. Hence, aluminum phosphide must be placed in secured and inaccessible places and it should be replaced by less poisonous rodenticides. Health education and awareness creation about this lethal toxin are strongly advisable.Keywords: trends, poisoning, Felege Hiwot Hospital, medical intensive care unit, Ethiopia

Published
2022

3. Missed Tuberculosis Investigations and Associated Factors in Patients with Symptoms Indicative of Tuberculosis at Public Health Institutions in Northwest Ethiopia: The Application of a Negative Binomial Model

Author

Asemahagn MA

Subjects
tb, missed investigation, factors, patients, public health facilities, ethiopia., Infectious and parasitic diseases, RC109-216
Abstract

Mulusew Andualem Asemahagn School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, EthiopiaCorrespondence: Mulusew Andualem Asemahagn, Email muler.hi@gmail.comBackground: Tuberculosis (TB) remains one of the top health problems in Ethiopia, and over one-third of estimated TB cases remain undetected. This study examined the magnitude and factors of missed opportunities for TB investigation at public health facilities in Northwest Ethiopia.Methods: A facility-based cross-sectional study was conducted among 412 adult patients with TB symptoms from 34 randomly selected public health facilities. Data on socio-demographics, TB symptoms, and clinical status were collected by an exit interview. A patient was considered missed for TB investigation if he/she had at least one symptom suggestive of TB but did not receive a sputum smear and/or x-ray evaluation to rule out TB. We computed descriptive and analytical statistics using SPSS version 26. A negative binomial regression analysis was used to identify factors associated with missed opportunities for TB investigation. Statistical significance was determined at a p-value less than 0.05.Results: A total of 412 presumptive TB patients, 235 (57%) females and 247 (60%) rural dwellers were interviewed. The mean age of respondents was 35 ± 8 years and 228 (55.3%) were from health centers. Over two-thirds, 284 (69%) were new patients, 62 (15%) were HIV positive and 78 (19%) had diabetes mellitus (DM). Fifty patients with symptoms suggestive of TB did not receive sputum evaluation services. Inability to read and write, having DM, having normal body mass index and facility type they visited were significant factors to missing opportunities to get TB investigations.Conclusion: A significant number of patients with symptoms suggestive of TB were missed for sputum evaluation to rule out TB. Education level, comorbidity, nutritional status and type of facility patients attended were factors of missing opportunities for TB investigation. Thus, improving quality of TB diagnosis, screening TB among all types of patients, and paying attention to screen illiterate people are crucial to avoid missing potential TB cases.Keywords: TB, missed investigation, factors, patients, public health facilities, Ethiopia

Published
2022

4. Trends and Outcomes of Acute Poisoning in Felege Hiwot Comprehensive Specialized Hospital Medical Intensive Care Units: Retrospective Study [Corrigendum]

Author

Shumet A, Shiferaw N, Mekonnen D, and Asemahagn MA

Subjects
trends, poisoning, felege hiwot hospital, medical intensive care unit, ethiopia, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Shumet A, Shiferaw N, Mekonnen D, Asemahagn MA. Open Access Emerg Med. 2022;14:649–656. The authors have advised there is an error in affiliations 3 and 4 on page 649. The text “Dar University” should read “Bahir Dar University”. The authors apologize for this error.

Published
2023

5. Geographic Accessibility, Readiness, and Barriers of Health Facilities to Offer Tuberculosis Services in East Gojjam Zone, Ethiopia: A Convergent Parallel Design

Author

Asemahagn MA, Alene GD, and Yimer SA

Subjects
accessibility, readiness, barriers, health facilities, tb services, ethiopia, Arctic medicine. Tropical medicine, RC955-962
Abstract

Mulusew Andualem Asemahagn,1 Getu Degu Alene,1 Solomon Abebe Yimer2,3 1School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia; 2Department of Microbiology, Unit for Genome Dynamics, Faculty of Medicine, University of Oslo, Oslo, Norway; 3Coalition for Epidemic Preparedness Innovations (CEPI), Oslo, NorwayCorrespondence: Mulusew Andualem Asemahagn Email muler.hi@gmail.comBackground: Tuberculosis (TB) remains a foremost global public health threat. Active TB control needs geographically accessible health facilities that have quality diagnostics, equipment, supplies, medicines, and staff.Objective: This study aimed at assessing the geographic distribution, physical accessibility, readiness and barriers of health facilities for TB services in East Gojjam zone, Ethiopia.Methods: A convergent parallel design was applied using health facility and geographic data. Data on facility attributes, service availability and readiness were collected by inteviewing TB officers, laboratory heads and onsite facility visits. Coordinates of health facilities and kebele centroids were collected by GPS. We used ArcGIS 10.6 to measure Euclidean distance from each kebele centroids to the nearest health facility. Descriptive statistics were computed by using SPSS version 25. Barriers to TB service readiness were explored by in-depth interviews. NVivo12 was used to thematically analyze the qualitative data.Results: The overall TB health service coverage (THSC) was 23% (ranging: 10– 85%). The mean distance from the nearest health facility was 8km (ranging: 0.5– 16km). About 132 (32%) kebeles had poor geographic accessibility to TB services (over 10km distance from the nearest health facility) and had poor facility readiness. Although 114 (95%) health facilities offered at least one TB service, 44 (38.6%) of them had no sputum smear microscopy. The overall TB readiness index was 63.5%: first-line anti-TB drugs (97%), diagnostics (63%), trained staffs, diagnostic and treatment guidelines (53%) and laboratory supplies (41%). Lack of health workers (laboratory personnel), inadequate budget, poor management practice and TB program support, inadequate TB commodity suppliers, and less accessible geographic locations of health facilities were identified as barriers to TB service readiness distribution.Conclusion: Considerable proportion of the population in the study area have poor access to quality TB diagnostic services due to low THSC and poor facility readiness. Barriers to TB service availability and readiness were health system related. Regular refresher training of health workers on TB, creating mechanisms to attract laboratory personnel to work in the study area and scaling up of sputum smear microscopy services, establishing an efficient mechanism for procurement, distribution, utilization and reporting of TB commodity supplies, and good management practices are crucial to enhance TB service readiness in the study zone.Keywords: tuberculosis, accessibility, readiness, barriers, health facilities, TB services, East Gojjam Zone, Ethiopia

Published
2020

6. Mapping age- and sex-specific HIV prevalence in adults in sub-Saharan Africa, 2000–2018

Author

Haeuser, E, Serfes, AL, Cork, MA, Yang, M, Abbastabar, H, Abhilash, ES, Adabi, M, Adebayo, OM, Adekanmbi, V, Adeyinka, DA, Afzal, S, Ahinkorah, BO, Ahmadi, K, Ahmed, MB, Akalu, Y, Akinyemi, RO, Akunna, CJ, Alahdab, F, Alanezi, FM, Alanzi, TM, Alene, KA, Alhassan, RK, Alipour, V, Almasi-Hashiani, A, Alvis-Guzman, N, Ameyaw, EK, Amini, S, Amugsi, DA, Ancuceanu, R, Anvari, D, Appiah, SCY, Arabloo, J, Aremu, O, Asemahagn, MA, Jafarabadi, MA, Awedew, AF, Quintanilla, BPA, Ayanore, MA, Aynalem, YA, Azari, S, Azene, ZN, Darshan, BB, Babalola, TK, Baig, AA, Banach, M, Bärnighausen, TW, Bell, AW, Bhagavathula, AS, Bhardwaj, N, Bhardwaj, P, Bhattacharyya, K, Bijani, A, Bitew, ZW, Bohlouli, S, Bolarinwa, OA, Boloor, A, Bozicevic, I, Butt, ZA, Cárdenas, R, Carvalho, F, Charan, J, Chattu, VK, Chowdhury, MAK, Chu, D-T, Cowden, RG, Dahlawi, SMA, Damiani, G, Darteh, EKM, Darwesh, AM, das Neves, J, Weaver, ND, De Leo, D, De Neve, J-W, Deribe, K, Deuba, K, Dharmaratne, S, Dianatinasab, M, Diaz, D, Didarloo, A, Djalalinia, S, Dorostkar, F, Dubljanin, E, Duko, B, El Tantawi, M, El-Jaafary, SI, Eshrati, B, Eskandarieh, S, Eyawo, O, Ezeonwumelu, IJ, Ezzikouri, S, Farzadfar, F, Fattahi, N, Fauk, NK, Fernandes, E, Filip, I, Fischer, F, Foigt, NA, Foroutan, M, Fukumoto, T, Gad, MM, Gaidhane, AM, Gebregiorgis, BG, Gebremedhin, KB, Getacher, L, Ghadiri, K, Ghashghaee, A, Golechha, M, Gubari, MIM, Gugnani, HC, Guimarães, RA, Haider, MR, Haj-Mirzaian, A, Hamidi, S, Hashi, A, Hassanipour, S, Hassankhani, H, Hayat, K, Herteliu, C, Ho, HC, Holla, R, Hosseini, M, Hosseinzadeh, M, Hwang, B-F, Ibitoye, SE, Ilesanmi, OS, Ilic, IM, Ilic, MD, Islam, RM, Iwu, CCD, Jakovljevic, M, Jha, RP, Ji, JS, Johnson, KB, Joseph, N, Joshua, V, Joukar, F, Jozwiak, JJ, Kalankesh, LR, Kalhor, R, Kamyari, N, Kanchan, T, Matin, BK, Karimi, SE, Kayode, GA, Karyani, AK, Keramati, M, Khan, EA, Khan, G, Khan, MN, Khatab, K, Khubchandani, J, Kim, YJ, Kisa, A, Kisa, S, Kopec, JA, Kosen, S, Laxminarayana, SLK, Koyanagi, A, Krishan, K, Defo, BK, Kugbey, N, Kulkarni, V, Kumar, M, Kumar, N, Kusuma, D, La Vecchia, C, Lal, DK, Landires, I, Larson, HJ, Lasrado, S, Lee, PH, Li, S, Liu, X, Maleki, A, Malik, P, Mansournia, MA, Martins-Melo, FR, Mendoza, W, Menezes, RG, Mengesha, EW, Meretoja, TJ, Mestrovic, T, Mirica, A, Moazen, B, Mohamad, O, Mohammad, Y, Mohammadian-Hafshejani, A, Mohammadpourhodki, R, Mohammed, S, Mokdad, AH, Moradi, M, Moraga, P, Mubarik, S, Mulu, GBB, Mwanri, L, Nagarajan, AJ, Naimzada, MD, Naveed, M, Nazari, J, Ndejjo, R, Negoi, I, Ngalesoni, FN, Nguefack-Tsague, G, Ngunjiri, JW, Nguyen, CT, Nguyen, HLT, Nnaji, CA, Noubiap, JJ, Nuñez-Samudio, V, Nwatah, VE, Oancea, B, Odukoya, OO, Olagunju, AT, Olakunde, BO, Olusanya, BO, Olusanya, JO, Bali, AO, Onwujekwe, OE, Orisakwe, OE, Otstavnov, N, Otstavnov, SS, Owolabi, MO, Mahesh, PA, Padubidri, JR, Pana, A, Pandey, A, Pandi-Perumal, SR, Kan, FP, Patton, GC, Pawar, S, Peprah, EK, Postma, MJ, Preotescu, L, Syed, ZQ, Rabiee, N, Radfar, A, Rafiei, A, Rahim, F, Rahimi-Movaghar, V, Rahmani, AM, Ramezanzadeh, K, Rana, J, Ranabhat, CL, Rao, SJ, Rawaf, DL, Rawaf, S, Rawassizadeh, R, Regassa, LD, Rezaei, N, Rezapour, A, Riaz, MA, Ribeiro, AI, Ross, JM, Rubagotti, E, Rumisha, SF, Rwegerera, GM, Moghaddam, SS, Sagar, R, Sahiledengle, B, Sahu, M, Salem, MR, Kafil, HS, Samy, AM, Sartorius, B, Sathian, B, Seidu, A-A, Shaheen, AA, Shaikh, MA, Shamsizadeh, M, Shiferaw, WS, Shin, JI, Shrestha, R, Singh, JA, Skryabin, VY, Skryabina, AA, Soltani, S, Sufiyan, MB, Tabuchi, T, Tadesse, EG, Taveira, N, Tesfay, FH, Thapar, R, Tovani-Palone, MR, Tsegaye, GW, Umeokonkwo, CD, Unnikrishnan, B, Villafañe, JH, Violante, FS, Vo, B, Vu, GT, Wado, YD, Waheed, Y, Wamai, RG, Wang, Y, Ward, P, Wickramasinghe, ND, Wilson, K, Yaya, S, Yip, P, Yonemoto, N, Yu, C, Zastrozhin, MS, Zhang, Y, Zhang, Z-J, Hay, SI, Dwyer-Lindgren, L, Local Burden of Disease sub-Saharan Africa HIV Prevalence Collaborators, Value, Affordability and Sustainability (VALUE), Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Microbes in Health and Disease (MHD), Haeuser, Emily, Serfes, Audrey L., Cork, Michael A., Yang, Mingyou, Ahmed, Muktar Beshir, Dwyer Lindgrena, Laura, HUS Comprehensive Cancer Center, Helsinki University Hospital Area, Department of Oncology, Epidemiologie, and RS: NUTRIM - R3 - Respiratory & Age-related Health

Subjects
Male, Adult, Settore MED/17 - Malattie Infettive, Adolescent, Settore MED/42 - Igiene Generale e Applicata, HIV Infections, Settore MED/01 - Statistica Medica, Young Adult, HIV Infections/prevention & control, Pregnancy, Seroepidemiologic Studies, General & Internal Medicine, Prevalence, Humans, Geostatistics, Africa, Demographics, HIV, HIV prevalence, Mapping, Spatial statistics, 11 Medical and Health Sciences, Africa South of the Sahara, Acquired Immunodeficiency Syndrome, Acquired Immunodeficiency Syndrome/epidemiology, General Medicine, Middle Aged, Settore SECS-S/04 - Demografia, Africa South of the Sahara/epidemiology, 3142 Public health care science, environmental and occupational health, 3121 General medicine, internal medicine and other clinical medicine, Female
Abstract

Background Human immunodeficiency virus and acquired immune deficiency syndrome (HIV/AIDS) is still among the leading causes of disease burden and mortality in sub-Saharan Africa (SSA), and the world is not on track to meet targets set for ending the epidemic by the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the United Nations Sustainable Development Goals (SDGs). Precise HIV burden information is critical for effective geographic and epidemiological targeting of prevention and treatment interventions. Age- and sex-specific HIV prevalence estimates are widely available at the national level, and region-wide local estimates were recently published for adults overall. We add further dimensionality to previous analyses by estimating HIV prevalence at local scales, stratified into sex-specific 5-year age groups for adults ages 15–59 years across SSA. Methods We analyzed data from 91 seroprevalence surveys and sentinel surveillance among antenatal care clinic (ANC) attendees using model-based geostatistical methods to produce estimates of HIV prevalence across 43 countries in SSA, from years 2000 to 2018, at a 5 × 5-km resolution and presented among second administrative level (typically districts or counties) units. Results We found substantial variation in HIV prevalence across localities, ages, and sexes that have been masked in earlier analyses. Within-country variation in prevalence in 2018 was a median 3.5 times greater across ages and sexes, compared to for all adults combined. We note large within-district prevalence differences between age groups: for men, 50% of districts displayed at least a 14-fold difference between age groups with the highest and lowest prevalence, and at least a 9-fold difference for women. Prevalence trends also varied over time; between 2000 and 2018, 70% of all districts saw a reduction in prevalence greater than five percentage points in at least one sex and age group. Meanwhile, over 30% of all districts saw at least a five percentage point prevalence increase in one or more sex and age group. Conclusions As the HIV epidemic persists and evolves in SSA, geographic and demographic shifts in prevention and treatment efforts are necessary. These estimates offer epidemiologically informative detail to better guide more targeted interventions, vital for combating HIV in SSA.

