Prevalence and Determinants of Premarital Sexual Practice among Youths in Ethiopia: Based on the Ethiopian Demographic and Health Survey Data.

Background: Premarital sexual practice becomes a common phenomenon among youths in Ethiopia. It is usually associated with unwanted pregnancies, abortions, and sexually transmitted diseases including HIV/AIDS. Objective: This study is aimed at assessing the magnitude and determinants of premarital sexual practice among Ethiopian youths. Methods: A community-based cross-sectional study was conducted in all regions of Ethiopia from January 18 to June 27, 2016. A total of 7389 youths with the age range from 19 to 24 were included in the present study. Bivariable and multivariable binary logistic regression analyses were employed to identify factors associated with premarital sex. A 95% CI and p value < 0.05 were used to declare statistical significance. Result: The prevalence of premarital sexual practice was 10.8% (95% CI, 10%-11.5%). Being in the age group of 20-24 (AOR = 3.6, 95% CI (2.8, 4.6)), male sex (AOR = 1.7, 95% CI (1.3, 2.2)), employed (AOR = 1.4, 95% CI (1.03, 1.8)), from pastoral region (AOR = 1.4, 95% CI (1.3,2.4)), having mobile phone (AOR = 1.7, 95% CI, (1.3, 2.3)), ever use of internet (AOR = 1.8, 95% CI (1.3, 2.5)), ever drinking alcohol (AOR = 2.4, 95% CI (1.7, 2.5)), ever chewed khat (AOR = 2.4, 95% CI (1.6, 3.5), and ever tested for HIV (AOR = 1.3, 95% CI (1.1,1.6)) were statistically significant factors associated with premarital sex. Conclusion: For every 10 youths, at least one of them had sexual intercourse before they got married. Being in the age group of 20-24, male sex, employed, from a pastoral region, having a mobile phone, ever use of the internet, alcohol drinking, khat chewing, and ever tested for HIV were important factors affecting premarital sex. Thus, national sexual education and reproductive health behavior change interventions should give due attention to those groups. Furthermore, adequate education should be given about premarital sexual intercourse when youths come for HIV tests.

A qualitative study of perception related to risky driving behavior in Debre Markos City, North West Ethiopia, 2021.

BACKGROUND: About 1.35 million deaths and around 50 million injuries are attributed to road traffic crashes every year in the world. In Ethiopia, road traffic crashes contributed to a fatality rate of 37 per 100,000 populations per year, and 83% of traffic crashes were attributed to risky driving behavior. This study aimed to explore perceptions related to risky driving behavior among public transport vehicle drivers in Debre Markos City, North West Ethiopia, in 2021. METHODS: A generic qualitative study was conducted from August 05- September 15, 2021. A total of 17 participants (10 drivers, 4 drivers' training school instructors, and 3 traffic police officers) were selected by a purposive heterogeneous sampling technique. An open-ended interview guide was used during the interview, and all interviews were audio recorded. Data collected in the local language was transcribed verbatim and translated into English. The ATLAS-TI version 7.5 software was used to code the data, and finally, thematic analysis was done. RESULT: Four themes were identified. The first theme was "transport safety rule and enforcement problem," which includes gaps in the transport safety rule itself and gaps in the implementation of the rule. The second theme was "Drivers' training curriculum and application gaps," which focuses on gaps in the training curriculum and its application during recruitment, training, and examination of trainees. The third theme was "technical and financial problems". This theme includes problems related to the vehicles' technical issues and the appropriateness of transport tariffs. The final theme was "passenger and vehicle owners' related problems". This theme is about the influence of passengers' and vehicle owners' practices on drivers' risky driving behavior. CONCLUSION: Revising transport safety rules and strictly following the implementation of the drivers' training curriculum and transport safety rules should be given due attention. In addition, behavior change communications tailored to drivers and vehicle owners could be beneficial in reducing risky driving behaviors.

Youth friendly reproductive health service utilization and its associated factors among secondary school students, East Belesa district, northwest, Ethiopia, 2022.

