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3. Home-based HPV self-sampling assisted by a cloud-based electronic data system: Lessons learnt from a pilot community cervical cancer screening campaign in rural Ethiopia

Author

Jede, Felix, primary, Brandt, Theresa, additional, Gedefaw, Molla, additional, Wubneh, Solomon Berhe, additional, Abebe, Tamrat, additional, Teka, Brhanu, additional, Alemu, Kassahun, additional, Tilahun, Binyam, additional, Azemeraw, Temesgen, additional, Gebeyehu, Abebaw, additional, Schmidt, Dietmar, additional, Pesic, Aleksandra, additional, Kaufmann, Andreas M., additional, Abebe, Bewketu, additional, Ayichew, Zelalem, additional, Byczkowski, Michael, additional, Vaucher, Timoté, additional, Sartor, Heike, additional, Andargie, Gashaw, additional, Bärnighausen, Till, additional, von Knebel Doeberitz, Magnus, additional, and Bussmann, Hermann, additional

Published
2020
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4. Addressing the Impact of Noncommunicable Diseases and Injuries (NCDIs) in Ethiopia: Findings and Recommendations from the Ethiopia NCDI Commission.

Author

Memirie, Solomon Tessema, Dagnaw, Wubaye Walelgne, Habtemariam, Mahlet Kifle, Bekele, Alemayehu, Yadeta, Dejuma, Bekele, Amsalu, Bekele, Wondu, Gedefaw, Molla, Assefa, Mathewos, Tolla, Mieraf Taddese, Misganaw, Awoke, Gupta, Neil, Bukhman, Gene, and Norheim, Ole F.

Subjects
NON-communicable diseases, RHEUMATIC heart disease, DISEASE risk factors, HEART diseases in women, EARLY death, WOUNDS & injuries
Abstract

BACKGROUND: Noncommunicable diseases and injuries (NCDIs) are the leading causes of premature mortality globally. Ethiopia is experiencing a rapid increase in NCDI burden. The Ethiopia NCDI Commission aimed to determine the burden of NCDIs, prioritize health sector interventions for NCDIs and estimate the cost and available fiscal-space for NCDI interventions. METHODS: We retrieved data on NCDI disease burden and concomitant risk factors from the Global Burden of Disease (GBD) Study, complemented by systematic review of published literature from Ethiopia. Cost-effective interventions were identified through a structured priority-setting process and costed using the One Health tool. We conducted fiscal-space analysis to identify an affordable package of NCDI services in Ethiopia. RESULTS: We find that there is a large and diverse NCDI disease burden and their risk factors such as hypertension and diabetes (these conditions are NCDIs themselves and could be risk factors to other NCDIs), including less common but more severe NCDIs such as rheumatic heart disease and cancers in women. Mental, neurological, chronic respiratory and surgical conditions also contribute to a substantial proportion of NCDI disease burden in Ethiopia. Among an initial list of 235 interventions, the commission recommended 90 toppriority NCDI interventions (including essential surgery) for implementation. The additional annual cost for scaling up of these interventions was estimated at US$550m (about US$4.7 per capita). CONCLUSIONS: A targeted investment in cost-effective interventions could result in substantial reduction in premature mortality and may be within the projected fiscal space of Ethiopia. Innovative financing mechanisms, multi-sectoral governance, regional implementation, and an integrated service delivery approach mainly using primary health care are required to achieve these goals. [ABSTRACT FROM AUTHOR]

Published
2022
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5. National mortality burden due to communicable, non-communicable, and other diseases in Ethiopia, 1990–2015: findings from the Global Burden of Disease Study 2015

Author

Misganaw, Awoke, Haregu, Tilahun N., Deribe, Kebede, Tessema, Gizachew Assefa, Deribew, Amare, Melaku, Yohannes Adama, Amare, Azmeraw T., Abera, Semaw Ferede, Gedefaw, Molla, Dessalegn, Muluken, Lakew, Yihunie, Bekele, Tolesa, Mohammed, Mesoud, Yirsaw, Biruck Desalegn, Damtew, Solomon Abrha, Krohn, Kristopher J., Achoki, Tom, Blore, Jed, Assefa, Yibeltal, and Naghavi, Mohsen