Published
2022

7. Mapping inequalities in exclusive breastfeeding in low- and middle-income countries, 2000-2018

Author

Bhattacharjee, NV, Schaeffer, LE, Hay, SI, Lu, D, Schipp, MF, Lazzar-Atwood, A, Donkers, KM, Abady, GG, Abd-Allah, F, Abdelalim, A, Abebo, ZH, Abejie, AN, Abosetugn, AE, Abreu, LG, Abrigo, MRM, Abu-Gharbieh, E, Abushouk, AI, Adamu, AL, Adedeji, IA, Adegbosin, AE, Adekanmbi, V, Adetokunboh, OO, Agudelo-Botero, M, Aji, B, Akinyemi, OO, Alamneh, AA, Alanezi, FM, Alanzi, TM, Albright, J, Alcalde-Rabanal, JE, Alemu, BW, Alhassan, RK, Ali, BA, Ali, S, Alinia, C, Alipour, V, Amit, AML, Amugsi, DA, Anbesu, EW, Ancuceanu, R, Anjomshoa, M, Ansari, F, Antonio, CAT, Anvari, D, Arabloo, J, Arora, A, Artanti, KD, Asemahagn, MA, Asmare, WN, Atout, MMW, Ausloos, M, Awoke, N, Quintanilla, BPA, Ayanore, MA, Aynalem, YA, Ayza, MA, Azene, ZN, Darshan, BB, Badiye, AD, Baig, AA, Bakkannavar, SM, Banach, M, Banik, PC, Bärnighausen, TW, Basaleem, H, Bayati, M, Baye, BA, Bedi, N, Belay, SA, Bhagavathula, AS, Bhandari, D, Bhardwaj, N, Bhardwaj, P, Bhutta, ZA, Bijani, A, Birhan, TA, Birihane, BM, Bitew, ZW, Bohlouli, S, Bohluli, M, Bojia, HA, Boloor, A, Brady, OJ, Bragazzi, NL, Brunoni, AR, Budhathoki, SS, Nagaraja, SB, Butt, ZA, Cárdenas, R, Castaldelli-Maia, JM, Castro, F, Cernigliaro, A, Charan, J, Chatterjee, P, Chatterjee, S, Chattu, VK, Chaturvedi, S, Chowdhury, MAK, Chu, D-T, Collison, ML, Cook, AJ, Cork, MA, Couto, RAS, Dagnew, B, Dai, H, Dandona, L, Dandona, R, Daneshpajouhnejad, P, Darwesh, AM, Darwish, AH, Daryani, A, Das, JK, Gupta, RD, Dávila-Cervantes, CA, Davis, AC, Weaver, ND, Denova-Gutiérrez, E, Deribe, K, Desalew, A, Deshpande, A, Dessie, A, Deuba, K, Dharmaratne, SD, Dhimal, M, Dhungana, GP, Diaz, D, Didarloo, A, Dipeolu, IO, Doan, LP, Duko, B, Duraes, AR, Dwyer-Lindgren, L, Earl, L, Zaki, MES, Tantawi, ME, Elema, TB, Elhabashy, HR, El-Jaafary, SI, Faris, PS, Faro, A, Farzadfar, F, Feigin, VL, Feleke, BE, Ferede, TY, Fischer, F, Foigt, NA, Folayan, MO, Franklin, RC, Gad, MM, Gaidhane, S, Gardner, WM, Geberemariyam, BS, Gebregiorgis, BG, Gebremedhin, KB, Gebremichael, B, Ghaffarpasand, F, Gilani, SA, Ginindza, TG, Glagn, M, Golechha, M, Gonfa, KB, Goulart, BNG, Gudi, N, Guido, D, Guled, RA, Guo, Y, Hamidi, S, Handiso, DW, Hasaballah, AI, Hassan, A, Hayat, K, Hegazy, MI, Heidari, B, Henry, NJ, Herteliu, C, de, Hidru, HD, Ho, HC, Hoang, CL, Holla, R, Hon, J, Hosseini, M, Hosseinzadeh, M, Househ, M, Hsairi, M, Hu, G, Huda, TM, Hwang, B-F, Ibitoye, SE, Ilesanmi, OS, Ilic, IM, Ilic, MD, Inbaraj, LR, Iqbal, U, Irvani, SSN, Islam, MM, Iwu, CCD, Iwu, CJ, Jain, A, Janodia, MD, Javaheri, T, John-Akinola, YO, Johnson, KB, Joukar, F, Jozwiak, JJ, Kabir, A, Kalankesh, LR, Kalhor, R, Kamath, A, Kamyari, N, Kanchan, OT, Kapoor, N, Matin, BK, Karimi, SE, Kasaye, HK, Kassahun, G, Kassebaum, NJ, Kayode, GA, Karyani, AK, Keiyoro, PN, Kelkay, B, Khalid, N, Khan, MN, Khatab, K, Khater, AM, Khater, MM, Khatib, MN, Kim, YJ, Kimokoti, RW, Kinyoki, DK, Kisa, A, Kisa, S, Kosen, S, Krishan, K, Kulkarni, V, Kumar, GA, Kumar, M, Kumar, N, Kumar, P, Kurmi, OP, Kusuma, D, Vecchia, CL, Lad, SD, Lami, FH, Landires, I, Lansingh, VC, Lasrado, S, Lee, PH, LeGrand, KE, Letourneau, ID, Lewycka, S, Li, B, Li, M-C, Li, S, Liu, X, Lodha, R, Lopez, JCF, Louie, C, Machado, DB, Maled, V, Maleki, S, Malta, DC, Mamun, AA, Manafi, N, Mansournia, MA, Mapoma, CC, Marczak, LB, Martins-Melo, FR, Mehndiratta, MM, Mejia-Rodriguez, F, Mekonnen, TC, Mendoza, W, Menezes, RG, Mengesha, EW, Mersha, AM, Miller, TR, Mini, GK, Mirrakhimov, EM, Misra, S, Moghadaszadeh, M, Mohammad, DK, Mohammadian-Hafshejani, A, Mohammed, JA, Mohammed, S, Mokdad, AH, Montero-Zamora, PA, Moradi, M, Moradzadeh, R, Moraga, P, Mosser, JF, Mousavi, SM, Khaneghah, AM, Munro, SB, Muriithi, MK, Mustafa, G, Muthupandian, S, Nagarajan, AJ, Naik, G, Naimzada, MD, Nangia, V, Nascimento, BR, Nayak, VC, Ndejjo, R, Ndwandwe, DE, Negoi, I, Nguefack-Tsague, G, Ngunjiri, JW, Nguyen, CT, Nguyen, DN, Nguyen, HLT, Nigussie, SN, Nigussie, TTN, Nikbakhsh, R, Nnaji, CA, Nunez-Samudio, V, Oancea, B, Oghenetega, OB, Olagunju, AT, Olusanya, BO, Olusanya, JO, Omer, MO, Onwujekwe, OE, Ortega-Altamirano, DV, Osgood-Zimmerman, AE, Otstavnov, N, Otstavnov, SS, Owolabi, MO, Mahesh, PA, Padubidri, JR, Pana, A, Pandey, A, Pandi-Perumal, SR, Pangaribuan, HU, Parsekar, SS, Pasupula, DK, Patel, UK, Pathak, A, Pathak, M, Pattanshetty, SM, Patton, GC, Paulos, K, Pepito, VCF, Pickering, BV, Pinheiro, M, Piwoz, EG, Pokhrel, KN, Pourjafar, H, Prada, SI, Pribadi, DRA, Syed, ZQ, Rabiee, M, Rabiee, N, Rahim, F, Rahimzadeh, S, Rahman, A, Rahman, MHU, Rahmani, AM, Rai, RK, Ranabhat, CL, Rao, SJ, Rastogi, P, Rathi, P, Rawaf, DL, Rawaf, S, Rawassizadeh, R, Rawat, R, Regassa, LD, Rego, MAS, Reiner, RC, Reshmi, B, Rezapour, A, Ribeiro, AI, Rickard, J, Roever, L, Rumisha, SF, Rwegerera, GM, Sagar, R, Sajadi, SM, Salem, MR, Samy, AM, Santric-Milicevic, MM, Saraswathy, SYI, Sarker, AR, Sartorius, B, Sathian, B, Saxena, D, Sbarra, AN, Sengupta, D, Senthilkumaran, S, Sha, F, Shafaat, O, Shaheen, AA, Shaikh, MA, Shalash, AS, Shannawaz, M, Sheikh, A, Shetty, BSK, Shetty, RS, Shibuya, K, Shiferaw, WS, Shin, JI, Silva, DAS, Singh, NP, Singh, P, Singh, S, Sintayehu, Y, Skryabin, VY, Skryabina, AA, Soheili, A, Soltani, S, Sorrie, MB, Spurlock, EE, Steuben, KM, Sudaryanto, A, Sufiyan, MB, Swartz, SJ, Tadesse, EG, Tamiru, AT, Tapak, L, Tareque, MI, Tarigan, IU, Tesema, GA, Tesfay, FH, Teshome, A, Tessema, ZT, Thankappan, KR, Thapar, R, Thomas, N, Topor-Madry, R, Tovani-Palone, MR, Traini, E, Tran, BX, Truong, PN, Tsegaye, BTBT, Ullah, I, Umeokonkwo, CD, Unnikrishnan, B, Upadhyay, E, Uzochukwu, BSC, VanderHeide, JD, Violante, FS, Vo, B, Wado, YD, Waheed, Y, Wamai, RG, Wang, F, Wang, Y, Wang, Y-P, Wickramasinghe, ND, Wiens, KE, Wiysonge, CS, Woyczynski, L, Wu, A-M, Wu, C, Yamada, T, Yaya, S, Yeshaneh, A, Yeshaw, Y, Yeshitila, YG, Yilma, MT, Yip, P, Yonemoto, N, Yosef, T, Younis, MZ, Yousuf, AY, Yu, C, Yu, Y, Yuce, D, Zafar, S, Zaidi, SS, Zaki, L, Zakzuk, J, Zamanian, M, Zar, HJ, Zastrozhin, MS, Zastrozhina, A, Zelellw, DA, Zhang, Y, Zhang, Z-J, Zhao, X-JG, Zodpey, S, Zuniga, YMH, Local Burden of Disease Exclusive Breastfeeding Collaborators, Bhattacharjee, Natalia V, Schaeffer, Lauren E, Hay, Simon I, Duko, Bereket, Yeshaw, Yigizie, Local Burden of Disease Exclusive Breastfeeding Collaborators, Bhattacharjee N.V., Schaeffer L.E., Hay S.I., Lu D., Schipp M.F., Lazzar-Atwood A., Donkers K.M., Abady G.G., Abd-Allah F., Abdelalim A., Abebo Z.H., Abejie A.N., Abosetugn A.E., Abreu L.G., Abrigo M.R.M., Abu-Gharbieh E., Abushouk A.I., Adamu A.L., Adedeji I.A., Adegbosin A.E., Adekanmbi V., Adetokunboh O.O., Agudelo-Botero M., Aji B., Akinyemi O.O., Alamneh A.A., Alanezi F.M., Alanzi T.M., Albright J., Alcalde-Rabanal J.E., Alemu B.W., Alhassan R.K., Ali B.A., Ali S., Alinia C., Alipour V., Amit A.M.L., Amugsi D.A., Anbesu E.W., Ancuceanu R., Anjomshoa M., Ansari F., Antonio C.A.T., Anvari D., Arabloo J., Arora A., Artanti K.D., Asemahagn M.A., Asmare W.N., Atout M.M.W., Ausloos M., Awoke N., Quintanilla B.P.A., Ayanore M.A., Aynalem Y.A., Ayza M.A., Azene Z.N., Darshan B.B., Badiye A.D., Baig A.A., Bakkannavar S.M., Banach M., Banik P.C., Barnighausen T.W., Basaleem H., Bayati M., Baye B.A., Bedi N., Belay S.A., Bhagavathula A.S., Bhandari D., Bhardwaj N., Bhardwaj P., Bhutta Z.A., Bijani A., Birhan T.A., Birihane B.M., Bitew Z.W., Bohlouli S., Bohluli M., Bojia H.A., Boloor A., Brady O.J., Bragazzi N.L., Brunoni A.R., Budhathoki S.S., Nagaraja S.B., Butt Z.A., Cardenas R., Castaldelli-Maia J.M., Castro F., Cernigliaro A., Charan J., Chatterjee P., Chatterjee S., Chattu V.K., Chaturvedi S., Chowdhury M.A.K., Chu D.-T., Collison M.L., Cook A.J., Cork M.A., Couto R.A.S., Dagnew B., Dai H., Dandona L., Dandona R., Daneshpajouhnejad P., Darwesh A.M., Darwish A.H., Daryani A., Das J.K., Gupta R.D., Davila-Cervantes C.A., Davis A.C., Weaver N.D., Denova-Gutierrez E., Deribe K., Desalew A., Deshpande A., Dessie A., Deuba K., Dharmaratne S.D., Dhimal M., Dhungana G.P., Diaz D., Didarloo A., Dipeolu I.O., Doan L.P., Duko B., Duraes A.R., Dwyer-Lindgren L., Earl L., Zaki M.E.S., Tantawi M.E., Elema T.B., Elhabashy H.R., El-Jaafary S.I., Faris P.S., Faro A., Farzadfar F., Feigin V.L., Feleke B.E., Ferede T.Y., Fischer F., Foigt N.A., Folayan M.O., Franklin R.C., Gad M.M., Gaidhane S., Gardner W.M., Geberemariyam B.S., Gebregiorgis B.G., Gebremedhin K.B., Gebremichael B., Ghaffarpasand F., Gilani S.A., Ginindza T.G., Glagn M., Golechha M., Gonfa K.B., Goulart B.N.G., Gudi N., Guido D., Guled R.A., Guo Y., Hamidi S., Handiso D.W., Hasaballah A.I., Hassan A., Hayat K., Hegazy M.I., Heidari B., Henry N.J., Herteliu C., de Hidru H.D., Ho H.C., Hoang C.L., Holla R., Hon J., Hosseini M., Hosseinzadeh M., Househ M., Hsairi M., Hu G., Huda T.M., Hwang B.-F., Ibitoye S.E., Ilesanmi O.S., Ilic I.M., Ilic M.D., Inbaraj L.R., Iqbal U., Irvani S.S.N., Islam M.M., Iwu C.C.D., Iwu C.J., Jain A., Janodia M.D., Javaheri T., John-Akinola Y.O., Johnson K.B., Joukar F., Jozwiak J.J., Kabir A., Kalankesh L.R., Kalhor R., Kamath A., Kamyari N., Kanchan O.T., Kapoor N., Matin B.K., Karimi S.E., Kasaye H.K., Kassahun G., Kassebaum N.J., Kayode G.A., Karyani A.K., Keiyoro P.N., Kelkay B., Khalid N., Khan M.N., Khatab K., Khater A.M., Khater M.M., Khatib M.N., Kim Y.J., Kimokoti R.W., Kinyoki D.K., Kisa A., Kisa S., Kosen S., Krishan K., Kulkarni V., Kumar G.A., Kumar M., Kumar N., Kumar P., Kurmi O.P., Kusuma D., Vecchia C.L., Lad S.D., Lami F.H., Landires I., Lansingh V.C., Lasrado S., Lee P.H., LeGrand K.E., Letourneau I.D., Lewycka S., Li B., Li M.-C., Li S., Liu X., Lodha R., Lopez J.C.F., Louie C., Machado D.B., Maled V., Maleki S., Malta D.C., Mamun A.A., Manafi N., Mansournia M.A., Mapoma C.C., Marczak L.B., Martins-Melo F.R., Mehndiratta M.M., Mejia-Rodriguez F., Mekonnen T.C., Mendoza W., Menezes R.G., Mengesha E.W., Mersha A.M., Miller T.R., Mini G.K., Mirrakhimov E.M., Misra S., Moghadaszadeh M., Mohammad D.K., Mohammadian-Hafshejani A., Mohammed J.A., Mohammed S., Mokdad A.H., Montero-Zamora P.A., Moradi M., Moradzadeh R., Moraga P., Mosser J.F., Mousavi S.M., Khaneghah A.M., Munro S.B., Muriithi M.K., Mustafa G., Muthupandian S., Nagarajan A.J., Naik G., Naimzada M.D., Nangia V., Nascimento B.R., Nayak V.C., Ndejjo R., Ndwandwe D.E., Negoi I., Nguefack-Tsague G., Ngunjiri J.W., Nguyen C.T., Nguyen D.N., Nguyen H.L.T., Nigussie S.N., Nigussie T.T.N., Nikbakhsh R., Nnaji C.A., Nunez-Samudio V., Oancea B., Oghenetega O.B., Olagunju A.T., Olusanya B.O., Olusanya J.O., Omer M.O., Onwujekwe O.E., Ortega-Altamirano D.V., Osgood-Zimmerman A.E., Otstavnov N., Otstavnov S.S., Owolabi M.O., Mahesh P.A., Padubidri J.R., Pana A., Pandey A., Pandi-Perumal S.R., Pangaribuan H.U., Parsekar S.S., Pasupula D.K., Patel U.K., Pathak A., Pathak M., Pattanshetty S.M., Patton G.C., Paulos K., Pepito V.C.F., Pickering B.V., Pinheiro M., Piwoz E.G., Pokhrel K.N., Pourjafar H., Prada S.I., Pribadi D.R.A., Syed Z.Q., Rabiee M., Rabiee N., Rahim F., Rahimzadeh S., Rahman A., Rahman M.H.U., Rahmani A.M., Rai R.K., Ranabhat C.L., Rao S.J., Rastogi P., Rathi P., Rawaf D.L., Rawaf S., Rawassizadeh R., Rawat R., Regassa L.D., Rego M.A.S., Reiner R.C., Reshmi B., Rezapour A., Ribeiro A.I., Rickard J., Roever L., Rumisha S.F., Rwegerera G.M., Sagar R., Sajadi S.M., Salem M.R., Samy A.M., Santric-Milicevic M.M., Saraswathy S.Y.I., Sarker A.R., Sartorius B., Sathian B., Saxena D., Sbarra A.N., Sengupta D., Senthilkumaran S., Sha F., Shafaat O., Shaheen A.A., Shaikh M.A., Shalash A.S., Shannawaz M., Sheikh A., Shetty B.S.K., Shetty R.S., Shibuya K., Shiferaw W.S., Shin J.I., Silva D.A.S., Singh N.P., Singh P., Singh S., Sintayehu Y., Skryabin V.Y., Skryabina A.A., Soheili A., Soltani S., Sorrie M.B., Spurlock E.E., Steuben K.M., Sudaryanto A., Sufiyan M.B., Swartz S.J., Tadesse E.G., Tamiru A.T., Tapak L., Tareque M.I., Tarigan I.U., Tesema G.A., Tesfay F.H., Teshome A., Tessema Z.T., Thankappan K.R., Thapar R., Thomas N., Topor-Madry R., Tovani-Palone M.R., Traini E., Tran B.X., Truong P.N., Tsegaye B.T.B.T., Ullah I., Umeokonkwo C.D., Unnikrishnan B., Upadhyay E., Uzochukwu B.S.C., VanderHeide J.D., Violante F.S., Vo B., Wado Y.D., Waheed Y., Wamai R.G., Wang F., Wang Y., Wang Y.-P., Wickramasinghe N.D., Wiens K.E., Wiysonge C.S., Woyczynski L., Wu A.-M., Wu C., Yamada T., Yaya S., Yeshaneh A., Yeshaw Y., Yeshitila Y.G., Yilma M.T., Yip P., Yonemoto N., Yosef T., Younis M.Z., Yousuf A.Y., Yu C., Yu Y., Yuce D., Zafar S., Zaidi S.S., Zaki L., Zakzuk J., Zamanian M., Zar H.J., Zastrozhin M.S., Zastrozhina A., Zelellw D.A., Zhang Y., Zhang Z.-J., Zhao X.-J.G., Zodpey S., Zuniga Y.M.H., Collaborators, Local Burden of Disease Exclusive Breastfeeding, and Instituto de Saúde Pública da Universidade do Porto

Subjects
RJ101, Psychological intervention, Breastfeeding, Social Sciences, geography, Behavioral Neuroscience, 0302 clinical medicine, RA0421, Prevalence, Psychology, policy making, 030212 general & internal medicine, Policy Making, humans, media_common, CHILD GROWTH FAILURE, Developing world, 0303 health sciences, education.field_of_study, Psychology, Biological, Geography, Psychology, Experimental, Health Status Disparitie, Multidisciplinary Sciences, Breast Feeding, breast feeding, Scale (social sciences), Science & Technology - Other Topics, Life Sciences & Biomedicine, Human, AFRICA, Social Psychology, Inequality, spatial analysis, media_common.quotation_subject, public policy, Population, prevalence, Public policy, Developing country, Experimental and Cognitive Psychology, Public Policy, Local Burden of Disease Exclusive Breastfeeding Collaborators, Article, Developing Countrie, 03 medical and health sciences, Environmental health, Humans, Nutrition disorders, education, Developing Countries, 030304 developmental biology, Spatial Analysis, Science & Technology, Neurosciences, Health Status Disparities, developing countries, health status disparities, Risk factors, Neurosciences & Neurology, Breast feeding
Abstract

Exclusive breastfeeding (EBF)—giving infants only breast-milk for the first 6 months of life—is a component of optimal breastfeeding practices effective in preventing child morbidity and mortality. EBF practices are known to vary by population and comparable subnational estimates of prevalence and progress across low- and middle-income countries (LMICs) are required for planning policy and interventions. Here we present a geospatial analysis of EBF prevalence estimates from 2000 to 2018 across 94 LMICs mapped to policy-relevant administrative units (for example, districts), quantify subnational inequalities and their changes over time, and estimate probabilities of meeting the World Health Organization’s Global Nutrition Target (WHO GNT) of ≥70% EBF prevalence by 2030. While six LMICs are projected to meet the WHO GNT of ≥70% EBF prevalence at a national scale, only three are predicted to meet the target in all their district-level units by 2030., Bhattacharjee and Schaeffer et al. map exclusive breastfeeding (EBF) in 94 low- and middle-income countries (LMICs), finding increased EBF practice and reduced subnational variation across the majority of LMICs from 2000 to 2018. However, only six LMICs will meet WHO’s target of ≥70% EBF by 2030 nationally, and only three will achieve this in all districts.