BACKGROUND: Youths are people aged between 15 and 24 years. Globally, there were 37.7 million people living with HIV/AIDS, and 90% occur among youths. Despite enormous efforts made in Ethiopia to improve the reproductive health of the youth the utilization is still low. There is no study conducted on YFRHS utilization and associated factors among youths in East Belesa. Therefore, this study is aimed to assess YFRHS utilization and its associated factors among secondary school youths in East Belesa district. OBJECTIVE: To assess the prevalence of youth friendly reproductive health service utilization and associated factors among secondary school students in East Belesa district, Ethiopia, 2022. METHOD: Institution based cross-sectional study design was used with a total sample size of 347 youths in East Belesa schools from May 23 to June 12, 2022. Stratified simple random sampling was employed. Data were entered using EpiData and analyzed using Stata version 14. Descriptive statistics and Logistic regression were done to describe and identify factors associated with reproductive health services utilization. A P-value of less than 0.05 was considered to declare a level of significance. RESULTS: A total of 346 students participated in the study with a response rate of 99.8%.the magnitude of youth friendly reproductive health service utilization was 28.9% (24.3, 33.9). Being married (AOR = 0.27, 95%CI: 0.14, 0.52), mothers attended higher education (AOR = 1.40, 95%CI: 1.87, 4.95), availability (AOR = 2.58. 95%CI: 1.29, 5.16) and students who had never discussed about reproductive issues with their families (AOR = 0.18, 95%CI: 0.07, 0.49) were significantly associated with youth friendly service utilization. Therefore, behavior change communication interventions targeted at advancing mothers' knowledge, encouraging open discussion between parents and children, and enhancing the availability of youth friendly services are important to enhance youth friendly service utilization.

Knowledge of Fertile Period and Its Determinants Among Women of Childbearing age in Ethiopia: A Multilevel Analysis Based on 2016 Ethiopian Demographic and Health Survey.

Background: The knowledge of the fertile period is one of the science techniques used to delay pregnancy. Although it is a highly effective method, most women lack correct knowledge about it and end up with unintended pregnancies and undergo through unsafe abortion, which is among the leading factors for maternal death. Therefore, this study is aimed to assess the knowledge about fertile period and its determinant factors among reproductive age women in Ethiopia. Methods: The data were extracted from the 2016 national cross-sectional Ethiopian Demographic and Health Survey. The data were collected using a two-stage cluster design. Descriptive statistics were used to summarize the study findings. The determinants of knowledge about fertile period were analyzed using a multilevel binary logistic regression model. Results: A total of 15,683 women were included. From this, 23.6% (95% CI: 23-24) had knowledge about fertile period. Age group of 20-24 years, 25-29 years, 30-34 years, 35-39 years, 40-44 years, and 45-49 years; accomplishment of primary education, secondary education, and higher education; partner high level of education; wealth status of poorer, middle, richer, and richest; a person listened to radio < once a week; and a person who watch TV at least once in a week and who ever heard about family planning; internet usage in the last 12 months, being protestant religion follower; and community family planning message exposure were significantly associated with knowledge about fertile period. Conclusion: The number of reproductive age women who know about fertile period is low in Ethiopia. Age above 19 years, respondent's education attainment from primary to higher education, partner high level of education, being from poorer to richest wealth status, listening to radio, watching TV, ever heard of FP, internet usage in the last 12 months, being protestant religion follower, and community family planning exposure were significantly associated with good knowledge about fertile period.

Physical exercise and its associated factors among Ethiopian pregnant women: a cross-sectional study based on the theory of planned behavior.

INTRODUCTION: Women in Ethiopia prefer sedentary behavior and are physically inactive during pregnancy; this increases the risks of pregnancy-related complications. Therefore, this study aimed to assess physical exercise and its associated factors among pregnant women attending Antenatal Care at Debermarkose Referral Hospital, Northwest Ethiopia: using the theory of planned behavior. METHODS: An institution-based cross-sectional study was conducted from 23rd February to 10th June, 2020. A systematic random sampling technique was used to select 333 study participants. Data were collected with face-to-face interviews using a pretested structured questionnaire. Epi-info and STATA version 14.0 were used for data entry and analysis respectively. Multivariable linear regression analysis was done to identify the association between dependent and independent factors, and p < 0.05 was used as a cutoff to determine statistical significance at multivariable logistics regressions. RESULT: A total of 333 pregnant women were participated in this study with response rate of 98%. The proportion of variance (R2) in intention accounted for the factors was 0.79. The magnitude of intention to do physical exercise during the current pregnancy was 3.8 ± 2. primary level of education (ß = 0.43; 95% CI 0.25, 0.61), 2nd trimester gestational age (ß = 0.19; 95% CI 0.04, 0.33), 3rd trimester gestational age (ß = 0.17; 95% CI 0.02, 0.32), Attitude (ß = 0.34; 95% CI 0.19, 0.49), subjective norm (ß = 0.12; 95% CI 0.01, 0.23) and perceived behavioral control (ß = 0.45; 95% CI 0.33, 0.57) were significantly associated with pregnant womens' intention to do physical exercise during pregnancy period. CONCLUSION AND RECOMMENDATIONS: This study provided that the theory of planned behavior could be successfully applied to identify the factors related to the intention to do physical exercise during pregnancy The program designers who work on pregnancy better consider providing Information education and communication to change the attitude, work on influencing significant individuals and barriers and enabling factors.

