Addis Continental Institute of Public Health

Addis, Ethiopia

Addis Continental Institute of Public Health

Addis, Ethiopia
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Abebe S.M.,Health Science University | Berhane Y.,Addis Continental Institute of Public Health | Worku A.,Addis Ababa Institute of Technology
PLoS ONE | Year: 2013

Background: Diabetes mellitus is becoming one of the major causes of premature adult mortality in developing countries. However, there is a very little documentation of the morbidity trend in such countries. Objective: To assess the ten-year trend of diabetes mellitus at Gondar University Teaching Referral Hospital, northwest Ethiopia. Methods: A hospital-based retrospective record review was done at the main referral hospital in northwest Ethiopia. Data were obtained from medical records of all registered diabetic patients in the Diabetic Follow up Clinic between 2000 and 2009. An Extended Mantel-Haenzel chi-square test for the linear trend was used to examine the trend over time. Result: Out of the total 354,524 patients who visited the Outpatient Department of the hospital during the study period, 1553 (4.4/1000) were diabetes patients, of which 50.1% was type 1 and 49.9% type 2 diabetes mellitus. The average increase in the proportion of both Type 1 and Type 2 diabetes mellitus cases between 2000 and 2009 was 125%. The mean (±SD) age for Type 1 diabetes mellitus was 29.1 (±12), and 53.5 (±12) for Type 2 diabetes. Overall 42.5% of the diabetes mellitus patients were female and 31.7% were rural residents. The mean body mass index for both type of diabetes mellitus increased from 15.9 to 18.3 kg for type 1 and from 23.8 to 24.6 for type 2 between 2000 and 2009, respectively. Conclusion: The number of diabetes mellitus cases seen at Gondar Referral Hospital is rising steadily. A comprehensive diabetes prevention, treatment, and care program is needed to improve the quality of life of the increasing diabetes mellitus cases in Ethiopia. © 2013 Abebe et al.


Abebe F.,Amhara National Regional Health Bureau | Berhane Y.,Addis Continental Institute of Public Health | Girma B.,Addis Continental Institute of Public Health
BMC Research Notes | Year: 2012

Background: In Ethiopia although pregnant mothers increasingly attend antenatal clinics, utilization of skilled delivery service remains very low. The individual or health system factors that affect women's preferences for delivery places are not well known. Method. A case control study was conducted in July 2010 to assess factors associated with utilization of institutional delivery service. A total of 324 mothers who recently delivered and visited either postnatal care or sought immunization services were included. Cases (n = 108) were mothers who gave birth at home and controls (n = 216) were those who delivered at health facility. Pre-tested and standardized questionnaires were used to collect relevant data by trained data collectors. Logistic regression model was used to control for confounding. Result: The likelihood of delivering at home was greater among mothers with inadequate knowledge of pregnancy related services (AOR = 62, 95% CI: 3, 128.4), those who started attending ANC after 24 weeks of gestation (AOR 8.7, 95% CI: 2.2, 33.3), mothers having no formal education (Adjusted OR 4.2, 95% CI 1.63, 11.27) and rural residents (AOR = 3.6, 95%CI: 1.4, 9.0). Conclusion: The predominant factors associated with home delivery services were lack of knowledge about obstetrics care, delay in starting Antenatal Care (ANC) follow up, having, Illiteracy and rural residence. Audience specific behavioral change communication should be designed to improve the demand for delivery services. Health professionals should take the opportunity to encourage mothers attend delivery services during ANC follow up. Improvements should be made in social conditions including literacy and major social mobilization endeavors. © 2012 Abebe et al.; licensee BioMed Central Ltd.


Girma B.,Addis Continental Institute of Public Health | Berhane Y.,Addis Continental Institute of Public Health
BMC Public Health | Year: 2011