Subjects
Adult, lcsh:Computer applications to medicine. Medical informatics, Global Health, Communicable Diseases, Infant, Newborn, Diseases, Pregnancy, Cause of Death, Infant Mortality, Humans, Non-communicable diseases, Mortality, Child, Noncommunicable Diseases, Causes of death, Mortality, Premature, Communicable disease, lcsh:Public aspects of medicine, Research, Infant, Newborn, Infant, lcsh:RA1-1270, Pregnancy Complications, Global burden of disease, Maternal Mortality, lcsh:R858-859.7, Wounds and Injuries, Female, Ethiopia
Abstract

Background: Ethiopia lacks a complete vital registration system that would assist in measuring disease burden and risk factors. We used the Global Burden of Diseases, Injuries, and Risk factors 2015 (GBD 2015) estimates to describe the mortality burden from communicable, non-communicable, and other diseases in Ethiopia over the last 25 years. \ud \ud Methods: GBD 2015 mainly used cause of death ensemble modeling to measure causes of death by age, sex, and year for 195 countries. We report numbers of deaths and rates of years of life lost (YLL) for communicable, maternal, neonatal, and nutritional (CMNN) disorders, non-communicable diseases (NCDs), and injuries with 95% uncertainty intervals (UI) for Ethiopia from 1990 to 2015.\ud \ud Results: CMNN causes of death have declined by 65% in the last two-and-a-half decades. Injury-related causes of death have also decreased by 70%. Deaths due to NCDs declined by 37% during the same period. Ethiopia showed a faster decline in the burden of four out of the five leading causes of age-standardized premature mortality rates when compared to the overall sub-Saharan African region and the Eastern sub-Saharan African region: lower respiratory infections, tuberculosis, HIV/AIDS, and diarrheal diseases; however, the same could not be said for ischemic heart disease and other NCDs. Non-communicable diseases, together, were the leading causes of age-standardized mortality rates, whereas CMNN diseases were leading causes of premature mortality in 2015. Although lower respiratory infections, tuberculosis, and diarrheal disease were the leading causes of age-standardized death rates, they showed major declines from 1990 to 2015. Neonatal encephalopathy, iron-deficiency anemia, protein-energy malnutrition, and preterm birth complications also showed more than a 50% reduction in burden. HIV/AIDS-related deaths have also decreased by 70% since 2005. Ischemic heart disease, hemorrhagic stroke, and ischemic stroke were among the top causes of premature mortality and age-standardized death rates in Ethiopia in 2015. \ud \ud Conclusions: Ethiopia has been successful in reducing deaths related to communicable, maternal, neonatal, and nutritional deficiency diseases and injuries by 65%, despite unacceptably high maternal and neonatal mortality rates. However, the country’s performance regarding non-communicable diseases, including cardiovascular disease, diabetes, cancer, and chronic respiratory disease, was minimal, causing these diseases to join the leading causes of premature mortality and death rates in 2015. While the country is progressing toward universal health coverage, prevention and control strategies in Ethiopia should consider the double burden of common infectious diseases and non-communicable diseases: lower respiratory infections, diarrhea, tuberculosis, HIV/AIDS, cardiovascular disease, cancer, and diabetes. Prevention and control strategies should also pay special attention to the leading causes of premature mortality and death rates caused by non-communicable diseases: cardiovascular disease, cancer, and diabetes. Measuring further progress requires a data revolution in generating, managing, analyzing, and using data for decision-making and the creation of a full vital registration system in the country.

Published
2017

6. National disability-adjusted life years (DALYs) for 257 diseases and injuries in Ethiopia, 1990–2015: findings from the global burden of disease study 2015

Author

Misganaw, Awoke, primary, Melaku, Yohannes Adama, additional, Tessema, Gizachew Assefa, additional, Deribew, Amare, additional, Deribe, Kebede, additional, Abera, Semaw Ferede, additional, Dessalegn, Muluken, additional, Lakew, Yihunie, additional, Bekele, Tolesa, additional, Haregu, Tilahun N., additional, Amare, Azmeraw T., additional, Gedefaw, Molla, additional, Mohammed, Mesoud, additional, Yirsaw, Biruck Desalegn, additional, Damtew, Solomon Abrha, additional, Achoki, Tom, additional, Blore, Jed, additional, Krohn, Kristopher J., additional, Assefa, Yibeltal, additional, Kifle, Mahlet, additional, and Naghavi, Mohsen, additional

Published
2017
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18. Childhood Diarrheal Diseases and Associated Factors in the Rural Community of Dejen District, Northwest Ethiopia

Author

Getu, Demeke, Gedefaw, Molla, Abebe, Nurilign, Getu, Demeke, Gedefaw, Molla, and Abebe, Nurilign