Application of Health Belief Model for the assessment of COVID-19 preventive behavior and its determinants among students: A structural equation modeling analysis.

BACKGROUND: COVID-19 is a new pandemic that poses a threat to people globally. In Ethiopia, where classrooms are limited, students are at higher risk for COVID-19 unless they take consistent preventative actions. However, there is a lack of evidence in the study area regarding student compliance with COVID-19 preventive behavior (CPB) and its predictors. OBJECTIVE: This study aimed to assess CPB and its predictors among students based on the perspective of the Health Belief Model (HBM). METHOD AND MATERIALS: A school-based cross-sectional survey was conducted from November to December 2020 to evaluate the determinants of CPB among high school students using a self-administered structured questionnaire. 370 participants were selected using stratified simple random sampling. Descriptive statistics were used to summarize data, and partial least squares structural equation modeling (PLS-SEM) analyses to evaluate the measurement and structural models proposed by the HBM and to identify associations between HBM variables. A T-value of > 1.96 with 95% CI and a P-value of < 0.05 were used to declare the statistical significance of path coefficients. RESULT: A total of 370 students participated with a response rate of 92%. The median (interquartile range) age of the participants (51.9% females) was 18 (2) years. Only 97 (26.2%), 121 (32.7%), and 108 (29.2%) of the students had good practice in keeping physical distance, frequent hand washing, and facemask use respectively. The HBM explained 43% of the variance in CPB. Perceived barrier (ß = - 0.15, p < 0.001) and self-efficacy (ß = 0.51, p <0.001) were significant predictors of student compliance to CPB. Moreover, the measurement model demonstrated that the instrument had acceptable reliability and validity. CONCLUSION AND RECOMMENDATIONS: COVID-19 prevention practice is quite low among students. HBM demonstrated adequate predictive utility in predicting CPBs among students, where perceived barriers and self-efficacy emerged as significant predictors of CPBs. According to the findings of this study, theory-based behavioral change interventions are urgently required for students to improve their prevention practice. Furthermore, these interventions will be effective if they are designed to remove barriers to CPBs and improve students' self-efficacy in taking preventive measures.

Violence against girls during COVID-19 pandemic and associated factors in Gondar city, North West Ethiopia.

In Ethiopia, the magnitude of violence against girls during COVID-19 in the study area is not known. Therefore, this study aimed to assess the violence and associated factors during COVID-19 pandemic among Gondar city secondary school girls in North West Ethiopia. An institution-based cross-sectional study was conducted from January to February 2021. Data were collected from four public and two private Gondar city secondary schools. Investigators used stratified simple random sampling to select participants and the investigators used roster of the students at selected schools. Investigators collected the data using self-reported history of experiencing violence (victimisation). Investigators analysed data using descriptive statistics and multivariable logistic regression. Investigators invited a total of 371 sampled female students to complete self-administered questionnaires. The proportion of girls who experienced violence was 42.05% and psychological violence was the highest form of violence. Having a father who attended informal education (AOR = 1.95, 95% CI 1.08-3.51), ever use of social media 1.65 (AOR = 1.65, 95% CI 1.02-2.69), ever watching sexually explicit material (AOR = 2.04, 95% CI 1.24-3.36) and use of a substance (AOR = 1.92, 95% CI 1.17-3.15) were significantly associated variables with violence. Almost for every five girls, more than two of them experienced violence during the COVID-19 lockdown. The prevalence of violence might be under reported due to desirability bias. Therefore, it is better to create awareness towards violence among substance users, fathers with informal education and social media including user females.

Help-seeking behaviour and associated factors among women who experienced physical and sexual violence in Ethiopia: evidence from the 2016 Ethiopia Demographic and Health Survey.