Published
2021

8. The global burden of cancer attributable to risk factors, 2010-19: a systematic analysis for the Global Burden of Disease Study 2019

Author

Khanh, BT, Lang, JJ, Compton, K, Xu, R, Acheson, AR, Henrikson, HJ, Kocarnik, JM, Penberthy, L, Aali, A, Abbas, Q, Abbasi, B, Abbasi-Kangevari, M, Abbasi-Kangevari, Z, Abbastabar, H, Abdelmasseh, M, Abd-Elsalam, S, Abdelwahab, AA, Abdoli, G, Abdulkadir, HA, Abedi, A, Abegaz, KH, Abidi, H, Aboagye, RG, Abolhassani, H, Absalan, A, Abtew, YD, Ali, HA, Abu-Gharbieh, E, Achappa, B, Acuna, JM, Addison, D, Addo, IY, Adegboye, OA, Adesina, MA, Adnan, M, Adnani, QES, Advani, SM, Afrin, S, Afzal, MS, Aggarwal, M, Ahinkorah, BO, Ahmad, AR, Ahmad, R, Ahmad, S, Ahmadi, S, Ahmed, H, Ahmed, LA, Ahmed, MB, Rashid, TA, Aiman, W, Ajami, M, Akalu, GT, Akbarzadeh-Khiavi, M, Aklilu, A, Akonde, M, Akunna, CJ, Al Hamad, H, Alahdab, F, Alanezi, FM, Alanzi, TM, Alessy, SA, Algammal, AM, Al-Hanawi, MK, Alhassan, RK, Ali, BA, Ali, L, Ali, SS, Alimohamadi, Y, Alipour, V, Aljunid, SM, Alkhayyat, M, Al-Maweri, SAA, Almustanyir, S, Alonso, N, Alqalyoobi, S, Al-Raddadi, RM, Al-Rifai, RHH, Al-Sabah, SK, Al-Tammemi, AB, Altawalah, H, Alvis-Guzman, N, Amare, F, Ameyaw, EK, Dehkordi, JJA, Amirzade-Iranaq, MH, Amu, H, Amusa, GA, Ancuceanu, R, Anderson, JA, Animut, YA, Anoushiravani, A, Anoushirvani, AA, Ansari-Moghaddam, A, Ansha, MG, Antony, B, Antwi, MH, Anwar, SL, Anwer, R, Anyasodor, AE, Arabloo, J, Arab-Zozani, M, Aremu, O, Argaw, AM, Ariffin, H, Aripov, T, Arshad, M, Al, A, Arulappan, J, Aruleba, RT, Aryannejad, A, Asaad, M, Asemahagn, MA, Asemi, Z, Asghari-Jafarabadi, M, Ashraf, T, Assadi, R, Athar, M, Athari, SS, Null, MMWA, Attia, S, Aujayeb, A, Ausloos, M, Avila-Burgos, L, Awedew, AF, Awoke, MA, Awoke, T, Quintanilla, BPA, Ayana, TM, Ayen, SS, Azadi, D, Null, SA, Azami-Aghdash, S, Azanaw, MM, Azangou-Khyavy, M, Jafari, AA, Azizi, H, Azzam, AYY, Babajani, A, Badar, M, Badiye, AD, Baghcheghi, N, Bagheri, N, Bagherieh, S, Bahadory, S, Baig, AA, Baker, JL, Bakhtiari, A, Bakshi, RK, Banach, M, Banerjee, I, Bardhan, M, Barone-Adesi, F, Barra, F, Barrow, A, Bashir, NZ, Bashiri, A, Basu, S, Batiha, 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Davitoiu, DV, Esmaeili, ED, De la Hoz, FP, Debela, SA, Dehghan, A, Demisse, B, Demisse, FW, DenovaGutiA, E, Derakhshani, A, Molla, MD, Dereje, D, Deribe, KS, Desai, R, Desalegn, MD, Dessalegn, FN, Dessalegni, SAA, Dessie, G, Desta, AA, Dewan, SMR, Dharmaratne, SD, Dhimal, M, Dianatinasab, M, Diao, N, Diaz, D, Digesa, LE, Dixit, SG, Doaei, S, Linh, PD, Doku, PN, Dongarwar, D, dos Santos, WM, Driscoll, TR, Dsouza, HL, Durojaiye, OC, Edalati, S, Eghbalian, F, Ehsani-Chimeh, E, Eini, E, Ekholuenetale, M, Ekundayo, TC, Ekwueme, DU, El Tantawi, M, Elbahnasawy, MA, Elbarazi, I, Elghazaly, H, Elhadi, M, El-Huneidi, W, Emamian, MH, Bain, LE, Enyew, DB, Erkhembayar, R, Eshetu, T, Eshrati, B, Eskandarieh, S, Espinosa-Montero, J, Etaee, F, Etemadimanesh, A, Eyayu, T, Ezeonwumelu, IJ, Ezzikouri, S, Fagbamigbe, AF, Fahimi, S, Fakhradiyev, IR, Faraon, EJA, Fares, J, Farmany, A, Farooque, U, Farrokhpour, H, Fasanmi, AO, Fatehizadeh, A, Fatima, W, Fattahi, H, Fekadu, G, Feleke, BE, Ferrari, AA, 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Hostiuc, M, Hostiuc, S, Househ, M, Huang, J, Hugo, FN, Humayun, A, Hussain, S, Hussein, NR, Hwang, B-F, Ibitoye, SE, Iftikhar, PM, Ikuta, KS, Ilesanmi, OS, Ilic, IM, Ilic, MD, Immurana, M, Innos, K, Iranpour, P, Irham, LM, Islam, MS, Islam, RM, Islami, F, Ismail, NE, Isola, G, Iwagami, M, Merin, LJ, Jaiswal, A, Jakovljevic, M, Jalili, M, Jalilian, S, Jamshidi, E, Jang, S-I, Jani, CT, Javaheri, T, Jayarajah, UU, Jayaram, S, Jazayeri, SB, Jebai, R, Jemal, B, Jeong, W, Jha, RP, Jindal, HA, John-Akinola, YO, Jonas, JB, Joo, T, Joseph, N, Joukar, F, Jozwiak, JJ, Jarisson, M, Kabir, A, Kacimi, SEO, Kadashetti, V, Kahe, F, Kakodkar, PV, Kalankesh, LR, Kalhor, R, Kamal, VK, Kamangar, F, Kamath, A, Kanchan, T, Kandaswamy, E, Kandel, H, Kang, H, Kanno, GG, Kapoor, N, Kar, SS, Karanth, SD, Karaye, IM, Karch, A, Karimi, A, Kassa, BG, Katoto, PDMC, Kauppila, JH, Kaur, H, Kebede, AG, Keikavoosi-Arani, L, Kejela, GG, Bohan, PMK, Keramati, M, Keykhaei, M, Khajuria, H, Khan, A, Khan, AAK, Khan, EA, Khan, G, Khan, MN, Ab Khan, M, Khanali, J, Khatab, K, Khatatbeh, MM, Khatib, MN, Khayamzadeh, M, Kashani, HRK, Tabari, MAK, Khezeli, M, Khodadost, M, Kim, MS, Kim, YJ, Kisa, A, Kisa, S, Klugar, M, Klugarova, J, Kolahi, A-A, Kolkhir, P, Kompani, F, Koul, PA, Laxminarayana, SLK, Koyanagi, A, Krishan, K, Krishnamoorthy, Y, Bicer, BK, Kugbey, N, Kulimbet, M, Kumar, A, Kumar, GA, Kumar, N, Kurmi, OP, Kuttikkattu, A, La Vecchia, C, Lahiri, A, Lal, DK, Lam, J, Lan, Q, Landires, I, Larijani, B, Lasrado, S, Lau, J, Lauriola, P, Ledda, C, Lee, S-W, Lee, SWH, Lee, W-C, Lee, YY, Lee, YH, Legesse, SM, Leigh, J, Leong, E, Li, M-C, Lim, SS, Liu, G, Liu, J, Lo, C-H, Lohiya, A, Lopukhov, PD, Lorenzovici, L, Lotfi, M, Loureiro, JA, Lunevicius, R, Madadizadeh, F, Mafi, AR, Magdeldin, S, Mahjoub, S, Mahmoodpoor, A, Mahmoudi, M, Mahmoudimanesh, M, Mahumud, RA, Majeed, A, Majidpoor, J, Makki, A, Makris, KC, Rad, EM, Malekpour, M-R, Malekzadeh, R, Malik, AA, Mallhi, TH, Mallya, SD, Mamun, MA, Manda, AL, Mansour-Ghanaei, F, Mansouri, B, Mansournia, MA, Mantovani, LG, Martini, S, Martorell, M, Masoudi, S, Masoumi, SZ, Matei, CN, Mathews, E, Mathur, MR, Mathur, V, McKee, M, Meena, JK, Mehmood, K, Nasab, EM, Mehrotra, R, Melese, A, Mendoza, W, Menezes, RG, Mengesha, SD, Mensah, LG, Mentis, A-FA, Mera-Mamian, AYM, Meretoja, TJ, Merid, MW, Mersha, AG, Meselu, BT, Meshkat, M, Mestrovic, T, Jonasson, JM, Miazgowski, T, Michalek, IM, Mijena, GFW, Miller, TR, Mir, SA, Mirinezhad, SK, Mirmoeeni, S, Mirza-Aghazadeh-Attari, M, Mirzaei, H, Mirzaei, HR, Misganaw, AS, Misra, S, AbdulmuhsinMohammad, K, Mohammadi, E, Mohammadi, M, Mohammadian-Hafshejani, A, Mohammadpourhodki, R, Mohammed, A, Mohammed, S, Mohan, S, Mohseni, M, Moka, N, Mokdad, AH, Molassiotis, A, Molokhia, M, Momenzadeh, K, Momtazmanesh, S, Monasta, L, Mons, U, Al Montasir, A, Montazeri, F, Montero, A, Moosavi, MA, Moradi, A, Moradi, Y, Sarabi, MM, Moraga, P, Morawska, L, Morrison, SD, Morze, J, Mosapour, A, Mostafavi, E, Mousavi, SM, Isfahani, HM, Khaneghah, AM, Mpundu-Kaambwa, C, Mubarik, S, Mulita, F, Munblit, D, Munro, SB, Murillo-Zamora, E, Musa, J, Nabhan, AF, Nagarajan, AJ, Nagaraju, SP, Nagel, G, Naghipour, M, Naimzada, MD, Nair, TS, Naqvi, AA, Swamy, SN, Narayana, AI, Nassereldine, H, Natto, ZS, Nayak, BP, Ndejjo, R, Nduaguba, SO, Negash, WW, Nejadghaderi, SA, Nejati, K, Kandel, SN, Huy, VNN, Niazi, RK, Noor, NM, Noori, M, Noroozi, N, Nouraei, H, Nowroozi, A, Nunez-Samudio, V, Nzoputam, CI, Nzoputam, OJ, Oancea, B, Odukoya, OO, Oghenetega, OB, Ogunsakin, RE, Oguntade, AS, Oh, I-H, Okati-Aliabad, H, Okekunle, AP, Olagunju, AT, Olagunju, TO, Olakunde, BO, Olufadewa, II, Omer, E, Omonisi, AEE, Ong, S, Onwujekwe, OE, Orru, H, Otstavnov, SS, Oulhaj, A, Oumer, B, Owopetu, OF, Oyinloye, BE, Mahesh, PA, Padron-Monedero, A, Padubidri, JR, Pakbin, B, Pakshir, K, Pakzad, R, Palicz, T, Pana, A, Pandey, A, Pant, S, Pardhan, S, Park, E-K, Park, S, Patel, J, Pati, S, Paudel, R, Paudel, U, Paun, M, Toroudi, HP, Peng, M, Pereira, J, Pereira, RB, Perna, S, Perumalsamy, N, Pestell, RG, Pezzani, R, Piccinelli, C, Pillay, JD, Piracha, ZZ, Pischon, T, Postma, MJ, Langroudi, AP, Pourshams, A, Pourtaheri, N, Prashant, A, Qadir, MMF, Syed, ZQ, Rabiee, M, Rabiee, N, Radfar, A, Radhakrishnan, RA, Radhakrishnan, V, Raeisi, M, Rafiee, A, Rafiei, A, Raheem, N, Rahim, F, Rahman, MO, Rahman, M, Rahman, MA, Rahmani, AM, Rahmani, S, Rahmanian, V, Rajai, N, Rajesh, A, Ram, P, Ramezanzadeh, K, Rana, J, Ranabhat, K, Ranasinghe, P, Rao, CR, Rao, SJ, Rashedi, S, Rashidi, A, Rashidi, M-M, Ratan, ZA, Rawaf, DL, Rawaf, S, Rawal, L, Rawassizadeh, R, Razeghinia, MS, Rehman, AU, Rehman, IU, Reitsma, MB, Renzaho, AMN, Rezaei, M, Rezaei, N, Rezaei, S, Rezaeian, M, Rezapour, A, Riad, A, Rikhtegar, R, Rios-Blancas, M, Roberts, TJ, Rohloff, P, Romero-Rodriguez, E, Roshandel, G, Rwegerera, GM, Manjula, S, Saber-Ayad, MM, Saberzadeh-Ardestani, B, Sabour, S, Saddik, B, Sadeghi, E, Saeb, MR, Saeed, U, Safaei, M, Safary, A, Sahebazzamani, M, Sahebkar, A, Sahoo, H, Sajid, MR, Salari, H, Salehi, S, Salem, MR, Salimzadeh, H, Samodra, YL, Samy, AM, Sanabria, J, Sankararaman, S, Sanmarchi, F, Santric-Milicevic, MM, Saqib, MAN, Sarveazad, A, Sarvi, F, Sathian, B, Satpathy, M, Sayegh, N, Schneider, IJC, Schwarzinger, M, Sekerija, M, Senthilkumaran, S, Sepanlou, SG, Seylani, A, Seyoum, K, Sha, F, Shafaat, O, Shah, PA, Shahabi, S, Shahid, I, Shahrbaf, MA, Shahsavari, HR, Shaikh, MA, Shaka, MF, Shaker, E, Shannawaz, M, Sharew, MMS, Sharifi, A, Sharifi-Rad, J, Sharma, P, Shashamo, BB, Sheikh, A, Sheikh, M, Sheikhbahaei, S, Sheikhi, RA, Sheikhy, A, Shepherd, PR, Shetty, A, Shetty, JK, Shetty, RS, Shibuya, K, Shirkoohi, R, Shirzad-Aski, H, Shivakumar, KM, Shivalli, S, Shivarov, V, Shobeiri, P, Varniab, ZS, Shorofi, SA, Shrestha, S, Sibhat, MM, Malleshappa, SS, Sidemo, NB, Silva, DAS, Silva, LMLR, Julian, GS, Silvestris, N, Simegn, W, Singh, AD, Singh, A, Singh, G, Singh, H, Singh, JA, Singh, JK, Singh, P, Singh, S, Sinha, DN, Sinke, AH, Siraj, MS, Sitas, F, Siwal, SS, Skryabin, VY, Skryabina, AA, Socea, B, Soeberg, MJ, Sofi-Mahmudi, A, Solomon, Y, Soltani-Zangbar, MS, Song, S, Song, Y, Sorensen, RJD, Soshnikov, S, Sotoudeh, H, Sowe, A, Sufiyan, MB, Suk, R, Suleman, M, Abdulkader, RS, Sultana, S, Sur, D, Szacska, M, Tabaeian, SP, Tabares-Seisdedos, R, Tabatabaei, SM, Tabuchi, T, Tadbiri, H, Taheri, E, Taheri, M, Soodejani, MT, Takahashi, K, Talaat, IM, Tampa, M, Tan, K-K, Tat, NY, Tat, VY, Tavakoli, A, Tehrani-Banihashemi, A, Tekalegn, Y, Tesfay, FH, Thapar, R, Thavamani, A, Chandrasekar, VT, Thomas, N, Thomas, NK, Ticoalu, JHV, Tiyuri, A, Tollosa, DN, Topor-Madry, R, Touvier, M, Tovani-Palone, MR, Traini, E, Mai, TNT, Tripathy, JP, Ukke, GG, Ullah, I, Ullah, S, Unnikrishnan, B, Vacante, M, Vaezi, M, Tahbaz, SV, Valdez, PR, Vardavas, C, Varthya, SB, Vaziri, S, Velazquez, DZ, Veroux, M, Villeneuve, PJ, Violante, FS, Vladimirov, SK, Vlassov, V, Vo, B, Vu, LG, Wadood, AW, Waheed, Y, Walde, MT, Wamai, RG, Wang, C, Wang, F, Wang, N, Wang, Y, Ward, P, Waris, A, Westerman, R, Wickramasinghe, ND, Woldemariam, M, Woldu, B, Xiao, H, Xu, S, Xu, X, Yadav, L, Jabbari, SHY, Yang, L, Yazdanpanah, F, Yeshaw, Y, Yismaw, Y, Yonemoto, N, Younis, MZ, Yousefi, Z, Yousefian, F, Yu, C, Yu, Y, Yunusa, I, Zahir, M, Zaki, N, Zaman, BA, Zangiabadian, M, Zare, F, Zare, I, Zareshahrabadi, Z, Zarrintan, A, Zastrozhin, MS, Zeineddine, MA, Zhang, D, Zhang, J, Zhang, Y, Zhang, Z-J, Zhou, L, Zodpey, S, Zoladl, M, Vos, T, Hay, S, Force, LM, and Murray, CJL