Background: Improving child survival through various health interventions has been one of the main preoccupations of public health programs in developing nations. However, efforts to understand the child death determinants and determine whether the health interventions are really contributing to the reduction of mortality were not satisfactory. The purpose of this study is to identify determinants and causes of child mortality. Methods. The study was conducted in the town of Jimma, Ethiopia, using a case control study design. Cases were identified through enumeration of all children and deaths prior to interview of the study subjects. Controls were under five children of the same age (+/-2 months) residing in the nearest household. Data was entered into EPI -info 6.4 software and analyzed using SPSS. Results: Seventy four cases and 222 controls were included in the study. The study found that children who never breast fed [OR = 13.74, 95%CI (3.34, 56.42]] and children with mothers having more than five children [OR = 3.34, 95%CI (1.27, 8.76)] were more likely to die than their counterparts. Vaccination reduced the risk of death [OR=.26, 95%CI (0.10, 0.67) significantly. Pneumonia was the most common immediate cause of death [29.7% (95% CI (19.66, 41.48)] followed by acute diarrhea and malaria each contributing for 23% [95%CI (13.99, 34.21)] of deaths. Conclusion: Immunization, breastfeeding and low parity mothers were independently found to be protective from childhood death. Strengthening the child survival initiatives, namely universal child immunization, family planning and breast feeding - is strongly recommended. © 2011 Girma and Berhane; licensee BioMed Central Ltd.


Cherie A.,Addis Ababa Institute of Technology | Berhane Y.,Addis Continental Institute of Public Health
BMC Public Health | Year: 2012

Background: Understanding the full range of sexual behaviors of young people is crucial in developing appropriate interventions to prevent and control sexually transmitted infections including HIV. However, such information is meager in developing countries. The objective of this study was to describe oral and anal sex practices and identify associated factors among high school youth. Methods. A cross-sectional study was conducted among high school youth in Addis Ababa, Ethiopia. A multi-stage sampling procedure was followed to select a representative sample of school youth. The total sample size for this study was 3840. Data were collected using a self-administered questionnaire. Data analysis was guided by the ecological framework. Results: The overall proportion of people who reported ever having oral sex was 5.4% (190) and that of anal sex was 4.3% (154). Of these 51.6% (98) had oral sex and 57.1% (87) had anal sex in the past 12 months. Multiple partnerships were reported by 61.2% of the respondents who had oral sex and 51.1% of students practicing anal sex. Consistent condom use was reported by 12.2% of those practicing oral sex and 26.1% of anal sex. Reasons for oral and anal sex included prevention of pregnancy, preserving virginity, and reduction of HIV and STIs transmission. Oral sex practice was strongly and significantly associated with perception of best friends engagement in oral sex (AOR = 5.7; 95% CI 3.6-11.2) and having illiterate mothers (AOR = 11.5; 95%CI 6.4-18.5). Similarly, anal sex practice was strongly and significantly associated with favorable attitude towards anal sex (AOR = 6.2; 95%CI 3.8-12.4), and perceived best friends engagement in anal sex (AOR = 9.7; 95%CI 5.4-17.7). Conclusion: Considerable proportion of adolescents had engaged in oral and anal sex practices. Multiple sexual partnerships were common while consistent condom use was low. Sexual health education and behavior change communication strategies need to cover a full range of sexual practices. © 2011 Cherie and Berhane; licensee BioMed Central Ltd.


Oljira L.,Haramaya University | Berhane Y.,Addis Continental Institute of Public Health | Worku A.,Addis Ababa Institute of Technology
BMC Public Health | Year: 2012

Background: More adolescents in Ethiopia are in school today than ever, but few studies have assessed the sexual behaviour of these learners. Thus, this study tried to assess pre-marital sexual debut and factors associated with it among in-school adolescents in Eastern Ethiopia. Methods: A cross-sectional school-based study was conducted using a facilitator guided selfadministered questionnaire. Respondents were students attending regular school classes in fourteen high schools. The proportion of adolescents involved in pre-marital sexual debut and the mean age at sexual debut was computed. Factors associated with pre-marital sexual debut were assessed using bivariate and multivariable logistic regression. Results: About one in four, 686 (24.8%) never married in-school adolescent respondents reported pre-marital sexual debut of these 28.8% were males and 14.7% were females (p<0.001). Pre-marital sexual debut was more common among adolescents who had their parents in urban areas (Adjusted OR and [95% CI] =1.42 [1.17-1.73]), who received higher pocket money per month (Adjusted OR and [95% CI] = 1.56 [1.19-2.04]), who perceived low self-educational rank (Adjusted OR and [95% CI] =1.89 [1.07-3.34]) and who lived in rented houses (Adjusted OR and [95% CI] =1.32 [1.03-1.70]). The females and those who were less influenced by external pressure were more protected against pre-marital sexual debut (Adjusted OR and [95% CI] = 0.44 [0.350.56; 0.62 [0.52-0.74, respectively]) than their counterparts. Conclusion: A significant proportion of in-school adolescents were engaged in sexual relationship. Thus, public health interventions should consider the broader determinants of premarital sexual debut, including the ecological factors in which the behavior occurs. © 2012 Correa da silva et al.; licensee BioMed Central Ltd.