BACKGROUND: Violence against women remains devastatingly pervasive and remained unchanged over the past decade. Violence against women is preventable and help-seeking of women subjected to violence is an entry point. So, this study assessed help-seeking behaviour and associated factors among women who experienced physical and sexual violence in Ethiopia. METHOD: Using the 2016 Ethiopia Demographic and Health Surveys (EDHS), this paper analyzes the determinants of help-seeking behavior of women subjected to violence in Ethiopia. EDHS used a two-stage stratified cluster sampling technique. From 642 communities, a total of 1540 (weighted) reproductive age women were included in the analysis. Simple descriptive, bivariable and multivariable logistic regression analysis were employed. Statistical significance was set at a p-value of less than 0.05. RESULTS: Only 22.5% of the women who experienced violence sought help. Being aged 30 and above, working in sales, or an agricultural job, being in the richest wealth quintile, and experiencing severe violence were associated with increased help-seeking behaviour. Living in a rural area, having a husband who attended primary, secondary, and higher education, having a husband working in a professional job and agriculture were factors associated with lower odds of help-seeking behaviour. CONCLUSION: In Ethiopia below one-fourth of women who were subject to violence sought help. Socio-demographic factors and severity of the violence were associated with help-seeking. Preventing child marriages and reducing poverty as well as increased employment and education for women enhance help-seeking behaviour by the women. Interventions could include creating awareness, law enforcement, and support for victims.

Acceptance and willingness to pay for COVID-19 vaccine among school teachers in Gondar City, Northwest Ethiopia.

BACKGROUND: Vaccination is one of the strategies to prevent the COVID-19 pandemic. COVID-19 vaccine acceptance and cost are important factors affecting its uptake. However, little is known about acceptance and willingness to pay (WTP) for the vaccine. OBJECTIVE: This study aimed to assess acceptance and WTP for the COVID-19 vaccine and its associated factors among school teachers. METHODS: An institution-based cross-sectional study was conducted among school teachers. A stratified simple random sampling technique was employed to select the participants. The contingent valuation method was used to assess each respondent's willingness to pay for the COVID-19 vaccination. A multivariable logistic regression analysis was employed to identify significant factors associated with WTP for the COVID-19 vaccine. A p value of less than 0.05 and a 95% confidence interval were used to declare statistical significance. RESULT: A total of 301 school teachers participated with a response rate of 99.6%. The mean age of participants was 39.5 (SD ± 8.7 years). The mean WTP for the COVID-19 vaccine is US$ 4.98 (± US$ 1.6). Less than half (40.8%) of participants were willing to accept the COVID-19 vaccine whereas only 36.9% (95% CI, (31.6%, 42.5%)) of them were WTP for the vaccine. Being male (AOR = 3.23; 95% CI, (1.70, 6.14)), being a private school teacher (AOR = 3.27; 95% CI, (1.76, 6.10)), having high perceived susceptibility to COVID-19 (AOR = 2.69; 95% CI, (1.38, 5.24)), having high perceived seriousness of COVID-19 (AOR = 4.04; 95% CI, (1.80, 9.1)), and having high perceived benefit of COVID-19 vaccine (AOR = 3.0; 95% CI, (1.41, 6.34) were significant factors associated with WTP for COVID-19 vaccination. CONCLUSION AND RECOMMENDATION: The magnitude of acceptance and WTP for the COVID-19 vaccine was low among school teachers. Male sex, private school affiliation, high perceived risk of COVID-19, and benefit of COVID-19 vaccine were the most important factors affecting school teacher's WTP for COVID-19 vaccine. Thus, health communication programs should give due emphasis to raising teacher's perceived risk of COVID-19 and the benefit of the COVID-19 vaccine to improve their acceptance and WTP for the vaccine. Furthermore, subsidizing the cost of the vaccine may improve their WTP.

Behavioral and Sociodemographic Determinants of Hypertension and Its Burden among Bank Employees in Metropolitan Cities of Amhara Regional State, Ethiopia.

BACKGROUND: Hypertension is the leading cause of cardiovascular disease and premature death worldwide. Bank workers are at higher risk of hypertension because of their work sedentary characteristics. However, little is known about the prevalence and determinants of hypertension among this group of population. Therefore, this study aimed to assess the prevalence and associated factors of hypertension among bank employees in metropolitan cities in Amhara Regional State of Ethiopia. METHOD: An institution-based cross-sectional study was conducted among 368 bank employees. A simple random sampling technique was used to select participants. A pretested self-administered questionnaire and biophysical measurements were employed to collect the data. Descriptive statistics and logistic regression analyses were done to summarize the data and identify factors associated with hypertension, respectively. RESULT: The overall prevalence of hypertension among bank employees was 52.4% (95% CI: 47.2, 57.7). Increased age (AOR = 1.1, 95% CI: 1.03, 1.11), male sex (AOR = 2.5, 95% CI: 1.2, 5.1), overweight (AOR = 2.7, 95% CI: 1.5, 5.2), obesity (AOR = 5.6, 95% CI: 2.0, 11.3), moderate/high physical activity (AOR = 0.36, 95% CI: 0.2, 0.62), daily fruit intake (AOR = 0.1, 95% CI: 0.04, 0.3), stressful life event experience (AOR = 1.8, 95% CI: 1.01, 3.4), family history of hypertension (AOR = 2.8, 95% CI: 1.5, 5.4), and poor knowledge of CVDs (AOR = 2.4, 95% CI: 1.2, 4.8) were significantly associated with hypertension. CONCLUSION: The prevalence of hypertension among bank workers was very high. Increased age, male sex, overweight and obesity, daily fruit intake, moderate/high physical activity, the experience of stressful events, familial history of hypertension, and poor CVDs knowledge were associated with hypertension. Thus, raising awareness about cardiovascular disorders and behavior change interventions that enhance bank workers' engagement in physical exercise, screening behavior, and a healthy diet is urgently required for this group of population.