Abstract

Diarrheal diseases are among the three most important causes of morbidity, and mortality in low income countries including Ethiopia. Lack of sanitation facilities is a serious health risk and obliges people to practice open defecation, thereby increasing the risk of disease transmission. These problems are clear at Dejen district where childhood diarrheal disease is the top cause of morbidity among under five children. The aim of this study was to assess prevalence of childhood diarrheal diseases and associated factors in the rural community of Dejen district, northwest Ethiopia, 2014. In this paper; a community-based cross-sectional study was conducted. Five of the 21 rural kebeles in the district was selected randomly, finally 710 households were chosen by systematic random sampling using existing list of all households as a sampling frame. Data was collected using pre-tested WHO core questionnaire that was designed to explore factors related to diarrhea. Data enter and analysis was carried out using SPSS version 20. The level of association was dealt using confidence interval and odds ratio.This study conducted among 710 participants with response rate of 96.4% shows that, the prevalence of diarrhea was 23.8%. Tube well water source (AOR: 2.59,95% CI (169,3.95)), throwing away disposal of feces (AOR: 1.58,95% CI (1.10,2.26)), mother’s used hand washing with practice only water (AOR: 1.61,95% CI (1.04,2.84)) and having not supplemented with vitamin A (AOR: 1.92,95% CI(1.35,2.74)) were significantly associated with diarrhea. the prevalence of childhood diarrhea is high at Dejen district. Tube well source of water, throwing away disposal of feces, poor hand washing practice of the mother and lack of vitamin A supplementation were significantly associated with childhood diarrheal disease. The District and Zonal water office should increasing access of piped water in rural areas. The District and Zonal health office should improve awareness of the community on h

Published
2014

28. Childhood Diarrheal Diseases and Associated Factors in the Rural Community of Dejen District, Northwest Ethiopia

Author

Getu, Demeke, Gedefaw, Molla, Abebe, Nurilign, Getu, Demeke, Gedefaw, Molla, and Abebe, Nurilign

Abstract

Diarrheal diseases are among the three most important causes of morbidity, and mortality in low income countries including Ethiopia. Lack of sanitation facilities is a serious health risk and obliges people to practice open defecation, thereby increasing the risk of disease transmission. These problems are clear at Dejen district where childhood diarrheal disease is the top cause of morbidity among under five children. The aim of this study was to assess prevalence of childhood diarrheal diseases and associated factors in the rural community of Dejen district, northwest Ethiopia, 2014. In this paper; a community-based cross-sectional study was conducted. Five of the 21 rural kebeles in the district was selected randomly, finally 710 households were chosen by systematic random sampling using existing list of all households as a sampling frame. Data was collected using pre-tested WHO core questionnaire that was designed to explore factors related to diarrhea. Data enter and analysis was carried out using SPSS version 20. The level of association was dealt using confidence interval and odds ratio.This study conducted among 710 participants with response rate of 96.4% shows that, the prevalence of diarrhea was 23.8%. Tube well water source (AOR: 2.59,95% CI (169,3.95)), throwing away disposal of feces (AOR: 1.58,95% CI (1.10,2.26)), mother’s used hand washing with practice only water (AOR: 1.61,95% CI (1.04,2.84)) and having not supplemented with vitamin A (AOR: 1.92,95% CI(1.35,2.74)) were significantly associated with diarrhea. the prevalence of childhood diarrhea is high at Dejen district. Tube well source of water, throwing away disposal of feces, poor hand washing practice of the mother and lack of vitamin A supplementation were significantly associated with childhood diarrheal disease. The District and Zonal water office should increasing access of piped water in rural areas. The District and Zonal health office should improve awareness of the community on h

Published
2013

32. Cases of human fascioliasis in North-West Ethiopia

Author

Bayu, Bitew, primary, Asnake, Sebhat, additional, Woretaw, Alemseged, additional, Ali, Jemal, additional, Gedefaw, Molla, additional, Fente, Tsegaw, additional, Getachew, Assefa, additional, Tsegaye, Sintayehu, additional, Dagne, Tamiru, additional, and Yitayew, Gashaw, additional

Published
2006
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34. THE STATUS OF IODINE NUTRITION AND IODINE DEFICIENCY DISORDERS AMONG SCHOOL CHILDREN IN METEKEL ZONE, NORTHWEST ETHIOPIA.