Berhe F.,Hawassa University | Berhane Y.,Addis Continental Institute of Public Health
BMC Public Health | Year: 2014

Background: Ethiopia has been implementing a community-level health intervention package (referred to as "Health Extension Program") to improve the health of children in particular.However, its effect on the major childhood illnesses in Ethiopia has not been studied. This study was conducted to determine whether a fully-implemented health extension program reduces diarrhea in children under the age of five. Method. A Community-based comparative cross-sectional study was carried out by comparing model households (i.e. households that fully implemented the health extension package) with non-model households (i.e. households that did not fully implement the health extension package). The study participants were mothers having children under the age of five. Data were collected through a household survey. A multiple logistic regression model was used to control known confounders. Result: After controlling potential confounding factors using a logistic regression model, under five year children residing in non-model households, were more likely to have diarrhea in the two weeks preceding the survey compared to those residing in model households [AOR: 2.65, 95%CI (1.11, 6.27)]. Conclusion: Diarrhea among under five children significantly reduced among families who fully implemented basic health packages. The finding suggests that being a model HH can have a positive impact on diarrhea morbidity among under five children. © 2014 Berhe and Berhane; licensee BioMed Central Ltd.


Alemu K.,University Institute of Health Sciences | Worku A.,Addis Ababa Institute of Technology | Berhane Y.,Addis Continental Institute of Public Health
PLoS ONE | Year: 2013

Background: Malaria elimination requires successful nationwide control efforts. Detecting the spatiotemporal distribution and mapping high-risk areas are useful to effectively target pockets of malaria endemic regions for interventions. Objective: The aim of the study was to identify patterns of malaria distribution by space and time in unstable malaria transmission areas in northwest Ethiopia. Methods: Data were retrieved from the monthly reports stored in the district malaria offices for the period between 2003 and 2012. Eighteen districts in the highland and fringe malaria areas were included and geo-coded for the purpose of this study. The spatial data were created in ArcGIS10 for each district. The Poisson model was used by applying Kulldorff methods using the SaTScan™ software to analyze the purely temporal, spatial and space-time clusters of malaria at a district levels. Results: The study revealed that malaria case distribution has spatial, temporal, and spatiotemporal heterogeneity in unstable transmission areas. Most likely spatial malaria clusters were detected at Dera, Fogera, Farta, Libokemkem and Misrak Este districts (LLR =197764.1, p<0.001). Significant spatiotemporal malaria clusters were detected at Dera, Fogera, Farta, Libokemkem and Misrak Este districts (LLR=197764.1, p<0.001) between 2003/1/1 and 2012/12/31. A temporal scan statistics identified two high risk periods from 2009/1/1 to 2010/12/31 (LLR=72490.5, p<0.001) and from 2003/1/1 to 2005/12/31 (LLR=26988.7, p<0.001). Conclusion: In unstable malaria transmission areas, detecting and considering the spatiotemporal heterogeneity would be useful to strengthen malaria control efforts and ultimately achieve elimination. © 2013 Alemu et al.


Oljira L.,Haramaya University | Berhane Y.,Addis Continental Institute of Public Health | Worku A.,Addis Ababa Institute of Technology
Journal of the International AIDS Society | Year: 2013

Introduction: In Ethiopia, more adolescents are in school today than ever before; however, there are no studies that have assessed their comprehensive knowledge of HIV/AIDS. Thus, this study tried to assess the level of this knowledge and the factors associated with it among in-school adolescents in eastern Ethiopia. Methods: A cross-sectional school-based study was conducted using a facilitator-guided self-administered questionnaire. The respondents were students attending regular school in 14 high schools located in 14 different districts in eastern Ethiopia. The proportion of in-school adolescents with comprehensive HIV/AIDS knowledge was computed and compared by sex. The factors that were associated with the comprehensive HIV/AIDS knowledge were assessed using bivariate and multivariable logistic regression. Results: Only about one in four, 677 (24.5%), in-school adolescents have comprehensive HIV/AIDS knowledge. The knowledge was better among in-school adolescents from families with a relatively middle or high wealth index (adjusted OR [95% CI] = 1.39 [1.03 - 1.87] and 1.75 [1.24 - 2.48], respectively), who got HIV/AIDS information mainly from friends or mass media (adjusted OR [95% CI] = 1.63 [1.17 - 2.27] and 1.55 [1.14 - 2.11], respectively) and who received education on HIV/AIDS and sexual matters at school (adjusted OR [95% CI] = 1.59 [1.22 - 2.08]). The females were less likely to have comprehensive HIV/AIDS knowledge compared to males (adjusted OR and [95% CI] = 0.60 [0.49 - 0.75]). Conclusions: In general, only about a quarter of in-school adolescents had comprehensive HIV/AIDS knowledge. Although the female adolescents are highly vulnerable to HIV infection and its effects, they were by far less likely to have comprehensive HIV/AIDS knowledge. HIV/AIDS information, education and communication activities need to be intensified in high schools. © 2013 Oljira L et al; licensee International AIDS Society.