Abstract

BACKGROUND: Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. METHODS: The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk-outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. FINDINGS: Globally, in 2019, the risk factors included in this analysis accounted for 4·45 million (95% uncertainty interval 4·01-4·94) deaths and 105 million (95·0-116) DALYs for both sexes combined, representing 44·4% (41·3-48·4) of all cancer deaths and 42·0% (39·1-45·6) of all DALYs. There were 2·88 million (2·60-3·18) risk-attributable cancer deaths in males (50·6% [47·8-54·1] of all male cancer deaths) and 1·58 million (1·36-1·84) risk-attributable cancer deaths in females (36·3% [32·5-41·3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20·4% (12·6-28·4) and DALYs by 16·8% (8·8-25·0), with the greatest percentage increase in metabolic risks (34·7% [2

Published
2022

9. Global, regional, and national sex differences in the global burden of tuberculosis by HIV status, 1990–2019: results from the Global Burden of Disease Study 2019

Author

Ledesma, JR, Ma, J, Vongpradith, A, Maddison, ER, Novotney, A, Biehl, MH, LeGrand, KE, Ross, JM, Jahagirdar, D, Bryazka, D, Feldman, R, Abolhassani, H, Abosetugn, AE, Abu-Gharbieh, E, Adebayo, OM, Adnani, QES, Afzal, S, Ahinkorah, BO, Ahmad, SA, Ahmadi, S, Ahmed Rashid, T, Ahmed Salih, Y, Aklilu, A, Akunna, CJ, Al Hamad, H, Alahdab, F, Alemayehu, Y, Alene, KA, Ali, BA, Ali, L, Alipour, V, Alizade, H, Al-Raddadi, RM, Alvis-Guzman, N, Amini, S, Amit, AML, Anderson, JA, Androudi, S, Antonio, CAT, Antony, CM, Anwer, R, Arabloo, J, Arja, A, Asemahagn, MA, Atre, SR, Azhar, GS, B, DB, Babar, ZUD, Baig, AA, Banach, M, Barqawi, HJ, Barra, F, Barrow, A, Basu, S, Belgaumi, UI, Bhagavathula, AS, Bhardwaj, N, Bhardwaj, P, Bhattacharjee, NV, Bhattacharyya, K, Bijani, A, Bikbov, B, Boloor, A, Briko, NI, Buonsenso, D, Burugina Nagaraja, S, Butt, ZA, Carter, A, Carvalho, F, Charan, J, Chatterjee, S, Chattu, SK, Chattu, VK, Christopher, DJ, Chu, DT, Claassens, MM, Dadras, O, Dagnew, AB, Dai, X, Dandona, L, Dandona, R, Daneshpajouhnejad, P, Darwesh, AM, Dhamnetiya, D, Dianatinasab, M, Diaz, D, Doan, LP, Eftekharzadeh, S, Elhadi, M, Emami, A, Enany, S, Faraon, EJA, Farzadfar, F, Fernandes, E, Ferro Desideri, L, Filip, I, Fischer, F, Foroutan, M, Frank, TD, Garcia-Basteiro, AL, Ledesma, JR, Ma, J, Vongpradith, A, Maddison, ER, Novotney, A, Biehl, MH, LeGrand, KE, Ross, JM, Jahagirdar, D, Bryazka, D, Feldman, R, Abolhassani, H, Abosetugn, AE, Abu-Gharbieh, E, Adebayo, OM, Adnani, QES, Afzal, S, Ahinkorah, BO, Ahmad, SA, Ahmadi, S, Ahmed Rashid, T, Ahmed Salih, Y, Aklilu, A, Akunna, CJ, Al Hamad, H, Alahdab, F, Alemayehu, Y, Alene, KA, Ali, BA, Ali, L, Alipour, V, Alizade, H, Al-Raddadi, RM, Alvis-Guzman, N, Amini, S, Amit, AML, Anderson, JA, Androudi, S, Antonio, CAT, Antony, CM, Anwer, R, Arabloo, J, Arja, A, Asemahagn, MA, Atre, SR, Azhar, GS, B, DB, Babar, ZUD, Baig, AA, Banach, M, Barqawi, HJ, Barra, F, Barrow, A, Basu, S, Belgaumi, UI, Bhagavathula, AS, Bhardwaj, N, Bhardwaj, P, Bhattacharjee, NV, Bhattacharyya, K, Bijani, A, Bikbov, B, Boloor, A, Briko, NI, Buonsenso, D, Burugina Nagaraja, S, Butt, ZA, Carter, A, Carvalho, F, Charan, J, Chatterjee, S, Chattu, SK, Chattu, VK, Christopher, DJ, Chu, DT, Claassens, MM, Dadras, O, Dagnew, AB, Dai, X, Dandona, L, Dandona, R, Daneshpajouhnejad, P, Darwesh, AM, Dhamnetiya, D, Dianatinasab, M, Diaz, D, Doan, LP, Eftekharzadeh, S, Elhadi, M, Emami, A, Enany, S, Faraon, EJA, Farzadfar, F, Fernandes, E, Ferro Desideri, L, Filip, I, Fischer, F, Foroutan, M, Frank, TD, and Garcia-Basteiro, AL

Published
2022

10. Progress in health among regions of Ethiopia, 1990–2019: a subnational country analysis for the Global Burden of Disease Study 2019

Author

Misganaw, A, Naghavi, M, Walker, A, Mirkuzie, AH, Giref, AZ, Berheto, TM, Waktola, EA, Kempen, JH, Eticha, GT, Wolde, TK, Deguma, D, Abate, KH, Abegaz, KH, Ahmed, MB, Akalu, Y, Aklilu, A, Alemu, BW, Asemahagn, MA, Awedew, AF, Balakrishnan, S, Bekuma, TT, Beyene, AS, Beyene, MG, Bezabih, YM, Birhanu, BT, Chichiabellu, TY, Dachew, BA, Dagnew, AB, Demeke, FM, Demissie, GD, Derbew Molla, M, Dereje, N, Deribe, K, Desta, AA, Eshetu, MK, Ferede, TY, Gebreyohannes, EA, Geremew, A, Gesesew, HA, Getacher, L, Glenn, SD, Hafebo, AS, Hashi, A, Hassen, HY, Hay, SI, Hordofa, DF, Huluko, DH, Kasa, AS, Kassahun Azene, G, Kebede, EM, Kebede, HK, Kelkay, B, Kidane, SZ, Legesse, SM, Manamo, WA, Melaku, YAA, Mengesha, EW, Mengesha, SD, Merie, HE, Mersha, AM, Mersha, AG, Mirutse, MK, Mohammed, AS, Mohammed, H, Mohammed, S, Netsere, HB, Nigatu, D, Obsa, MS, Odo, DB, Omer, M, Regassa, LD, Sahiledengle, B, Shaka, MF, Shiferaw, WS, Sidemo, NB, Sinke, AH, Sintayehu, Y, Sorrie, MB, Tadesse, BT, Tadesse, EG, Tamir, Z, Tamiru, AT, Tareke, AA, Tefera, YG, Tekalegn, Y, Tesema, AK, Tesema, TT, Tesfay, Fisaha, Tessema, ZT, Tilahun, T, Tsegaye, GW, Tusa, BS, Weledesemayat, GT, Yazie, TS, Yeshitila, YG, Yirdaw, BW, Zegeye, DT, Murray, CJL, Gebremedhin, LT, Misganaw, A, Naghavi, M, Walker, A, Mirkuzie, AH, Giref, AZ, Berheto, TM, Waktola, EA, Kempen, JH, Eticha, GT, Wolde, TK, Deguma, D, Abate, KH, Abegaz, KH, Ahmed, MB, Akalu, Y, Aklilu, A, Alemu, BW, Asemahagn, MA, Awedew, AF, Balakrishnan, S, Bekuma, TT, Beyene, AS, Beyene, MG, Bezabih, YM, Birhanu, BT, Chichiabellu, TY, Dachew, BA, Dagnew, AB, Demeke, FM, Demissie, GD, Derbew Molla, M, Dereje, N, Deribe, K, Desta, AA, Eshetu, MK, Ferede, TY, Gebreyohannes, EA, Geremew, A, Gesesew, HA, Getacher, L, Glenn, SD, Hafebo, AS, Hashi, A, Hassen, HY, Hay, SI, Hordofa, DF, Huluko, DH, Kasa, AS, Kassahun Azene, G, Kebede, EM, Kebede, HK, Kelkay, B, Kidane, SZ, Legesse, SM, Manamo, WA, Melaku, YAA, Mengesha, EW, Mengesha, SD, Merie, HE, Mersha, AM, Mersha, AG, Mirutse, MK, Mohammed, AS, Mohammed, H, Mohammed, S, Netsere, HB, Nigatu, D, Obsa, MS, Odo, DB, Omer, M, Regassa, LD, Sahiledengle, B, Shaka, MF, Shiferaw, WS, Sidemo, NB, Sinke, AH, Sintayehu, Y, Sorrie, MB, Tadesse, BT, Tadesse, EG, Tamir, Z, Tamiru, AT, Tareke, AA, Tefera, YG, Tekalegn, Y, Tesema, AK, Tesema, TT, Tesfay, Fisaha, Tessema, ZT, Tilahun, T, Tsegaye, GW, Tusa, BS, Weledesemayat, GT, Yazie, TS, Yeshitila, YG, Yirdaw, BW, Zegeye, DT, Murray, CJL, and Gebremedhin, LT

Abstract

Background: Previous Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) studies have reported national health estimates for Ethiopia. Substantial regional variations in socioeconomic status, population, demography, and access to health care within Ethiopia require comparable estimates at the subnational level. The GBD 2019 Ethiopia subnational analysis aimed to measure the progress and disparities in health across nine regions and two chartered cities. Methods: We gathered 1057 distinct data sources for Ethiopia and all regions and cities that included census, demographic surveillance, household surveys, disease registry, health service use, disease notifications, and other data for this analysis. Using all available data sources, we estimated the Socio-demographic Index (SDI), total fertility rate (TFR), life expectancy, years of life lost, years lived with disability, disability-adjusted life-years, and risk-factor-attributable health loss with 95% uncertainty intervals (UIs) for Ethiopia's nine regions and two chartered cities from 1990 to 2019. Spatiotemporal Gaussian process regression, cause of death ensemble model, Bayesian meta-regression tool, DisMod-MR 2.1, and other models were used to generate fertility, mortality, cause of death, and disability rates. The risk factor attribution estimations followed the general framework established for comparative risk assessment. Findings: The SDI steadily improved in all regions and cities from 1990 to 2019, yet the disparity between the highest and lowest SDI increased by 54% during that period. The TFR declined from 6·91 (95% UI 6·59–7·20) in 1990 to 4·43 (4·01–4·92) in 2019, but the magnitude of decline also varied substantially among regions and cities. In 2019, TFR ranged from 6·41 (5·96–6·86) in Somali to 1·50 (1·26–1·80) in Addis Ababa. Life expectancy improved in Ethiopia by 21·93 years (21·79–22·07), from 46·91 years (45·71–48·11) in 1990 to 68·84 years (67·51–70·18) in 2019. Addis Ababa had t

Published
2022

11. Population-level risks of alcohol consumption by amount, geography, age, sex, and year: a systematic analysis for the Global Burden of Disease Study 2020

Author

Bryazka, D, Reitsma, MB, Griswold, MG, Abate, KH, Abbafati, C, Kangevari, MA, Kangevari, ZA, Abdoli, A, Abdollahi, M, Abdullah, AYM, Abhilash, ES, Abu Gharbieh, E, Acuna, JM, Addolorato, G, Adebayo, OM, Adekanmbi, V, Adhikari, K, Adhikari, S, Adnani, QES, Afzal, S, Agegnehu, WY, Aggarwal, M, Ahinkorah, BO, Ahmad, AR, Ahmad, S, Ahmad, T, Ahmadi, A, Ahmadi, S, Ahmed, H, Rashid, TA, Akunna, CJ, Al Hamad, H, Alam, MZ, Alem, DT, Alene, KA, Alimohamadi, Y, Alizadeh, A, Allel, K, Alonso, J, Alvand, S, Guzman, NA, Amare, F, Ameyaw, EK, Amiri, S, Ancuceanu, R, Anderson, JA, Andrei, CL, Andrei, T, Arabloo, J, Arshad, M, Artamonov, AA, Aryan, Z, Asaad, M, Asemahagn, MA, Burt, TA, Athari, SS, Atnafu, DD, Atorkey, P, Atreya, A, Ausloos, F, Ausloos, M, Ayano, G, Ayanore, MA, Ayinde, OO, Mateos, JLA, Azadnajafabad, S, Azanaw, MM, Khyavy, MA, Jafari, AA, Azzam, AY, Badiye, AD, Bagheri, N, Bagherieh, S, Bairwa, M, Bakkannavar, SM, Bakshi, RK, Balchut, AH, Null, T, Barra, F, Barrow, A, Baskaran, P, Belo, L, Bennett, DA, Bensenor, IM, Bhagavathula, AS, Bhala, N, Bhalla, A, Bhardwaj, N, Bhardwaj, P, Bhaskar, S, Bhattacharyya, K, Bhojaraja, VS, Bintoro, BS, Blokhina, EAE, Bodicha, BBA, Boloor, A, Bosetti, C, Braithwaite, D, Brenner, H, Briko, NI, Brunoni, AR, Butt, ZA, Cao, C, Cao, Y, Cardenas, R, Carvalho, AF, Carvalho, M, Maia, JMC, Castelpietra, G, de Araujo, LFSC, Cattaruzza, MS, Chakraborty, PA, Charan, J, Chattu, VK, Chaurasia, A, Cherbuin, N, Dinh, TC, Chudal, N, Chung, SC, Churko, C, Ciobanu, LG, Cirillo, M, Claro, RM, Costanzo, S, Cowden, RG, Criqui, MH, Martins, NC, Culbreth, GT, Dachew, BA, Dadras, O, Dai, X, Damiani, G, Dandona, L, Dandona, R, Daniel, BD, Danielewicz, A, Gela, JD, Davletov, K, de Araujo, JAP, de Sa Junior, AR, Debela, SA, Dehghan, A, Demetriades, AK, Molla, MD, Desai, R, Desta, AA, da Silva, DD, Diaz, D, Digesa, LE, Diress, M, Dodangeh, M, Dongarwar, D, Dorostkar, F, Dsouza, HL, Duko, B, Duncan, BB, Edvardsson, K, Ekholuenetale, M, Elgar, FJ, Elhadi, M, 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Lopukhov, PD, Lorkowski, S, Lozano, R, Lucchetti, G, Madadizadeh, F, Mahjoub, S, Mahmoodpoor, A, Mahumud, RA, Makki, A, Malekpour, MR, Manjunatha, N, Mansouri, B, Mansournia, MA, Raga, JM, Villa, FAM, Matzopoulos, R, Maulik, PK, Mayeli, M, McGrath, JJ, Meena, JK, Nasab, EM, Menezes, RG, Mensink, GBM, Mentis, AFA, Meretoja, A, Merga, BT, Mestrovic, T, Jonasson, JM, Miazgowski, B, de Sa, ACMGN, Miller, TR, Mini, G, Mirica, A, Mirijello, A, Mirmoeeni, S, Mirrakhimov, EM, Misra, S, Moazen, B, Mobarakabadi, M, Moccia, M, Mohammad, Y, Mohammadi, E, Hafshejani, AM, Mohammed, TA, Moka, N, Mokdad, AH, Momtazmanesh, S, Moradi, Y, Mostafavi, E, Mubarik, S, Mullany, EC, Mulugeta, BT, Zamora, EM, Murray, CJL, Mwita, JC, Naghavi, M, Naimzada, MD, Nangia, V, Nayak, BP, Negoi, I, Negoi, RI, Nejadghaderi, SA, Nepal, S, Neupane, SPP, Kandel, SN, Nigatu, YT, Nowroozi, A, Nuruzzaman, KM, Nzoputam, CI, Obamiro, KO, Ogbo, FA, Oguntade, AS, Aliabad, HO, Olakunde, BO, Oliveira, GMM, Bali, AO, Omer, E, Altamirano, DVO, Otoiu, A, Otstavnov, SS, Oumer, B, Mahesh, PA, Monedero, AP, Palladino, R, Pana, A, Jonas, SP, Pandey, A, Pardhan, S, Parekh, T, Park, EK, Parry, CDH, Kan, FP, Patel, J, Pati, S, Patton, GC, Paudel, U, Pawar, S, Peden, AE, Petcu, IR, Phillips, MR, Pinheiro, M, Plotnikov, E, Pradhan, PMS, Prashant, A, Quan, J, Radfar, A, Rafiei, A, Raghav, PR, Movaghar, VR, Rahman, A, Rahman, MM, Rahman, M, Rahmani, AM, Rahmani, S, Ranabhat, CL, Ranasinghe, P, Rao, CR, Rasali, DP, Rashidi, MM, Ratan, ZA, Rawaf, DL, Rawaf, S, Rawal, L, Renzaho, AMN, Rezaei, N, Rezaei, S, Rezaeian, M, Riahi, SM, Rodriguez, ER, Roth, GA, Rwegerera, GM, Saddik, B, Sadeghi, E, Sadeghian, R, Saeed, U, Saeedi, F, Sagar, R, Sahebkar, A, Sahoo, H, Sahraian, MA, Rahman, KSU, Salahi, S, Salimzadeh, H, Samy, AM, Sanmarchi, F, Milicevic, MMS, Sarikhani, Y, Sathian, B, Saya, GK, Sayyah, M, Schmidt, MI, Schutte, AE, Schwarzinger, M, Schwebel, DC, Seidu, AA, Kumar, NS, SeyedAlinaghi, S, Seylani, A, Sha, F, Shahin, S, Sanavi, FS, Shahrokhi, S, Shaikh, MA, Shaker, E, Shakhmardanov, MZ, Beyranvand, MS, Sheikhbahaei, S, Sheikhi, RA, Shetty, A, Shetty, JK, Shiferaw, DS, Shigematsu, M, Shiri, R, Shirkoohi, R, Shivakumar, KM, Shivarov, V, Shobeiri, P, Shrestha, R, Sidemo, NB, Sigfusdottir, ID, Silva, DAS, da Silva, NT, Singh, JA, Singh, S, Skryabin, VY, Skryabina, AA, Sleet, DA, Solmi, M, Solomon, Y, Song, S, Song, Y, Sorensen, RJD, Soshnikov, S, Soyiri, IN, Stein, DJ, Subba, SH, Szocska, M, Seisdedos, RT, Tabuchi, T, Taheri, M, Tan, KK, Tareke, M, Tarkang, EE, Temesgen, G, Temesgen, WA, Temsah, MH, Thankappan, KR, Thapar, R, Thomas, NK, Tiruneh, C, Todorovic, J, Torrado, M, Touvier, M, Palone, MRT, Mai, TNT, Llimos, ST, Tripathy, JP, Vakilian, A, Valizadeh, R, Varmaghani, M, Varthya, SB, Vasankari, TJ, Vos, T, Wagaye, B, Waheed, Y, Walde, MT, Wang, C, Wang, Y, Wang, YP, Westerman, R, Wickramasinghe, ND, Wubetu, AD, Xu, S, Yamagishi, K, Yang, L, Yesera, GEE, Yigit, A, Yigit, V, Yimaw, AE, Yon, DK, Yonemoto, N, Yu, C, Zadey, S, Zahir, M, Zare, I, Zastrozhin, MS, Zastrozhina, A, Zhang, ZJ, Zhong, C, Zmaili, M, Zuniga, YMH, Gakidou, E, and Madureira-Carvalho, AM