Author

Kibatu, Girma, Nibret, Endalkachew, and Gedefaw, Molla

Subjects
IODINE deficiency diseases, SCHOOL children, IODINE deficiency, IODINE in the body, PUBLIC health, JUVENILE diseases
Abstract

BACKGROUND: Iodine deficiency disorders are serious public health problems in Ethiopia. The aim of this study was to measure the prevalence and severity of iodine deficiency disorders among school children in Metekel Zone. METHODS: A cross-sectional school based descriptive study was conducted between February 2011 and July 2012. One school containing 750 children aged between 6 and 18 years was randomly selected. Two hundred students from this school were selected by systematic random sampling. Physical examination was made according to WHO goiter classification system; 50 salt samples from households to which the sampled children belonged were tested for iodine using rapid field test kits and titration; a casual urine sample (5 ml) was taken from 30 children to measure urinary iodine spectrophotometrically, and 5 ml venous blood sample were collected from 37 children to measure thyroid relevant blood constituents using ELISA. RESULTS: The total goiter prevalence was 39.5%; 60% of the salt samples contained no iodine. The median urinary iodine concentration ranged from 20.54 - 62.2 (39.9 µg/L). School children who were assessed for thyroid hormones showed 18.92% elevated and 27.03% suppressed TSH levels. CONCLUSION: The study demonstrated that iodine deficiency is still a severe public health problem in Metekel Zone. There is a need to further strengthen the existing controlling and monitoring system in order to achieve proper elimination of IDDs in the community. [ABSTRACT FROM AUTHOR]

Published
2014
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35. Epidemiology of human fascioliasis and intestinal parasitosis among schoolchildren in Lake Tana Basin, northwest Ethiopia.

Author

Fentie, Tsegaw, Erqou, Sebhat, Gedefaw, Molla, and Desta, Almaw

Subjects
FASCIOLIASIS, EPIDEMIOLOGY, PARASITOLOGY, ASCARIS lumbricoides, PARASITIC diseases
Abstract

Background Parasitic diseases are the second most frequent cause of outpatient morbidity in Ethiopia. Methods A cross-sectional study was conducted in Lake Tana Basin, northwest Ethiopia, from November 2007 to February 2008, to assess the magnitude and associated risk factors for parasitic diseases, including human fascioliasis. We examined 520 stool samples from randomly selected schoolchildren in six schools by microscopy. Rapid sedimentation and Kato–Katz techniques were used to detect and count Fasciola and Schistosoma eggs. The formol–ether concentration method was used for the identification of other helminth eggs, larvae and cysts of protozoan parasites. Results The overall prevalence of intestinal parasitic infections was 71.3% (95% CI 67.3–75.1%). Hookworm was the predominant intestinal parasite (23.5%, 95% CI 19.8–27.1%), followed by Ascaris lumbricoides (18.5%, 95% CI 15.2–21.9%) and Schistosoma mansoni (16.7%, 95% CI 13.5–19.9%). One hundred and sixty-three (31.4%) children had multiple parasitic infections. The most relevant finding was a prevalence of Fasciola spp. of 3.3% in an area where only sporadic cases have been reported previously. The risk of Fasciola spp. infection was significantly associated with raw vegetable consumption, use of unsafe drinking water sources, irrigation practices and sheep and/or cattle ownership. Irrigation practices, male gender, raw vegetable consumption and use of unsafe drinking water sources were risk factors for S. mansoni infection. Conclusions A high prevalence of parasitic infections among children in the region was found, including a relatively high prevalence of Fasciola spp. infection. Epidemiological studies on the magnitude of parasitic infections in different regions will enable high-risk communities to be identified and allow for planning of appropriate interventions. [ABSTRACT FROM AUTHOR]

Published
2013
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37. National mortality burden due to communicable, non-communicable, and other diseases in Ethiopia,1990-2015: Findings from the Global Burden of Disease Study 2015

Author

Misganaw, Awoke, Haregu, Tilahun N, Deribe, Kebede, Tessema, Gizachew Assefa, Deribew, Amare, Melaku, Yohannes Adama, Amare, Azmeraw T, Abera, Semaw Ferede, Gedefaw, Molla, Dessalegn, Muluken, Lakew, Yihunie, Bekele, Tolesa, Mohammed, Mesoud, Yirsaw, Biruck Desalegn, Damtew, Solomon Abrha, Krohn, Kristopher J, Achoki, Tom, Blore, Jed, Assefa, Yibeltal, and Naghavi, Mohsen