Haile F.,Mekelle University | Brhan Y.,Addis Continental Institute of Public Health
BMC Pregnancy and Childbirth | Year: 2014

Background: Male partner participation is a crucial component to optimize antenatal care/prevention of mother to child transmission of HIV(ANC/PMTCT) service. It creates an opportunity to capture pregnant mothers and their male partners to reverse the transmission of HIV during pregnancy, labour and breast feeding. Thus involving male partners during HIV screening of pregnant mothers at ANC is key in the fight against mother to child transmission of HIV(MTCT). So, the aim of this study is to determine the level of male partner involvement in PMTCT and factors that affecting it.Methods: A Cross-sectional study was conducted among 473 pregnant mothers attending ANC/PMTCT in Mekelle town health facilities in January 2011. Systematic sampling was used to select pregnant mothers attending ANC/PMTCT service after determination of the client load at each health facility. Clinic exit structured interviews were used to collect the data. Finally multiple logistic regression was used to identify factors that affect male involvement in ANC/PMTCT.Results: Twenty percent of pregnant mothers have been accompanied by their male partner to the ANC/PMTCT service. Knowledge of HIV sero status [Adj.OR (95% CI) = 0.43 (0.18- 0.66)], maternal willingness to inform their husband about the availability of voluntary counselling and testing services in ANC/PMTCT [Adj.OR (95% CI) =3.74(1.38-10.17)] and previous history of couple counselling [Adj.OR (95% CI) =4.68 (2.32-9.44)] were found to be the independent predictors of male involvement in ANC/PMTCT service.Conclusion: Male partner involvement in ANC/PMTCT is low. Thus, comprehensive strategy should be put in place to sensitize and advocate the importance of male partner involvement in ANC/PMTCT in order to reach out male partners. © 2014 Haile and Brhan; licensee BioMed Central Ltd.


Fikre A.A.,Clear Impact Consult CIC | Demissie M.,Addis Continental Institute of Public Health
Reproductive Health | Year: 2012

Background: Giving birth in a medical institution under the care and supervision of trained health-care providers promotes child survival and reduces the risk of maternal mortality. According to Ethiopian Demographic and Health Survey (EDHS) 2005 and 2011, the proportion of women utilizing safe delivery service in the country in general and in Oromia region in particular is very low. About 30% of the eligible mothers received Ante Natal Care (ANC) service and only 8% of the mothers sought care for delivery in the region. The aim of this study is to determine the prevalence of institutional delivery and understand the factors associated with institutional delivery in Dodota, Woreda, Oromia Region. Methods. A community based cross sectional study that employed both quantitative and a supplementary qualitative method was conducted from Jan 10-30, 2011 in Dodota Woreda. Multi stage sampling method was used in selection of study participants and total of 506 women who gave birth in the last two years were interviewed. Qualitative data was collected through focus group discussions (FGDs). Data was entered and analyzed using EPI info 3.5.1 and SPSS version 16.0. Frequencies, binary and multiple logistic regression analysis were done, OR and 95% confidence interval were calculated. Results: Only 18.2% of the mothers gave birth to their last baby in health facilities. Urban residence, educational level of mothers, pregnancy related health problems, previous history of prolonged labour, and decision made by husbands or relatives showed significant positive association with utilization of institutional delivery services (P < 0.05). While ANC attendance during the index pregnancy did not show any association. Conclusion: Institutional Delivery is low. Increasing accessibility of the delivery services and educating husbands not only mothers appear very important factors in improving institutional delivery. Health education on the importance of institutional delivery should also address the general population. The quality and content of the ANC services need to be investigated. © 2012 Fikre and Demissie; licensee BioMed Central Ltd.

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