Abstract

BACKGROUND: The health risks associated with moderate alcohol consumption continue to be debated. Small amounts of alcohol might lower the risk of some health outcomes but increase the risk of others, suggesting that the overall risk depends, in part, on background disease rates, which vary by region, age, sex, and year. METHODS: For this analysis, we constructed burden-weighted dose-response relative risk curves across 22 health outcomes to estimate the theoretical minimum risk exposure level (TMREL) and non-drinker equivalence (NDE), the consumption level at which the health risk is equivalent to that of a non-drinker, using disease rates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2020 for 21 regions, including 204 countries and territories, by 5-year age group, sex, and year for individuals aged 15-95 years and older from 1990 to 2020. Based on the NDE, we quantified the population consuming harmful amounts of alcohol. FINDINGS: The burden-weighted relative risk curves for alcohol use varied by region and age. Among individuals aged 15-39 years in 2020, the TMREL varied between 0 (95% uncertainty interval 0-0) and 0·603 (0·400-1·00) standard drinks per day, and the NDE varied between 0·002 (0-0) and 1·75 (0·698-4·30) standard drinks per day. Among individuals aged 40 years and older, the burden-weighted relative risk curve was J-shaped for all regions, with a 2020 TMREL that ranged from 0·114 (0-0·403) to 1·87 (0·500-3·30) standard drinks per day and an NDE that ranged between 0·193 (0-0·900) and 6·94 (3·40-8·30) standard drinks per day. Among individuals consuming harmful amounts of alcohol in 2020, 59·1% (54·3-65·4) were aged 15-39 years and 76·9% (73·0-81·3) were male. INTERPRETATION: There is strong evidence to support recommendations on alcohol consumption varying by age and location. Stronger interventions, particularly those tailored towards younger individuals, are needed to reduce the substantial global health loss attribu

Published
2022

12. Anemia prevalence in women of reproductive age in low- and middle-income countries between 2000 and 2018

Author

Kinyoki, D, Osgood-Zimmerman, AE, Bhattacharjee, NV, Schaeffer, LE, Lazzar-Atwood, A, Lu, D, Ewald, SB, Donkers, KM, Letourneau, ID, Collison, M, Schipp, MF, Abajobir, A, Abbasi, S, Abbasi, N, Abbasifard, M, Abbasi-Kangevari, M, Abbastabar, H, Abd-Allah, F, Abdelalim, A, Abd-Elsalam, SM, Abdoli, A, Abdollahpour, I, Abedi, A, Abolhassani, H, Abraham, B, Abreu, LG, Abrigo, MRM, Abualhasan, A, Abu-Gharbieh, E, Abushouk, AI, Accrombessi, MMK, Adabi, M, Adebayo, OM, Adegbosin, AE, Adekanmbi, V, Adetokunboh, OO, Adeyinka, DA, Adham, D, Advani, SM, Agasthi, P, Aghaali, M, Ahmad, S, Ahmad, T, Ahmadi, K, Ahmadi, S, Ahmed, MB, Aichour, MTE, Aji, B, Akinyemi, OO, Aklilu, A, Akunna, CJ, Al-Aly, Z, Alanzi, TM, Alcalde-Rabanal, JE, Alemu, BW, Alemu, A, Alhassan, RK, Alif, SM, Alipour, V, Alizade, H, Aljunid, SM, Almasi-Hashiani, A, Al-Mekhlafi, HM, Al-Raddadi, RM, Alvis-Guzman, N, Amini, S, Amiri, F, Amugsi, DA, Anber, NH, Ancuceanu, R, Andrei, T, Anegago, MT, Anjomshoa, M, Ansari, F, Ansari-Moghaddam, A, Anteneh, ZA, Antriyandarti, E, Anvari, D, Anwer, R, Aqeel, M, Arabloo, J, Arab-Zozani, M, Aremu, O, Areri, HA, Artaman, A, Arzani, A, Asaad, M, Asadi-Aliabadi, M, Asadi-Pooya, AA, Asemahagn, MA, Asghari Jafarabadi, M, Ashebir, MM, Ataro, Z, Athari, SM, Athari, SS, Atout, MMW, Ausloos, M, Awoke, N, Ayala Quintanilla, BP, Ayano, G, Kinyoki, D, Osgood-Zimmerman, AE, Bhattacharjee, NV, Schaeffer, LE, Lazzar-Atwood, A, Lu, D, Ewald, SB, Donkers, KM, Letourneau, ID, Collison, M, Schipp, MF, Abajobir, A, Abbasi, S, Abbasi, N, Abbasifard, M, Abbasi-Kangevari, M, Abbastabar, H, Abd-Allah, F, Abdelalim, A, Abd-Elsalam, SM, Abdoli, A, Abdollahpour, I, Abedi, A, Abolhassani, H, Abraham, B, Abreu, LG, Abrigo, MRM, Abualhasan, A, Abu-Gharbieh, E, Abushouk, AI, Accrombessi, MMK, Adabi, M, Adebayo, OM, Adegbosin, AE, Adekanmbi, V, Adetokunboh, OO, Adeyinka, DA, Adham, D, Advani, SM, Agasthi, P, Aghaali, M, Ahmad, S, Ahmad, T, Ahmadi, K, Ahmadi, S, Ahmed, MB, Aichour, MTE, Aji, B, Akinyemi, OO, Aklilu, A, Akunna, CJ, Al-Aly, Z, Alanzi, TM, Alcalde-Rabanal, JE, Alemu, BW, Alemu, A, Alhassan, RK, Alif, SM, Alipour, V, Alizade, H, Aljunid, SM, Almasi-Hashiani, A, Al-Mekhlafi, HM, Al-Raddadi, RM, Alvis-Guzman, N, Amini, S, Amiri, F, Amugsi, DA, Anber, NH, Ancuceanu, R, Andrei, T, Anegago, MT, Anjomshoa, M, Ansari, F, Ansari-Moghaddam, A, Anteneh, ZA, Antriyandarti, E, Anvari, D, Anwer, R, Aqeel, M, Arabloo, J, Arab-Zozani, M, Aremu, O, Areri, HA, Artaman, A, Arzani, A, Asaad, M, Asadi-Aliabadi, M, Asadi-Pooya, AA, Asemahagn, MA, Asghari Jafarabadi, M, Ashebir, MM, Ataro, Z, Athari, SM, Athari, SS, Atout, MMW, Ausloos, M, Awoke, N, Ayala Quintanilla, BP, and Ayano, G

Abstract

Anemia is a globally widespread condition in women and is associated with reduced economic productivity and increased mortality worldwide. Here we map annual 2000–2018 geospatial estimates of anemia prevalence in women of reproductive age (15–49 years) across 82 low- and middle-income countries (LMICs), stratify anemia by severity and aggregate results to policy-relevant administrative and national levels. Additionally, we provide subnational disparity analyses to provide a comprehensive overview of anemia prevalence inequalities within these countries and predict progress toward the World Health Organization’s Global Nutrition Target (WHO GNT) to reduce anemia by half by 2030. Our results demonstrate widespread moderate improvements in overall anemia prevalence but identify only three LMICs with a high probability of achieving the WHO GNT by 2030 at a national scale, and no LMIC is expected to achieve the target in all their subnational administrative units. Our maps show where large within-country disparities occur, as well as areas likely to fall short of the WHO GNT, offering precision public health tools so that adequate resource allocation and subsequent interventions can be targeted to the most vulnerable populations.

Published
2021

13. Population-level risks of alcohol consumption by amount, geography, age, sex, and year: a systematic analysis for the Global Burden of Disease Study 2020