Subjects
Global burden of disease, Communicable disease, Non-communicable diseases, Ethiopia, Causes of death Mortality
Abstract

Background: Ethiopia lacks a complete vital registration system that would assist in measuring disease burden and risk factors. We used the Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015) estimates to describe the mortality burden from communicable, non-communicable, and other diseases in Ethiopia over the last 25 years. Methods: GBD 2015 mainly used cause of death ensemble modeling to measure causes of death by age, sex, and year for 195 countries. We report numbers of deaths and rates of years of life lost (YLL) for communicable, maternal, neonatal, and nutritional (CMNN) disorders, non-communicable diseases (NCDs), and injuries with 95% uncertainty intervals (UI) for Ethiopia from 1990 to 2015. Results: CMNN causes of death have declined by 65% in the last two-and-a-half decades. Injury-related causes of death have also decreased by 70%. Deaths due to NCDs declined by 37% during the same period. Ethiopia showed a faster decline in the burden of four out of the five leading causes of age-standardized premature mortality rates when compared to the overall sub-Saharan African region and the Eastern sub-Saharan African region: lower respiratory infections, tuberculosis, HIV/AIDS, and diarrheal diseases; however, the same could not be said for ischemic heart disease and other NCDs. Non-communicable diseases, together, were the leading causes of age-standardized mortality rates, whereas CMNN diseases were leading causes of premature mortality in 2015. Although lower respiratory infections, tuberculosis, and diarrheal disease were the leading causes of age-standardized death rates, they showed major declines from 1990 to 2015. Neonatal encephalopathy, iron-deficiency anemia, protein-energy malnutrition, and preterm birth complications also showed more than a 50% reduction in burden. HIV/AIDS-related deaths have also decreased by 70% since 2005. Ischemic heart disease, hemorrhagic stroke, and ischemic stroke were among the top causes of premature mortality and age-standardized death rates in Ethiopia in 2015. Conclusions: Ethiopia has been successful in reducing deaths related to communicable, maternal, neonatal, and nutritional deficiency diseases and injuries by 65%, despite unacceptably high maternal and neonatal mortality rates. However, the country's performance regarding non-communicable diseases, including cardiovascular disease, diabetes, cancer, and chronic respiratory disease, was minimal, causing these diseases to join the leading causes of premature mortality and death rates in 2015. While the country is progressing toward universal health coverage, prevention and control strategies in Ethiopia should consider the double burden of common infectious diseases and non-communicable diseases: lower respiratory infections, diarrhea, tuberculosis, HIV/AIDS, cardiovascular disease, cancer, and diabetes. Prevention and control strategies should also pay special attention to the leading causes of premature mortality and death rates caused by non-communicable diseases: cardiovascular disease, cancer, and diabetes. Measuring further progress requires a data revolution in generating, managing, analyzing, and using data for decision-making and the creation of a full vital registration system in the country. Refereed/Peer-reviewed

Published
2017

38. Diarrhoea-associated parasites in HIV-1 seropositive and sero-negative patients in a teaching hospital, Northwest Ethiopia.

Author

Andualem B, Kassu A, Moges F, Gedefaw M, Diro E, Mengistu G, and Andargie G

Subjects
Adolescent, Adult, Cross-Sectional Studies, Ethiopia epidemiology, Female, Hospitals, Teaching, Humans, Male, Middle Aged, Prevalence, Diarrhea parasitology, HIV Seronegativity, HIV Seropositivity epidemiology, HIV-1
Abstract

Objective: to determine the prevalence and type of intestinal parasites in HIV infected and uninfected patients with diarrhea., Design: A cross-sectional study was conducted at Gondar University hospital, Northwest Ethiopia, between March 2003 and October 2004., Patients and Methods: A total 312 consecutive diarrheic patients were included in the study. Stool specimens were collected and examined for intestinal parasites following direct, formol-ether concentration and modified acid fast staining methods., Results: Among the patients, 63.8% were found to be HIV seropositive. The prevalence of intestinal parasites in HIV seropositive and seronegative diarrheic patients was 30.6% and 33.6%, respectively. The most prevalent parasites were Strongyoides stercoralis (9.0%) and Entamoeba histolytica (8.3%) followed by Ascaris lumbricoides (5.4%) and Cryptosporidium species (5. 1%)., Conclusion and Recommendation: The prevalence of intestinal parasites in diarrheic patients was very high. Institution of appropriate intervention measures are needed to reduce morbidity in such patients.

Published
2007

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