Male circumcision and its association with HIV infection and sexually transmitted diseases: evidence from 18 demographic and health surveys in sub-Saharan Africa

The study aimed to assess the association between male circumcision and HIV infection and STDs. The issue is controversial as various studies reported conflicting findings. A cross-sectional comparative study based on the secondary data of 18 Demographic Health Surveys (DHS); carried out in Sub-Saharan Africa starting from 2003; was conducted. From all surveys; information on 70 554 males aged 15 - 59 years was extracted. The association between male circumcision and HIV infection and STD symptoms (genital discharge or genital ulcer/sore) was assessed using binary logistic regression. Adjustment was made for sexual history and basic socio-demographic variables. The weighted prevalence of HIV among men 15 - 59 years was 3.1. In the bivariate analysis uncircumcised status was significantly associated with risk of HIV; with odds ratio (OR) of 4.12 (95 CI: 3.85 - 4.42). The association was even more significant (4.95 (95 CI: 4.57-5.36)) after adjustment for number of lifetime sexual partners and socio-demographic variables. The risk associated with uncircumcised status is significantly lower among younger men aged 15 - 29 years than those in 30 - 59-year age category. About 5.5 of the study subjects reported either genital discharge or genital sore/ulcer in the preceding 12 months of the surveys. Circumcision status was not significantly associated with either of the symptoms; with adjusted OR of 1.07 (95 CI: 0.99 - 1.15). The study concludes that there is a strong association between uncircumcised status and HIV infection. Hence; male circumcision can be considered as a possible way of reducing the spread of HIV infection in areas where the practice is rare. A comprehensive study to assess the association between circumcision and different types of STDs is recommended

Correlates of Anemia among Women of Reproductive Age in Ethiopia: Evidence from Ethiopian DHS 2005

Background:Globally; 41.8of pregnant women and 30.2of non-pregnant women are anemic. Previous studies which attempted to identify determinants of anemia among women of reproductive age reported conflicting findings. Objective: To assess the correlates of anemia among women of reproductive age in Ethiopia. Methods: A quantitative cross-sectional study carried out based on the secondary data of the Ethiopia Demographic Health Survey (EDHS) 2005. Data of a total of 5963 women of reproductive age were include in the analysis. Data were mainly analyzed using ANOVA and binary logistic regression. Result: The prevalence of anemia was 27.4(95CI: 26.3-28.5). Rural residence; poor educational and economic status; 30-39 years of age and high parity were key factors predisposing women to anemia. Lactating women and those who gave birth in the month of the interview had 1.3 (p = 0.000) and 2.2 (p = 0.012) times higher risk than their counterparts. Those not using contraceptive were 1.4 times (p = 0.02) more likely to develop anemia than current contraceptive users. The average Dietary Diversity Score (DDS) was only 4.01; and not more than 15of the respondents consumed iron rich foods in the preceding day of the survey. Respondents with low DDS and those who did not consume iron rich foods in the reference period had significantly higher risk of anemia with odds ratio of 1.3 (p = 0.01) and 1.3 (p = 0.002); respectively. Utilizing maternity services; taking iron and vitamin A supplement during pregnancy and postpartum period; respectively; didn't have a significant effect in reducing the burden of anemia. Recommendation: Family planning; economic and educational empowerment of women have affirmative inputs in combating anemia. A combination of nutrition; educational and livelihood promotion strategies should be instated to enhance dietary diversity. Maternal nutrition interventions should be integrated in a stronger manner into maternity services

Assessment of Vitamin A Supplementation Coverage and its Association with Childhood Illness in Boloso Sore Woreda; Welayta Zone; SNNP Region; Ethiopia

Background: Vitamin A plays vital role in the physiology of vision and immunity. Globally quarters of a billion children are Vitamin A deficient. Vitamin A supplementation of children and mothers during postpartum period is a key strategy to avert the deficiency. However the effect of Vitamin A supplementation on incidence of childhood illnesses is controversial. Objective: To assess the effect of Vitamin A supplementation on the reduction of common childhood illnesses; and to measure the coverage of vitamin A supplementation among children aged 6-59 months and mothers during postpartum period. Methods: A retrospective cohort study which involves comparison between Vitamin A supplemented and nonsupplemented children was conducted in Feb 2008 in Boloso Sore Woreda; Wolayta Zone; SNNPR. A total of 1601 children aged 6-59 months were selected using Probability Proportional to Size (PPS) sampling technique. Results: Vitamin A supplementation coverage among children (6-59 months) was 83.1and among women (in postpartum period) who had given birth in the preceding 12 months of the survey was 13.2. In comparison with the corresponding level in 2005; the coverage in the area has increased significantly (P0.05). Most of the vitamin A supplementation coverage was achieved through Enhanced Outreach Strategy. Vitamin A supplementation status was not significantly associated with history of Fever [AORCI 0.89-1.77)]; Cough or rapid breathing/difficulty in breathing [AOR=1.15 (95CI 0.77-1.72)]; Eye infection [AOR=1.22 (95CI 0.78-1.89)]; and Diarrhea [AOR=0.98 (95CI 0.64-1.52)]. Recommendations: The effect of Vitamin A supplementation on reduction of childhood illnesses should be assessed through longitudinal studies among Vitamin A deficient children