Author

Dana Bryazka, Marissa B Reitsma, Max G Griswold, Kalkidan Hassen Abate, Cristiana Abbafati, Mohsen Abbasi-Kangevari, Zeinab Abbasi-Kangevari, Amir Abdoli, Mohammad Abdollahi, Abu Yousuf Md Abdullah, E S Abhilash, Eman Abu-Gharbieh, Juan Manuel Acuna, Giovanni Addolorato, Oladimeji M Adebayo, Victor Adekanmbi, Kishor Adhikari, Sangeet Adhikari, Qorinah Estiningtyas Sakilah Adnani, Saira Afzal, Wubetu Yimam Agegnehu, Manik Aggarwal, Bright Opoku Ahinkorah, Araz Ramazan Ahmad, Sajjad Ahmad, Tauseef Ahmad, Ali Ahmadi, Sepideh Ahmadi, Haroon Ahmed, Tarik Ahmed Rashid, Chisom Joyqueenet Akunna, Hanadi Al Hamad, Md Zakiul Alam, Dejene Tsegaye Alem, Kefyalew Addis Alene, Yousef Alimohamadi, Atiyeh Alizadeh, Kasim Allel, Jordi Alonso, Saba Alvand, Nelson Alvis-Guzman, Firehiwot Amare, Edward Kwabena Ameyaw, Sohrab Amiri, Robert Ancuceanu, Jason A Anderson, Catalina Liliana Andrei, Tudorel Andrei, Jalal Arabloo, Muhammad Arshad, Anton A Artamonov, Zahra Aryan, Malke Asaad, Mulusew A Asemahagn, Thomas Astell-Burt, Seyyed Shamsadin Athari, Desta Debalkie Atnafu, Prince Atorkey, Alok Atreya, Floriane Ausloos, Marcel Ausloos, Getinet Ayano, Martin Amogre ayanore Ayanore, Olatunde O Ayinde, Jose L Ayuso-Mateos, Sina Azadnajafabad, Melkalem Mamuye Azanaw, Mohammadreza Azangou-Khyavy, Amirhossein Azari Jafari, Ahmed Y Azzam, Ashish D Badiye, Nasser Bagheri, Sara Bagherieh, Mohan Bairwa, Shankar M Bakkannavar, Ravleen Kaur Bakshi, Awraris Hailu Balchut/Bilchut, Till Winfried Bärnighausen, Fabio Barra, Amadou Barrow, Pritish Baskaran, Luis Belo, Derrick A Bennett, Isabela M Benseñor, Akshaya Srikanth Bhagavathula, Neeraj Bhala, Ashish Bhalla, Nikha Bhardwaj, Pankaj Bhardwaj, Sonu Bhaskar, Krittika Bhattacharyya, Vijayalakshmi S Bhojaraja, Bagas Suryo Bintoro, Elena A Elena Blokhina, Belay Boda Abule Bodicha, Archith Boloor, Cristina Bosetti, Dejana Braithwaite, Hermann Brenner, Nikolay Ivanovich Briko, Andre R Brunoni, Zahid A Butt, Chao Cao, Yin Cao, Rosario Cárdenas, Andre F Carvalho, Márcia Carvalho, Joao Mauricio Castaldelli-Maia, Giulio Castelpietra, Luis F S Castro-de-Araujo, Maria Sofia Cattaruzza, Promit Ananyo Chakraborty, Jaykaran Charan, Vijay Kumar Chattu, Akhilanand Chaurasia, Nicolas Cherbuin, Dinh-Toi Chu, Nandita Chudal, Sheng-Chia Chung, Chuchu Churko, Liliana G Ciobanu, Massimo Cirillo, Rafael M Claro, Simona Costanzo, Richard G Cowden, Michael H Criqui, Natália Cruz-Martins, Garland T Culbreth, Berihun Assefa Dachew, Omid Dadras, Xiaochen Dai, Giovanni Damiani, Lalit Dandona, Rakhi Dandona, Beniam Darge Daniel, Anna Danielewicz, Jiregna Darega Gela, Kairat Davletov, Jacyra Azevedo Paiva de Araujo, Antonio Reis de Sá-Junior, Sisay Abebe Debela, Azizallah Dehghan, Andreas K Demetriades, Meseret Derbew Molla, Rupak Desai, Abebaw Alemayehu Desta, Diana Dias da Silva, Daniel Diaz, Lankamo Ena Digesa, Mengistie Diress, Milad Dodangeh, Deepa Dongarwar, Fariba Dorostkar, Haneil Larson Dsouza, Bereket Duko, Bruce B Duncan, Kristina Edvardsson, Michael Ekholuenetale, Frank J Elgar, Muhammed Elhadi, Mohamed A Elmonem, Aman Yesuf Endries, Sharareh Eskandarieh, Azin Etemadimanesh, Adeniyi Francis Fagbamigbe, Ildar Ravisovich Fakhradiyev, Fatemeh Farahmand, Carla Sofia e Sá Farinha, Andre Faro, Farshad Farzadfar, Ali Fatehizadeh, Nelsensius Klau Fauk, Valery L Feigin, Rachel Feldman, Xiaoqi Feng, Zinabu Fentaw, Simone Ferrero, Lorenzo Ferro Desideri, Irina Filip, Florian Fischer, Joel Msafiri Francis, Richard Charles Franklin, Peter Andras Gaal, Mohamed M Gad, Silvano Gallus, Fabio Galvano, Balasankar Ganesan, Tushar Garg, Mesfin Gebrehiwot Damtew Gebrehiwot, Teferi Gebru Gebremeskel, Mathewos Alemu Gebremichael, Tadele Regasa Gemechu, Lemma Getacher, Motuma Erena Getachew, Abera Getachew Obsa, Asmare Getie, Amir Ghaderi, Mansour Ghafourifard, Alireza Ghajar, Seyyed-Hadi Ghamari, Lilian A Ghandour, Mohammad Ghasemi Nour, Ahmad Ghashghaee, Sherief Ghozy, Franklin N Glozah, Ekaterina Vladimirovna Glushkova, Justyna Godos, Amit Goel, Salime Goharinezhad, Mahaveer Golechha, Pouya Goleij, Mohamad Golitaleb, Felix Greaves, Michal Grivna, Giuseppe Grosso, Temesgen Worku Gudayu, Bhawna Gupta, Rajeev Gupta, Sapna Gupta, Veer Bala Gupta, Vivek Kumar Gupta, Nima Hafezi-Nejad, Arvin Haj-Mirzaian, Brian J Hall, Rabih Halwani, Tiilahun Beyene Handiso, Graeme J Hankey, Sanam Hariri, Josep Maria Haro, Ahmed I Hasaballah, Hossein Hassanian-Moghaddam, Simon I Hay, Khezar Hayat, Golnaz Heidari, Mohammad Heidari, Delia Hendrie, Claudiu Herteliu, Demisu Zenbaba Heyi, Kamal Hezam, Mbuzeleni Mbuzeleni Hlongwa, Ramesh Holla, Md Mahbub Hossain, Sahadat Hossain, Seyed Kianoosh Hosseini, Mehdi hosseinzadeh, Mihaela Hostiuc, Sorin Hostiuc, Guoqing Hu, Junjie Huang, Salman Hussain, Segun Emmanuel Ibitoye, Irena M Ilic, Milena D Ilic, Mustapha Immurana, Lalu Muhammad Irham, M Mofizul Islam, Rakibul M Islam, Sheikh Mohammed Shariful Islam, Hiroyasu Iso, Ramaiah Itumalla, Masao Iwagami, Roxana Jabbarinejad, Louis Jacob, Mihajlo Jakovljevic, Zahra Jamalpoor, Elham Jamshidi, Sathish Kumar Jayapal, Umesh Umesh Jayarajah, Ranil Jayawardena, Rime Jebai, Seyed Ali Jeddi, Alelign Tasew Jema, Ravi Prakash Jha, Har Ashish Jindal, Jost B Jonas, Tamas Joo, Nitin Joseph, Farahnaz Joukar, Jacek Jerzy Jozwiak, Mikk Jürisson, Ali Kabir, Robel Hussen Kabthymer, Bhushan Dattatray Kamble, Himal Kandel, Girum Gebremeskel Kanno, Neeti Kapoor, Ibraheem M Karaye, Salah Eddin Karimi, Bekalu Getnet Kassa, Rimple Jeet Kaur, Gbenga A Kayode, Mohammad Keykhaei, Himanshu Khajuria, Rovshan Khalilov, Imteyaz A Khan, Moien AB Khan, Hanna Kim, Jihee Kim, Min Seo Kim, Ruth W Kimokoti, Mika Kivimäki, Vitalii Klymchuk, Ann Kristin Skrindo Knudsen, Ali-Asghar Kolahi, Vladimir Andreevich Korshunov, Ai Koyanagi, Kewal Krishan, Yuvaraj Krishnamoorthy, G Anil Kumar, Narinder Kumar, Nithin Kumar, Ben Lacey, Tea Lallukka, Savita Lasrado, Jerrald Lau, Sang-woong Lee, Wei-Chen Lee, Yo Han Lee, Lee-Ling Lim, Stephen S Lim, Stany W Lobo, Platon D Lopukhov, Stefan Lorkowski, Rafael Lozano, Giancarlo Lucchetti, Farzan Madadizadeh, Áurea M Madureira-Carvalho, Soleiman Mahjoub, Ata Mahmoodpoor, Rashidul Alam Mahumud, Alaa Makki, Mohammad-Reza Malekpour, Narayana Manjunatha, Borhan Mansouri, Mohammad Ali Mansournia, Jose Martinez-Raga, Francisco A Martinez-Villa, Richard Matzopoulos, Pallab K Maulik, Mahsa Mayeli, John J McGrath, Jitendra Kumar Meena, Entezar Mehrabi Nasab, Ritesh G Menezes, Gert B M Mensink, Alexios-Fotios A Mentis, Atte Meretoja, Bedasa Taye Merga, Tomislav Mestrovic, Junmei Miao Jonasson, Bartosz Miazgowski, Ana Carolina Micheletti Gomide Nogueira de Sá, Ted R Miller, GK Mini, Andreea Mirica, Antonio Mirijello, Seyyedmohammadsadeq Mirmoeeni, Erkin M Mirrakhimov, Sanjeev Misra, Babak Moazen, Maryam Mobarakabadi, Marcello Moccia, Yousef Mohammad, Esmaeil Mohammadi, Abdollah Mohammadian-Hafshejani, Teroj Abdulrahman Mohammed, Nagabhishek Moka, Ali H Mokdad, Sara Momtazmanesh, Yousef Moradi, Ebrahim Mostafavi, Sumaira Mubarik, Erin C Mullany, Beemnet Tekabe Mulugeta, Efrén Murillo-Zamora, Christopher J L Murray, Julius C Mwita, Mohsen Naghavi, Mukhammad David Naimzada, Vinay Nangia, Biswa Prakash Nayak, Ionut Negoi, Ruxandra Irina Negoi, Seyed Aria Nejadghaderi, Samata Nepal, Sudan Prasad Prasad Neupane, Sandhya Neupane Kandel, Yeshambel T Nigatu, Ali Nowroozi, Khan M Nuruzzaman, Chimezie Igwegbe Nzoputam, Kehinde O Obamiro, Felix Akpojene Ogbo, Ayodipupo Sikiru Oguntade, Hassan Okati-Aliabad, Babayemi Oluwaseun Olakunde, Gláucia Maria Moraes Oliveira, Ahmed Omar Bali, Emad Omer, Doris V Ortega-Altamirano, Adrian Otoiu, Stanislav S Otstavnov, Bilcha Oumer, Mahesh P A, Alicia Padron-Monedero, Raffaele Palladino, Adrian Pana, Songhomitra Panda-Jonas, Anamika Pandey, Ashok Pandey, Shahina Pardhan, Tarang Parekh, Eun-Kee Park, Charles D H Parry, Fatemeh Pashazadeh Kan, Jay Patel, Siddhartha Pati, George C Patton, Uttam Paudel, Shrikant Pawar, Amy E Peden, Ionela-Roxana Petcu, Michael R Phillips, Marina Pinheiro, Evgenii Plotnikov, Pranil Man Singh Pradhan, Akila Prashant, Jianchao Quan, Amir Radfar, Alireza Rafiei, Pankaja Raghav Raghav, Vafa Rahimi-Movaghar, Azizur Rahman, Md Mosfequr Rahman, Mosiur Rahman, Amir Masoud Rahmani, Shayan Rahmani, Chhabi Lal Ranabhat, Priyanga Ranasinghe, Chythra R Rao, Drona Prakash Rasali, Mohammad-Mahdi Rashidi, Zubair Ahmed Ratan, David Laith Rawaf, Salman Rawaf, Lal Rawal, Andre M N Renzaho, Negar Rezaei, Saeid Rezaei, Mohsen Rezaeian, Seyed Mohammad Riahi, Esperanza Romero-Rodríguez, Gregory A Roth, Godfrey M Rwegerera, Basema Saddik, Erfan Sadeghi, Reihaneh Sadeghian, Umar Saeed, Farhad Saeedi, Rajesh Sagar, Amirhossein Sahebkar, Harihar Sahoo, Mohammad Ali Sahraian, KM Saif-Ur-Rahman, Sarvenaz Salahi, Hamideh Salimzadeh, Abdallah M Samy, Francesco Sanmarchi, Milena M Santric-Milicevic, Yaser Sarikhani, Brijesh Sathian, Ganesh Kumar Saya, Mehdi Sayyah, Maria Inês Schmidt, Aletta Elisabeth Schutte, Michaël Schwarzinger, David C Schwebel, Abdul-Aziz Seidu, Nachimuthu Senthil Kumar, SeyedAhmad SeyedAlinaghi, Allen Seylani, Feng Sha, Sarvenaz Shahin, Fariba Shahraki-Sanavi, Shayan Shahrokhi, Masood Ali Shaikh, Elaheh Shaker, Murad Ziyaudinovich Shakhmardanov, Mehran Shams-Beyranvand, Sara Sheikhbahaei, Rahim Ali Sheikhi, Adithi Shetty, Jeevan K Shetty, Damtew Solomon Shiferaw, Mika Shigematsu, Rahman Shiri, Reza Shirkoohi, K M Shivakumar, Velizar Shivarov, Parnian Shobeiri, Roman Shrestha, Negussie Boti Sidemo, Inga Dora Sigfusdottir, Diego Augusto Santos Silva, Natacha Torres da Silva, Jasvinder A Singh, Surjit Singh, Valentin Yurievich Skryabin, Anna Aleksandrovna Skryabina, David A Sleet, Marco Solmi, YONATAN SOLOMON, Suhang Song, Yimeng Song, Reed J D Sorensen, Sergey Soshnikov, Ireneous N Soyiri, Dan J Stein, Sonu Hangma Subba, Miklós Szócska, Rafael Tabarés-Seisdedos, Takahiro Tabuchi, Majid Taheri, Ker-Kan Tan, Minale Tareke, Elvis Enowbeyang Tarkang, Gebremaryam Temesgen, Worku Animaw Temesgen, Mohamad-Hani Temsah, Kavumpurathu Raman Thankappan, Rekha Thapar, Nikhil Kenny Thomas, Chalachew Tiruneh, Jovana Todorovic, Marco Torrado, Mathilde Touvier, Marcos Roberto Tovani-Palone, Mai Thi Ngoc Tran, Sergi Trias-Llimós, Jaya Prasad Tripathy, Alireza Vakilian, Rohollah Valizadeh, Mehdi Varmaghani, Shoban Babu Varthya, Tommi Juhani Vasankari, Theo Vos, Birhanu Wagaye, Yasir Waheed, Mandaras Tariku Walde, Cong Wang, Yanzhong Wang, Yuan-Pang Wang, Ronny Westerman, Nuwan Darshana Wickramasinghe, Abate Dargie Wubetu, Suowen Xu, Kazumasa Yamagishi, Lin Yang, Gesila Endashaw E Yesera, Arzu Yigit, Vahit Yiğit, Ayenew Engida Ayenew Engida Yimaw, Dong Keon Yon, Naohiro Yonemoto, Chuanhua Yu, Siddhesh Zadey, Mazyar Zahir, Iman Zare, Mikhail Sergeevich Zastrozhin, Anasthasia Zastrozhina, Zhi-Jiang Zhang, Chenwen Zhong, Mohammad Zmaili, Yves Miel H Zuniga, Emmanuela Gakidou, University of St Andrews. School of Medicine, University of St Andrews. Population and Behavioural Science Division, Department of Public Health, University of Helsinki, Hjelt Institute (-2014), Helsinki Inequality Initiative (INEQ), Clinicum, Helsinki University Hospital Area, Bill & Melinda Gates Foundation, King Edward Medical University (Pakistán), Alexander von Humboldt Foundation, University of Oxford (Reino Unido), Medical Research Council (Reino Unido), NIH - National Institute of Mental Health (NIMH) (Estados Unidos), Canada Research Chairs, National Health and Medical Research Council (Australia), National Heart Foundation of Australia, Ministry of Education, Science and Technological Development (Serbia), Wellcome Trust, NIH - National Institute on Aging (NIA) (Estados Unidos), Finlands Akademi (Finlandia), Panjab University (India), Federal Ministry of Education & Research (Alemania), National Council for Scientific and Technological Development (Brasil), Danish National Research Foundation, Queensland Centre for Mental Health Research (Australia), South African Medical Research Council, National Natural Science Foundation of China, Charles Sturt University (Australia), Ain Shams University (Egipto), Mizoram University (India), Kasturba Medical College (India), Manipal Academy of Higher Education (India), Coordenação de Aperfeicoamento de Pessoal de Nível Superior (Brasil), Ministerio de Ciencia e Innovación (España), Collaborators, GBD 2020 Alcohol, Bryazka, Dana, Reitsma, Marissa B, Griswold, Max G, Abate, Kalkidan Hassen, Abbafati, Cristiana, Abbasi-Kangevari, Mohsen, Abbasi-Kangevari, Zeinab, Abdoli, Amir, Abdollahi, Mohammad, Abdullah, Abu Yousuf Md, Abhilash, E S, Abu-Gharbieh, Eman, Acuna, Juan Manuel, Addolorato, Giovanni, Adebayo, Oladimeji M, Adekanmbi, Victor, Adhikari, Kishor, Adhikari, Sangeet, Adnani, Qorinah Estiningtyas Sakilah, Afzal, Saira, Agegnehu, Wubetu Yimam, Aggarwal, Manik, Ahinkorah, Bright Opoku, Ahmad, Araz Ramazan, Ahmad, Sajjad, Ahmad, Tauseef, Ahmadi, Ali, Ahmadi, Sepideh, Ahmed, Haroon, Ahmed Rashid, Tarik, Akunna, Chisom Joyqueenet, Al Hamad, Hanadi, Alam, Md Zakiul, Alem, Dejene Tsegaye, Alene, Kefyalew Addi, Alimohamadi, Yousef, Alizadeh, Atiyeh, Allel, Kasim, Alonso, Jordi, Alvand, Saba, Alvis-Guzman, Nelson, Amare, Firehiwot, Ameyaw, Edward Kwabena, Amiri, Sohrab, Ancuceanu, Robert, Anderson, Jason A, Andrei, Catalina Liliana, Andrei, Tudorel, Arabloo, Jalal, Arshad, Muhammad, Artamonov, Anton A, Aryan, Zahra, Asaad, Malke, Asemahagn, Mulusew A, Astell-Burt, Thoma, Athari, Seyyed Shamsadin, Atnafu, Desta Debalkie, Atorkey, Prince, Atreya, Alok, Ausloos, Floriane, Ausloos, Marcel, Ayano, Getinet, Ayanore, Martin Amogre ayanore, Ayinde, Olatunde O, Ayuso-Mateos, Jose L, Azadnajafabad, Sina, Azanaw, Melkalem Mamuye, Azangou-Khyavy, Mohammadreza, Azari Jafari, Amirhossein, Azzam, Ahmed Y, Badiye, Ashish D, Bagheri, Nasser, Bagherieh, Sara, Bairwa, Mohan, Bakkannavar, Shankar M, Bakshi, Ravleen Kaur, Balchut/bilchut, Awraris Hailu, Bärnighausen, Till Winfried, Barra, Fabio, Barrow, Amadou, Baskaran, Pritish, Belo, Lui, Bennett, Derrick A, Benseñor, Isabela M, Bhagavathula, Akshaya Srikanth, Bhala, Neeraj, Bhalla, Ashish, Bhardwaj, Nikha, Bhardwaj, Pankaj, Bhaskar, Sonu, Bhattacharyya, Krittika, Bhojaraja, Vijayalakshmi S, Bintoro, Bagas Suryo, Blokhina, Elena A Elena, Bodicha, Belay Boda Abule, Boloor, Archith, Bosetti, Cristina, Braithwaite, Dejana, Brenner, Hermann, Briko, Nikolay Ivanovich, Brunoni, Andre R, Butt, Zahid A, Cao, Chao, Cao, Yin, Cárdenas, Rosario, Carvalho, Andre F, Carvalho, Márcia, Castaldelli-Maia, Joao Mauricio, Castelpietra, Giulio, Castro-de-Araujo, Luis F S, Cattaruzza, Maria Sofia, Chakraborty, Promit Ananyo, Charan, Jaykaran, Chattu, Vijay Kumar, Chaurasia, Akhilanand, Cherbuin, Nicola, Chu, Dinh-Toi, Chudal, Nandita, Chung, Sheng-Chia, Churko, Chuchu, Ciobanu, Liliana G, Cirillo, Massimo, Claro, Rafael M, Costanzo, Simona, Cowden, Richard G, Criqui, Michael H, Cruz-Martins, Natália, Culbreth, Garland T, Dachew, 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Subjects
Adult, Male, Alcohol Drinking, CONTROL POLICIES, adult, Child, Preschool, Female, Geography, Global Burden of Disease, Global Health, Humans, Middle Aged, Quality-Adjusted Life Years, Risk Factors, NDAS, ALL-CAUSE, GUIDELINES, GBD 2020 Alcohol Collaborators, COST-EFFECTIVENESS, Medicine, General & Internal, DRINKING, SDG 3 - Good Health and Well-being, RA0421, General & Internal Medicine, Quality-Adjusted Life Year, RA0421 Public health. Hygiene. Preventive Medicine, DRINKERS, Child, Preschool, 11 Medical and Health Sciences, METAANALYSIS, MCC, Science & Technology, global burden of disease, Risk Factor, General Medicine, CANCER, alcohol drinking, AC, 3121 General medicine, internal medicine and other clinical medicine, REDUCED MORTALITY, Life Sciences & Biomedicine, Human
Abstract

Background: The health risks associated with moderate alcohol consumption continue to be debated. Small amounts of alcohol might lower the risk of some health outcomes but increase the risk of others, suggesting that the overall risk depends, in part, on background disease rates, which vary by region, age, sex, and year. Methods: For this analysis, we constructed burden-weighted dose-response relative risk curves across 22 health outcomes to estimate the theoretical minimum risk exposure level (TMREL) and non-drinker equivalence (NDE), the consumption level at which the health risk is equivalent to that of a non-drinker, using disease rates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2020 for 21 regions, including 204 countries and territories, by 5-year age group, sex, and year for individuals aged 15-95 years and older from 1990 to 2020. Based on the NDE, we quantified the population consuming harmful amounts of alcohol. Findings: The burden-weighted relative risk curves for alcohol use varied by region and age. Among individuals aged 15-39 years in 2020, the TMREL varied between 0 (95% uncertainty interval 0-0) and 0·603 (0·400-1·00) standard drinks per day, and the NDE varied between 0·002 (0-0) and 1·75 (0·698-4·30) standard drinks per day. Among individuals aged 40 years and older, the burden-weighted relative risk curve was J-shaped for all regions, with a 2020 TMREL that ranged from 0·114 (0-0·403) to 1·87 (0·500-3·30) standard drinks per day and an NDE that ranged between 0·193 (0-0·900) and 6·94 (3·40-8·30) standard drinks per day. Among individuals consuming harmful amounts of alcohol in 2020, 59·1% (54·3-65·4) were aged 15-39 years and 76·9% (73·0-81·3) were male. Interpretation: There is strong evidence to support recommendations on alcohol consumption varying by age and location. Stronger interventions, particularly those tailored towards younger individuals, are needed to reduce the substantial global health loss attributable to alcohol. Research reported in this publication was supported by the Bill & Melinda Gates Foundation. S Afzal acknowledges the support for intellectual contributions to this manuscript by the Department of Community Medicine and Epidemiology at King Edward Medical University, Lahore, Pakistan. T Bärnighausen was supported by the Alexander von Humboldt Foundation through the Alexander von Humboldt Professor award, funded by the German Federal Ministry of Education and Research. L Belo acknowledges support from FCT in the scope of the project UIDP/04378/2020 and UIDB/04378/2020 of UCIBIO and the project LA/P/0140/2020 of i4HB. D Bennett is supported by the UK Medical Research Council Population Health Research Unit at the University of Oxford (Oxford, UK). M Carvalho acknowledges support from FCT in the scope of the project UIDP/04378/2020 and UIDB/04378/2020 of UCIBIO and the project LA/P/0140/2020 of i4HB. L Castro-de-Araujo was funded by the Medical Research Council (UK), Grant no. MR/T03355X/1 and by the National Institute of Mental Health Grant no. R01MH128911. FJ Elgar is supported by the Canada Research Chairs program. F Greaves acknowledges support from the NIHR Applied Research Collaboration for NW London. V K Gupta acknowledges funding support from the National Health and Medical Research Council (NHMRC), Australia. VB Gupta acknowledges funding support from the National Health and Medical Research Council (NHMRC), Australia. C Herteliu is partially supported by a grant from the Romanian National Authority for Scientific Research and Innovation, CNDS-UEFISCDI, project number PN-III-P4-ID-PCCF-2016-0084. C Herteliu is partially supported by a grant from the Romanian Ministry of Research Innovation and Digitalization, MCID, project number ID-585-CTR-42-PFE-2021. S Hussain was supported by the Operational Programme Research, Development and Education –Project, Postdoc2MUNI “(No. CZ.02.2.69/0.0/0.0/18_053/0016952). S M S Islam is funded by the National Health and Medical Research Council and received funding from the National Heart Foundation of Australia. The Serbian part of this GBD-related contribution has been co-financed through Grant OI 175 014 of the Ministry of Education Science and Technological Development of the Republic of Serbia. M Kivimaki was supported by the Wellcome Trust (221854/Z/20/Z), the UK Medical Research Council (MR/S011676/1), the US National Institute on Aging (R01AG056477), and the Academy of Finland (350426). K Krishan is supported by the UGC Centre of Advanced Study (Phase II), awarded to the Department of Anthropology, Panjab University, Chandigarh, India. B Lacey acknowledges support from the UK Biobank, funded largely by the UK Medical Research Council and Wellcome. S Lorkowski acknowledges institutional support from the Competence Cluster for Nutrition and Cardiovascular Health (nutriCARD) Halle-Jena-Leipzig (Germany; German Federal Ministry of Education and Research; grant agreement number 01EA1808A). G Lucchetti received a productivity scholarship from the Brazilian National Council for Scientific and Technological Development — CNPq (Level 1D). J McGrath was supported by the Danish National Research Foundation (Niels Bohr Professor). J McGrath is employed by the Queensland Centre for Mental Health Research (Australia), which receives support from the Queensland Health Department. C Parry acknowleges the South African Medical Research Council. A Peden is supported by a National Health and Medical Research Council Emerging Leadership Fellowship (Grant ID: APP2009306). M R Phillips was supported in part by the Global Alliance for Chronic Diseases - National Natural Science Foundation of China (NSFC. No. 81761128031). M Pinheiro acknowledges FCT for funding through program DL 57/2016 – Norma transitória. A Rahman acknowledges the support from the Data Science Research Unit in Charles Sturt University (Bathurst, NSW, Australia). U Saeed would like to acknowledge the International Center of Medical Sciences Research (ICMSR), Islamabad, Pakistan. A M Samy acknowledges support from Ain Shams University (Cairo, Egypt) and the Egyptian Fulbright Mission Program. N Senthil Kumar acknowledges the DBT, New Delhi sponsored Advanced State Level Biotech Hub (BT/NER/143/SP44475/2021), Mizoram University (Aizawl, Mizoram, India) for facilitating this work. F Sha is supported by the Shenzhen Science and Technology Program (Grant No. KQTD20190929172835662). A Shetty acknowledges Kasturba Medical College (Mangalore, India) and Manipal Academy of Higher Education (Manipal, India) for all the academic support. R Shrestha acknowledges a career development award from the National Institutes of Health (K01DA051346). D Silva was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior-Brazil (CAPES)-Finance Code 001 and is supported in part by CNPq - Brazil (309589/2021-5). D Sleet acknowledges partial support from Veritas Management Group, Inc and The Bizzell Group, LLC. S Trias-Llimós acknowledges research funding from the Juan de la Cierva-Formación program of the Spanish Ministry of Science and Innovation (FJC-2019-039314-I). Sí

Published
2022

14. A cross-sectional study of evidence-based practice and its determinants among healthcare professionals in Northwest Ethiopia.

Author

Melkamu Y, Asemahagn MA, Walle AA, and Tsega Y

Abstract

Background: Evidence-based practice (EBP) is the integration of current best evidence with clinical expertise by considering patient preferences and values. Evidence based practice has not been well studied in Ethiopia. Therefore, this study aimed to assess EBP and its determinants among health professionals working at primary public hospitals in the Central Gondar zone, Northwest Ethiopia., Methods: A facility-based cross-sectional study was conducted on 422 health professionals. A simple random sampling technique was used to select the study participants. The data were entered into EpiData version 4.6 and exported to SPSS version 25 for analysis. The descriptive, bivariable, and multivariable logistic regression analysis were conducted. Adjusted Odds Ratio (AOR) with 95% confidence intervals and p -value <0.05 were used to assess association of explanatory variables with EBP and declare statistical significance, respectively., Result: About 44.1% (95%CI: 39, 50%) of healthcare professionals had good evidence-based practice. Educational status (AOR: 3.05, CI: 1.07-8.66), spare time (AOR: 1.90, CI: 1.09, 3.31), good knowledge (AOR: 7.95, CI: 4.83, 13.08), good skill (AOR: 2.39: CI: 1.27, 4.53), training (AOR: 2.13, CI: 1.26, 3.58), and internet access (AOR = 2.02: 95% CI: 1.25-3.27) were found to be significant predictors of evidence-based practice., Conclusion: This study revealed that EBP was low compared to national standards. Moreover, having good knowledge and skill about evidence-based practice, being trained, having spare time and internet access and upgrading educational status of health care professionals would enhance good evidence-based practice., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Melkamu, Asemahagn, Walle and Tsega.)

Published
2024
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15. Burden of lower respiratory infections and associated risk factors across regions in Ethiopia: a subnational analysis of the Global Burden of Diseases 2019 study.

Author

Yigezu A, Misganaw A, Getnet F, Berheto TM, Walker A, Zergaw A, Gobena FA, Haile MA, Hailu A, Memirie ST, Tolosa DM, Abate SM, Molla Adane M, Akalu GT, Aklilu A, Tsegaye D, Gebru Z, Asemahagn MA, Atlaw D, Awoke T, Abebe H, Bekele NC, Belete MA, Hailemariam T, Yirga A, Birara SA, Bodicha BBA, Churko C, Demeke FM, Desta AA, Ena L, Eyayu T, Fentaw Z, Gargamo DB, Gebrehiwot MD, Gebremichael MA, Getachew M, Molla G, Sahiledengle B, Beyene B, Sibhat M, Sidamo NB, Solomon D, Solomon Y, Wagaye B, Wedajo S, Weldemariam M, Yismaw YE, and Naghavi M

Subjects
Child, Humans, Aged, Child, Preschool, Ethiopia epidemiology, Risk Factors, Cost of Illness, Air Pollution, Respiratory Tract Infections epidemiology
Abstract

Objective: This analysis is to present the burden and trends of morbidity and mortality due to lower respiratory infections (LRIs), their contributing risk factors, and the disparity across administrative regions and cities from 1990 to 2019., Design: This analysis used Global Burden of Disease 2019 framework to estimate morbidity and mortality outcomes of LRI and its contributing risk factors. The Global Burden of Disease study uses all available data sources and Cause of Death Ensemble model to estimate deaths from LRI and a meta-regression disease modelling technique to estimate LRI non-fatal outcomes with 95% uncertainty intervals (UI)., Study Setting: The study includes nine region states and two chartered cities of Ethiopia., Outcome Measures: We calculated incidence, death and years of life lost (YLLs) due to LRIs and contributing risk factors using all accessible data sources. We calculated 95% UIs for the point estimates., Results: In 2019, LRIs incidence, death and YLLs among all age groups were 8313.7 (95% UI 7757.6-8918), 59.4 (95% UI 49.8-71.4) and 2404.5 (95% UI 2059.4-2833.3) per 100 000 people, respectively. From 1990, the corresponding decline rates were 39%, 61% and 76%, respectively. Children under the age of 5 years account for 20% of episodes, 42% of mortalities and 70% of the YLL of the total burden of LRIs in 2019. The mortality rate was significantly higher in predominantly pastoralist regions-Benishangul-Gumuz 101.8 (95% UI 84.0-121.7) and Afar 103.7 (95% UI 86.6-122.6). The Somali region showed the least decline in mortality rates. More than three-fourths of under-5 child deaths due to LRIs were attributed to malnutrition. Household air pollution from solid fuel attributed to nearly half of the risk factors for all age mortalities due to LRIs in the country., Conclusion: In Ethiopia, LRIs have reduced significantly across the regions over the years (except in elders), however, are still the third-leading cause of mortality, disproportionately affecting children younger than 5 years old and predominantly pastoralist regions. Interventions need to consider leading risk factors, targeted age groups and pastoralist and cross-border communities., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ.)

Published
2023
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16. Incidence of stroke and its predictors among hypertensive patients in Felege Hiwot comprehensive specialized hospital, Bahir Dar, Ethiopia, a retrospective follow-up study.

Author

Misgana S, Asemahagn MA, Atnafu DD, and Anagaw TF

Subjects
Adult, Humans, Middle Aged, Aged, Incidence, Follow-Up Studies, Ethiopia epidemiology, Retrospective Studies, Hospitals, Hypertension complications, Hypertension epidemiology, Stroke epidemiology
Abstract

Background: Globally, one in three adults has hypertension, a condition that causes 51% of all deaths from stroke. Stroke is becoming a major public health problem and the most common cause of morbidity and mortality among non-communicable diseases in the world and Ethiopia. Therefore, this study assesses the incidence of stroke and its predictors among hypertensive patients in Felege Hiwot Comprehensive Specialized Hospital, Bahir Dar, Ethiopia 2021., Methods: A hospital-based retrospective follow-up study design was used, simple random sampling technique was used to select 583 hypertensive patients that had follow-up registration between January 2018 and December 30th, 2020. Data were entered into Epi-data version 3.1 and exported to STATA version 14. The adjusted hazard ratio for each predictor with a 95% confidence interval was calculated using the Cox proportional hazards regression model, and a P-value ≤  0.05 was used to denote statistical significance., Results: From 583 hypertensive patients 106(18.18%) [95% CI 15-20] were developed stroke. The overall incidence rate was 1 per 100 person-years (95% CI 0.79-1.19). Comorbidities (Adjusted hazard ratio(AHR): 1.88, 95% CI 1.0-3.5), stage two hypertension (AHR = 5.21, 95%CI 2.75-9.8), uncontrolled systolic blood pressure (AHR: 2, 95% CI 1.21-354), uncontrolled diastolic blood pressure (AHR:1.9, 95% CI 1.1-3.57), alcohol consumption (AHR = 2.04, 95%CI 1.2-3.49), age 45-65 (AHR = 10.25, 95%CI 7.47-11.1); and drug discontinuation (AHR = 2.05,95% CI 1.26-3.35) were independent predictors for the incidence of stroke among hypertensive patients., Conclusion: The incidence of stroke among hypertensive patients was high and various modifiable and non-modifiable risk factors highly contributed to its incidence. This study recommends early screening of blood pressure, giving priority to comorbid patients and patients with advanced stage hypertension, and giving health education about behavioral risks and drug adherence., (© 2023. The Author(s).)

Published
2023
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17. Data quality and associated factors of routine health information system among health centers of West Gojjam Zone, northwest Ethiopia, 2021.

Author

Chekol A, Ketemaw A, Endale A, Aschale A, Endalew B, and Asemahagn MA

Abstract

Background: Data quality is a multidimensional term that includes accuracy, precision, completeness, timeliness, integrity, and confidentiality. The quality of data generated by a routine health information system (RHIS) is still very poor in low- and middle-income countries. There is a paucity of studies as to what determines data quality in health facilities in the study area. Therefore, the aim of the present study was to assess the magnitude of the quality of routine health information system data and its determinants among health centers., Methods: A facility-based quantitative study design triangulated by the qualitative method was conducted. A total of 314 health professionals from 32 health centers were selected using a simple random sampling procedure. Data were gathered using a standardized checklist, interviewer-administered questionnaires, and key informant interview guidelines. Descriptive statistics were used to describe variables and binary logistic regression was used to identify factors associated with data quality using STATA version 14. Variables with p -value <0.25 in the bivariate analysis were entered to a multivariable logistic regression analysis. P -values <0.05 at 95% confidence intervals (CI) were taken to be statistically significant. A manual analysis was conducted for the qualitative data collected from purposively selected key informants., Results: The study found that the overall data quality at the health centers of West Gojjam Zone was 74% (95% CI 68-78). The complexity of the routine health information system format [adjusted odds ratio (AOR) 3.8; 95% CI 1.7-8.5], problem-solving skills for RHIS tasks (AOR 2.8; 95% CI 1.2-6.4), and knowing duties, roles, and responsibilities were significantly associated with data quality (AOR 12; 95% CI 5.6-25.8), and lack of human resources, poor feedback mechanisms, delay in completing data records, lack of data use, and inadequate training on health information systems were barriers affecting data quality., Conclusions: The level of data quality among public health centers in the Amhara region was lower than expected at the national level., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2023 Chekol, Ketemaw, Endale, Aschale, Endalew and Asemahagn.)

Published
2023
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18. Sputum smear conversion and associated factors among smear-positive pulmonary tuberculosis patients in East Gojjam Zone, Northwest Ethiopia: a longitudinal study.

Author

Asemahagn MA

Subjects
Adolescent, Adult, Antitubercular Agents therapeutic use, Ethiopia epidemiology, Female, Humans, Logistic Models, Longitudinal Studies, Male, Multivariate Analysis, Mycobacterium tuberculosis physiology, Risk Factors, Tuberculosis, Pulmonary drug therapy, Young Adult, Sputum microbiology, Tuberculosis, Pulmonary diagnosis, Tuberculosis, Pulmonary epidemiology
Abstract

Background: Sputum smear conversion is a key indicator of treatment response and reduced infectivity among bacteriologically confirmed pulmonary tuberculosis (PTB) patients. This study aimed at estimating sputum smear conversion and identifying factors hindering sputum smear conversion among bacteriologically confirmed PTB cases in East Gojjam Zone, Northwest Ethiopia., Methods: A total of 282 bacteriologically confirmed PTB patients were followed for 22 weeks through weekly sputum smear examination. Due to the absence of sputum culture and rapid diagnostic services, sputum smear conversion evaluation was conducted microscopically using acid-fast-bacilli staining technique of sediments from a 5% sodium hypochlorite concentration technique. Data on socio-demographic, clinical profile and personal behavior variables were collected using a pretested interviewer-administered questionnaire. Various descriptive statistics including mean, median with interquartile range (IQR), and proportions were computed to describe study objectives. Factors of sputum smear conversion were identified by multivariable logistic regression analysis and statistical significance was determined at a p value < 0.05., Results: Over half, 166 (59%) of bacteriologically confirmed PTB patients were males and 147 (52%) were rural dwellers. The mean age of respondents was 35 ± 5 SD years. About 88 (31.2%) of bacteriologically confirmed PTB patients had comorbidities, 102 (36.2%) faced stigma, and 54 (19%) history of cigarette smoking. The median sputum smear conversions during the intensive phase and 5th  months of treatment follow up were 35 dyas (IQR: 21-56 days) and 53 days (IQR: 28-82 days), respectuvely. The majority, 85% (95% CI 76-93%) and 95% (95% CI 85-99%) of bacteriologically confirmed PTB patients underwent sputum smear conversion at the end of 2nd and 5th months of treatment, respectively. Poor knowledge on TB, being HIV positive, higher smear grading, having diabetes mellitus, undernutrition, cigarette smoking, facing societal stigma, and TB service delays were positively associated with the length of sputum smear conversion (p value < 0.05)., Conclusion: Based on this study, the median sputum smear conversion time was higher compared to TB program expectations and findings from former studies. The study also identified important factors associated with sputum smear conversion time. Improving health literacy of the community by revising the existing community awareness strategies is essential to enhance treatment adherence and lower infectiousness after treatment initiation.

Published
2021
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19. Spatial-temporal clustering of notified pulmonary tuberculosis and its predictors in East Gojjam Zone, Northwest Ethiopia.

Author

Asemahagn MA, Alene GD, and Yimer SA

Subjects
Adolescent, Adult, Ethiopia epidemiology, Female, Health Facilities, Humans, Incidence, Male, Middle Aged, Retrospective Studies, Rural Population, Spatio-Temporal Analysis, Young Adult, Tuberculosis, Pulmonary epidemiology
Abstract

Background: Tuberculosis (TB) remains a key health menace in Ethiopia and its districts. This study aimed to assess the spatial-temporal clustering of notified pulmonary TB (PTB) cases in East Gojjam Zone, Northwest Ethiopia., Methods: A retrospective study was conducted among all PTB cases reported from 2013-2019. Case notification rates (CNRs) of PTB cases at Kebele (the lowest administrative unit), woreda, and zone levels were estimated. The PTB clustering was done using global Moran's I statistics on Arc GIS 10.6. We used Kulldorff SaTScan 9.6 with a discrete Poisson model to identify statistically significant spatial-temporal clustering of PTB cases at Kebele level. Similarly, a negative binomial regression analysis was used to identify factors associated with the incidence of PTB cases at kebele level., Results: A total of 5340 (52%) smear-positive and 4928 (48%) smear-negative PTB cases were analyzed. The overall mean CNR of PTB cases at zone, woreda and Kebele levels were 58(47-69), 82(56-204), and 69(36-347) per 100,000 population, respectively. The purely spatial cluster analysis identified eight most likely clusters (one for overall and one per year for seven reporting years) and 47 secondary clusters. Similarly, the space-time scan analysis identified one most likely and seven secondary clusters. The purely temporal analysis also detected one most likely cluster from 2013-2015. Rural residence, distance from the nearest health facility, and poor TB service readiness were factors (p-value <0.05) to PTB incidence at kebele level., Conclusion: The distribution of PTB cases was clustered. The PTB CNR was low and showed a decreasing trend during the reporting periods. Rural residence, distance from the health facilities, and poor facility readiness were factors of PTB incidence. Improving accessibility and readiness of health facilities mainly to rural and hotspot areas is vital to increase case detection and reduce TB transmission., Competing Interests: The authors have declared that no competing interests exist.

Published
2021
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20. Determinants of scabies outbreak in Takusa district of Amhara Region, Northwest Ethiopia.

Author

Debe Worku E, Asemahagn MA, and Endalifer ML

Abstract

Background: Human scabies is a highly contagious human dermatitis disease. As indicated by the national and regional reports, the epidemic of scabies became a major public health problem in Ethiopia since 2015., Objective: To identify the determinant factors of scabies outbreak in Takusa district, Northwest Ethiopia, 2017., Methods: A community based unmatched case-control study among 188 participants (63 cases and 125 controls) was conducted in Takusa district from September to October 2017. Data were collected using a pretested structured questionnaire. Multivariable logistic regression analysis was computed using SPSS version 22 to identify factors associated with scabies. Odds ratio at 95% CI and p-value less than 0.05 were used to describe the strength of the association and statistical significance., Results: The median age of cases was 20 years (ranges1-61). Presence of person with itching in the family (AOR=7.7, 95% CI:1.9-30.5), sleeping with scabies patient (AOR=3.99, 95% CI:1.37-11.7), travel to scabies epidemic area in the last six weeks (AOR=3.79, 95%CI:1.28-11.1) and infrequent use of detergent for showering (AOR=4.85; 95% CI: 1.3-17.9)) were found to be determinant factors of scabies outbreak., Conclusion: Frequent contact with people who develop scabies at home, not using detergents for washing, and mobility of people from non-epidemic to the epidemic areas were determinant factors. Giving special emphasis on regular awareness creation to the rural community is important to prevent scabies outbreak., Competing Interests: Conflict of interest: The authors declare no potential conflict of interest., (©Copyright: the Author(s).)

Published
2020
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21. A Qualitative Insight into Barriers to Tuberculosis Case Detection in East Gojjam Zone, Ethiopia.

Author

Asemahagn MA, Alene GD, and Yimer SA

Subjects
Adult, Ethiopia epidemiology, Female, Focus Groups, Health Facilities, Health Personnel, Health Services, Humans, Male, Rural Population, Patient Acceptance of Health Care statistics & numerical data, Surveys and Questionnaires, Tuberculosis diagnosis
Abstract

Tuberculosis (TB) remains to be the leading cause of morbidity and mortality in the developing world. Early TB case detection (TCD) and treatment of infectious cases is vital to reduce the TB burden. The objective of this study was to identify possible barriers to TCD in East Gojjam Zone, northwest Ethiopia. The study used a descriptive phenomenological research method. The study participants included 21 TB patients, six TB control officers, and 40 health workers (HWs) selected by a heterogeneous purposive sampling technique. In-depth interviews and focus group discussions were used to collect data. Interviews were audio recorded, transcribed verbatim, translated, and thematically analyzed using NVivo 12 software (developed by QSR International Qualitative Software Developer, Melbourne, Australia). The study participants identified numerous barriers to TCD which were grouped into three major themes and 14 subthemes: 1) patient-related barriers including rural residence, low income, poor health literacy, and health-seeking delay; 2) healthcare system barriers grouped into two subthemes: HWs barriers (shortage of HWs, lack of training access, and low level of knowledge and skills) and health facility barriers (health service delay, using only passive TCD strategy, poor health education provision, and lack of regular supervision and timely feedback); 3) sociocultural and environmental barriers which included stigma and discrimination, lack of health information sources, poor transportation infrastructure, and community resistance. In conclusion, the TCD activity which is one of the pillars of the TB control program has been confronted with several patient-related, environmental, and healthcare system-related barriers. Improving community health literacy, scale-up access, and improving quality of TB diagnostic services, conducting regular supportive supervision and provision of timely feedback, arranging regular refresher training and staff motivation and recruitment schemes, and engaging local health officials and political leaders to address budgetary problems for TB and transportation infrastructure challenges are imperative interventions to enhance the TCD efforts in the study area.

Published
2020
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22. Factors determining the knowledge and prevention practice of healthcare workers towards COVID-19 in Amhara region, Ethiopia: a cross-sectional survey.

Author

Asemahagn MA

Abstract

Background: Healthcare workers (HWs) are at the highest risk of getting CIVID-19. This study aimed to assess factors determining the knowledge and prevention of HWs towards COVID-19 in the Amhara Region, Ethiopia., Methods: A cross-sectional online survey was conducted among 442 HWs using email and telegram addresses. The knowledge and practice of HWs were estimated using 16 knowledge and 11 practice questions. A multivariable logistic regression analysis was used on SPSS version 25 to identify factors related to the knowledge and prevention practice of HWs on COVID-19. Significance was determined at a p value of < 0.05 and association was described by using odds ratio at 95% CI., Results: Of 442 HWs, 398 (90% response rate) responded to the online interview questionnaire. From 398 HWs, 231(58%), 225(56%), 207(53%), and 191(48%) were males, from rural area, aged ≥ 34 years and nurses, respectively. About 279(70%) HWs had good knowledge of COVID-19 followed by 247(62%) good prevention practices. Age < 34 years (AOR = 2.14, 95% CI = 1.25-3.62), rural residence (AOR = 0.44, 95% CI = 0.26-0.70), access to infection prevention (IP) training (AOR = 2.4, 95% CI = 1.36-4.21), presence of IP guideline (AOR = 2.82, 95% CI = 1.64-4.62), and using social media (AOR = 2.51, 95% CI = 1.42-4.53) were factors of knowledge about COVID-19. Whereas, rural residence (AOR = 0.45, 95% CI = 0.31-0.75), facility type (AOR = 0.40, 95% CI = 0.28-0.89), access to IP training (AOR = 2.32, 95% CI = 1.35-4.16), presence of IP guidelines (AOR = 2.10, 95% CI = 1.21-3.45), knowledge about COVID-19 (AOR = 2.98, 95% CI = 2.15-5.27), having chronic illnesses (AOR = 2.0, 95% CI = 1.15-3.75), lack of protective equipment (PPE) (AOR = 0.42, 95% CI = 0.32-0.74), and high workload (AOR = 0.40, 95% CI = 0.36-0.87) were factors of COVID-19 prevention., Conclusion: In this study, most of the HWs had good knowledge but had lower prevention practice of COVID-19. Socio-demographic and access to information sources were factors of knowledge on COVID-19. Similarly, residence, shortage of PPE, high workload, comorbidities, knowledge, and access to IP training and guideline were factors limiting prevention practices. Thus, a consistent supply of PPE and improving health workers' knowledge, making IP guidelines and information sources available, and managing chronic illnesses are crucial to prevent COVID-19 among HWs., Competing Interests: Competing interestsThe author declares as there are no competing interests in this work., (© The Author(s) 2020.)

Published
2020
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23. Epidemiology of HIV Infection in the Amhara Region of Ethiopia, 2015 to 2018 Surveillance Data Analysis.

Author

Worku ED, Asemahagn MA, and Endalifer ML

Abstract

Background: Globally, over 37.9 million people are living with HIV in 2018 and sub-Saharan Africa carries 71% of the global HIV epidemics. In Ethiopia, there were an estimated 613,000 HIV cases in 2017. This study aimed to assess the trend of HIV incidence in the Amhara Region, Ethiopia., Methods: A retrospective descriptive study was conducted using routine HIV data from 2015 to 2018. We extracted HIV records from the Amhara Regional Health Bureau database. Data confidentiality was secured through data anonymity. Data were entered, cleaned and analyzed by IBM SPSS version 22 (Armonk, NY, USA). Various descriptive statistics such as counts, proportions and trends were computed to see the magnitude of HIV in the study area., Results: A total of 57,293 new HIV cases were reported from 2015 to 2018 and 33,720 (59%) were females. The majority, 40,054 (70%), of HIV cases were among people in 25-49 years. The overall incidence rate of HIV from 2015 to 2018 was 6.9 per 1000 population. The annual HIV incidence rates were 7.3. 6.3, 7.4 and 6.63 per 1000 population in 2015, 2016, 2017 and 2018, respectively. The incidence rate per 1000 population was high in Dessie town (5.74), Bahir Dar city (4.27) and Gondar town (3.00). About 49,564 (86.5%) of HIV cases have started ART and 33% of them had TB infection where 54% of them were females. Only 14869 (30%) people on ART had normal nutritional status., Conclusion: HIV remains a public health concern in the Amhara Region and the burden varied by place, time, gender and age groups. Improving awareness creation and community mobilization, managing TB infection and undernutrition problems, and making HIV screening services available in all healthcare facilities are crucial to decrease HIV infection. Special attention is also required to avoid risk factors that increased HIV incidence among females., Competing Interests: The author declared that there is no financial and non-financial competing interest in this work., (© 2020 Worku et al.)

Published
2020
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24. Epidemiology of hepatitis B and C virus infections among patients who booked for surgical procedures at Felegehiwot referral hospital, Northwest Ethiopia.

Author

Asemahagn MA

Subjects
Adult, Cross-Sectional Studies, Ethiopia epidemiology, Female, Humans, Male, Seroepidemiologic Studies, Hepatitis B epidemiology, Hepatitis B surgery, Hepatitis C epidemiology, Hepatitis C surgery, Referral and Consultation
Abstract

Background: Hepatitis B virus(HBV) and hepatitis C virus(HCV) are the main causes of cirrhosis, liver cancer, and death. This study aimed to determine the seroprevalence and associated factors of HBV surface antigen(HBsAg) and anti-HCV among patients screened for surgery at Felegehiwot referral hospital, Northwest Ethiopia., Methods: A hospital-based cross-sectional study was conducted among 433 patients in 2018. Data on socio-demographic and risk factors were collected by an exit interview using a pretested structured questionnaire. A venous blood sample of 5ml was collected from each participant, and serum was tested for HBsAg and anti-HCV using one-step rapid test kits and enzyme-linked immunosorbent assay. Multivariable logistic regression analysis was computed to identify factors associated with HBV and HCV infections. The odds ratio with 95%CI was used to describe the strength of association and statistical significance., Results: A total of 422 patients gave data and included in the analysis. The mean age of patients was 36±5 years. About two-thirds, 269(64%) and 274(65%) patients were males, and from rural areas, respectively. The seroprevalence of HBsAg was 34(8%) followed by 18(4.3%) anti-HCV and 4(0.9%) co-infections. Being single(AOR = 1.96, 95%CI = 1.12-3.10), rural residence (AOR = 2.68, 95%CI = 1.28-5.61), ever heard about HBV (AOR = 2.41, 95%CI = 1.18-5.20), having multiple sexual partners(AOR = 2.85, 95%CI = 1.30-5.58), HIV positive(AOR = 3.14, 95%CI = 1.31-7.61), history of tooth extraction(AOR = 3.0, 95%CI = 1.40-6.56), hospitalization history(AOR = 2.95, 95%CI = 1.26-5.81), sharing of sharp instruments (AOR = 3.86, 95%CI = 1.82-8.79), and had blood contact(AOR = 2.64, 95%CI = 1.14-5.42) were statistically significant factors to HBV infection. Similarly, sharing of sharp instruments(AOR = 4.65, 95%CI = 1.32-15.1), tooth extraction practice(AOR = 2.81, 95%CI = 1.12-6.56), surgical history (AOR = 3.68, 95%CI = 1.64-9.82), hospitalization history(AOR = 4.51, 95%CI = 1.62-8.35) and had blood contact(AOR = 3.2, 95%CI = 1.56-8.51) were significant factors to HCV infection., Conclusion: The seroprevalence of HBsAg and ant-HCV was high compared to WHO and previous study findings. Giving special attention to awareness creation, rural settings, improving personal behaviors, infection prevention activities of health facilities, quality of healthcare procedures is crucial to prevent viral hepatitis infection., Competing Interests: The authors declared that they have no financial and non-financial competing interests in this work.

Published
2020
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25. Prevention of Sexually Transmitted Infections and Associated Factors Among Night School Students in Bahir Dar City, Ethiopia.

Author

Ayele YT, Asemahagn MA, and Awoke T

Abstract

Background: Sexually transmitted infections (STIs) continued to be a global public health concern, primarily among adolescents in poor socioeconomic countries. This study was aimed to assess knowledge, practice, and associated factors of night school students to prevent STIs in Bahir Dar city, Northwest Ethiopia., Methods: An institution-based cross-sectional study was conducted among 422 students randomly selected from night schools. Data were collected using a pretested structured questionnaire. Data were entered, cleaned, and analyzed using SPSS version 16 software. Descriptive statistics were used to describe study variables. A multivariable logistic regression analysis was used to identify factors associated with knowledge about STI and its prevention. The strengths of associations were described using odds ratio at 95% confidence interval and a P -value of less than 0.05., Results: A total of 420 consented students were enrolled into the study. More than half, 420 (57.9%), and three-fourths, 332 (79%), of the students were women and married. Only 24.8% and 12.4% of the students had good knowledge and practice on the prevention of STIs, respectively. Age, educational status, information access, school health education, and consistent use of condoms were factors associated with the knowledge of students about STIs. Similarly, age, sex, knowledge about STIs, and discussion with families were factors of STI prevention practice among night school students., Conclusions: Giving special attention to awareness creation, information access, discussion with families, and improving family/individual income is vital to prevent STIs and its impact among night school students., Competing Interests: Declaration of Conflicting Interests:The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2020.)

Published
2020
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26. Tuberculosis infectious pool and associated factors in East Gojjam Zone, Northwest Ethiopia.

Author

Asemahagn MA, Alene GD, and Yimer SA

Subjects
Adult, Ethiopia epidemiology, Female, Humans, Male, Prospective Studies, Risk Factors, Tuberculosis, Pulmonary epidemiology
Abstract

Background: Globally, tuberculosis (TB) lasts a major public health concern. Using feasible strategies to estimate TB infectious periods is crucial. The aim of this study was to determine the magnitude of TB infectious period and associated factors in East Gojjam zone., Methods: An institution-based prospective study was conducted among 348 pulmonary TB (PTB) cases between December 2017 and December 2018. TB cases were recruited from all health facilities located in Hulet Eju Enesie, Enebse Sarmider, Debay Tilatgen, Dejen, Debre-Markos town administration, and Machakel districts. Data were collected through an exit interview using a structured questionnaire and analyzed by IBM SPSS version25. The TB infectious period of each patient category was determined using the TB management time and sputum smear conversion time. The sum of the infectious period of each patient category gave the infectious pool of the study area. A multivariable logistic regression analysis was used to identify factors associated with the magnitude of TB infectious period., Results: Of the total participated PTB cases, 209(60%) were male, 226(65%) aged < 30 years, 205(59%) were from the rural settings, and 77 (22%) had comorbidities. The magnitude of the TB infectious pool in the study area was 78,031 infectious person-days. The undiagnosed TB cases (44,895 days), smear-positive (14,625 days) and smear-negative (12,995 days) were major contributors to the infectious pool. The overall average median TB management time was 142.4 days (IQR, 98-238 days). Similarly, the average sputum smear conversion time of PTB cases (new and repeat) was 46 days. Residence, knowledge, form of TB, smoking, alcohol history, distance from the facility, comorbidity history and stigma were statistically significant factors TB infectious period (p-value< 0.05)., Conclusions: The magnitude of the TB infectious pool is high even if it is lower than the findings of previous studies. This might be an indicator of poor access to TB services, service delays, low community awareness, impaired facility readiness, and poor transportation. Improving personal awareness and behavior, timely management of commodities, and using the TB management time in TB control are crucial to improving TB control activities.

Published
2019
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27. Are Shopkeepers Suffering from Pulmonary Tuberculosis in Bahir Dar City, Northwest Ethiopia: A Cross-Sectional Survey .

Author

Asemahagn MA

Abstract

Background: Despite several interventions, tuberculosis (TB) continues to be a major public health concern in developing countries., Objective: To determine pulmonary TB prevalence and associated factors among shopkeepers in Bahir Dar City, Ethiopia., Methods: A cross-sectional study was conducted in 2016 among 520 shopkeepers who had TB signs and symptoms using questionnaire interview and sputum samples processing. Shopkeepers were considered TB positive if two sputum slides became positive. Data were edited and analyzed using SPSS version 23. Multivariable logistic regression analysis was used to identify factors., Results: A total of 520 shopkeepers were interviewed and gave sputum samples. About 256 (49.2%) of them were under the ≤30 years' age category, 22.0% can read and write, 65.0% were Muslims, and 32.0% originated from rural areas. Pulmonary TB prevalence was 7.0% (37/520), and positivity proportion was 57.0% (21/37) in males and 70.0% (26/37) in urban residents. Smaller (44.0%) shopkeepers got health education on TB. Illiteracy, no health education, contact history, cigarette smoking, nonventilated shops, and comorbidities were factors to TB infection ( p value < 0.05)., Conclusions: Significant numbers of shopkeepers were infected by TB. Factors to TB infection were either personal or related to comorbidities or the environment. Therefore, TB officials need to specially emphasize awareness creation, occupational health, and early screening to prevent TB.

Published
2017
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28. Determinants of exclusive breastfeeding practices among mothers in azezo district, northwest Ethiopia.

Author

Asemahagn MA

Abstract

Background: Exclusive breastfeeding (EBF) is a very important, long lasting and cost effective intervention to help reduce the morbidity and mortality of infants. However, a large proportion of infants are not exclusively breastfed as recommended by the World Health Organization. The study aim was to assess the exclusive breastfeeding practices and identify determinants among mothers in Azezo District, Ethiopia., Methods: A community based cross-sectional study was conducted among 346 mothers with infants aged between 0-6 months. Data were collected using a pretested, interviewer administered questionnaire. Descriptive statistics and logistic regression analysis were used to describe the study objectives and identify the determinants of EBF in the previous 24 h. Associations between the study and outcome variables were described using odds ratios and 95 % confidence intervals (CI)., Results: Any breastfeeding and exclusive breastfeeding in the previous 24 h were 99 and 79 %, respectively. The mean number of exclusive breastfeeds in the 24 h period was 6.5. Exclusive breastfeeding rates were highest among mothers aged ≥ 30 years (Adjusted odds ratio [AOR] 1.75; 95 % CI 1.14, 3.42). Infants whose mothers were unemployed were more likely to be exclusively breastfed than infants whose mothers were employed (AOR 1.62; 95 % CI 1.03, 2.95). Mothers earning ≤ 1000 birr (US $47.62) monthly were 77 % less likely to practice EBF (AOR 0.23; 95 % CI 0.13, 0.44). Mothers who delivered at the healthcare facility practised more exclusive breastfeeding than those who delivered at home (AOR 2.18; 95 % CI 1.22, 4.35). Mothers who received antenatal and postnatal care had better rates of EBF (AOR 2.24; 95 % CI 1.18, 5.76 and AOR 1.62; 95 % CI 1.09, 3.21) and mothers not practicing prelacteal feeding were more likely to exclusively breastfeed compared with mothers practicing prelacteal feeding (AOR 2.16; 95 % CI 1.16, 4.06)., Conclusions: Any breastfeeding and exclusive breastfeeding rates in the previous 24 h are relatively high in the study area compared with previous studies. Maternal factors (age, education, income, employment, antenatal care, prelacteal feeding), infants' age, delivery place and information access were independent predictors to EBF in previous 24 h. Improving the mother's knowledge, income, information access, nutritional counselling, quality of antenatal and postnatal care service, place of delivery and avoiding prelacteal feeding practices are important to improving the exclusive breastfeeding rate in the previous 24 h.

Published
2016
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29. Knowledge and experience sharing practices among health professionals in hospitals under the Addis Ababa health bureau, Ethiopia.

Author

Asemahagn MA

Subjects
Adult, Cross-Sectional Studies, Ethiopia, Female, Humans, Male, Middle Aged, Odds Ratio, Socioeconomic Factors, Surveys and Questionnaires, Young Adult, Clinical Competence, Government Agencies, Interdisciplinary Communication, Medical Staff, Hospital
Abstract

Background: Health professionals need updated health information from credible sources to improve their knowledge and provide evidence based health care services. Various types of medical errors have occurred in resource-limited countries because of poor knowledge and experience sharing practices among health professionals. The aim of this study was to assess knowledge-sharing practices and determinants among health professionals in Addis Ababa, Ethiopia., Methods: An institutional based cross-sectional study was conducted among 320 randomly selected health professionals from August12-25/2012. A pretested, self-administered questionnaire was used to collect data about different variables. Data entry and analysis were done using Epi-Info version 3.5.4 and SPSS version20 respectively. Descriptive statistics and multivariate regression analyses were applied to describe study objectives and identify the determinants of knowledge sharing practices respectively. Odds ratio at 95% CI was used to describe the strength of association between the study and outcome variables., Results: Most of the respondents approved the need of knowledge and experience sharing practices in their routine activities. Nearly half, 152 (49.0%) of the study participants had knowledge and experience sharing practices. A majority, 219 (70.0%) of the respondents showed a willingness to share their knowledge and experiences. Trust on others' knowledge, motivation, supportive leadership, job satisfaction, awareness, willingness and resource allocation are the determinants of knowledge and experience sharing practices. Supportive leadership, resources, and trust on others' knowledge can enhance knowledge and experience sharing by OR = 3.12, 95% CI = [1.89 - 5.78], OR = 2.3, 95% CI = [1.61- 4.21] and OR = 2.78, 95% CI = [1.66 - 4.64] times compared with their counterparts respectively., Conclusion: Even though most of the respondents knew the importance of knowledge and experience sharing practices, only a limited number of respondents practiced it. Individual, organizational and resource related issues are the major determinants of low knowledge sharing practices. Improving management, proper resource allocation, motivating staffs, and accessing health information sources are important interventions to improve the problem in the study area.

Published
2014
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