Determinant of intention to receive COVID-19 vaccine among school teachers in Gondar City, Northwest Ethiopia.

BACKGROUND: Scientists across the world are working on innovating a successful vaccine that will save lives and end COVID-19 pandemic. World Health Organization (WHO) is working to make sure COVID-19 vaccines can be safely delivered to all those who need them. Indeed, the successful deployment and a sufficient uptake of vaccines is equally important. Acceptance and accessibility of such vaccine is a key indicator of vaccination coverage. OBJECTIVE: This study aimed to assess the determinants of intention to receive COVID-19 vaccine among school teachers in Gondar City. METHODS: An institution based cross-sectional study was conducted from December, 2020 to January, 2021. A total of 301 school teachers selected using stratified simple random sampling were included. Descriptive analysis such as medians, means, proportions, standard deviations and frequencies were computed. Linear regression analysis was done to identify factors associated with intention to receive COVID-19 vaccine. A p-value of less than 0.05 was used to declare statistical significance. RESULTS: The median intention to receive COVID-19 vaccine was 3.33 with interquartile range of 2.67-4.0. Of the participants 54.8% had scored above the median of intention to receive COVID-19 vaccine score. 54% variance in intention to receive COVID-19 vaccine was explained by the independent variables. Being affiliated with other category of religion, bachelor degree educational status, perceived susceptibility, perceived benefit, perceived barrier, and cues to action were significantly associated with the intention to receive COVID-19 vaccine. CONCLUSION: The median score of intention to receive COVID-19 vaccine was 3.33. Socio-demographic and health beliefs influenced the intention to receive the COVID-19 vaccine in the study participant. Policy makers and stakeholders should focus on strong health promotion about risks of the pandemic, benefit, safety, and efficacy of vaccination.

Intention to use institutional delivery service and its predictors among pregnant women, North West Ethiopia: Using theory of planned behavior.

BACKGROUND: Improving institutional delivery service is the most crucial strategies to reduce maternal and neonatal mortalities. In developing countries, only 50% of pregnant women deliver in health facilities and in Ethiopia only 48% of pregnant women deliver in health facilities. Maternal mortality remains the highest in Ethiopia. This study assessed intention to use institutional delivery service and its predictors among pregnant women using theory of planned behavior. METHODS: Community-based cross-sectional study was conducted among 645 Yilmana Densa District Pregnant women using multi-stage followed by cluster sampling technique. Data were entered into Epi Data version 4.6.0.2 and analyzed with STATA version 14. Binary logistic regression analysis was done to identify independent predictors of intention at 95% confidence level and P < 0.05 was used to determine statistically significant predictors. RESULTS: Intention of pregnant women to use institutional delivery service was 74.3% (CI; 70.71%, 77.6%). In the multivariable logistic regression; those who had 1-3 and 4 &above antenatal care 2.85(1.41, 5.75) and 3.14(1.16, 8.45) respectively, those who had past experience of institutional delivery (AOR = 3.39, 95%CI: 1.72, 6.71), parity of 1-3 and 4 & above % (AOR = 0.37, 0.19, 0.71) and (AOR = 0.25, 95%CI: 0.12, 0.55) respectively, rural residence (AOR = 0.51, 95%CI: 0.27, 0.96), favorable attitude (AOR = 2.93, 95%CI: 1.56, 5.50), favorable perceived behavioral control (AOR = 2.60, 95%CI: 1.44, 4.69) were factors significantly associated with intention to use institutional delivery service. CONCLUSION AND RECOMMENDATION: Majority of the pregnant women were intended to deliver in the institution. Good Knowledge on institutional delivery, antenatal care visit, past experience of institutional delivery, rural residence, parity, attitude and perceived behavioral control were identified factors significantly associated with intention to use institutional delivery service. So, strengthening awareness creation and behavioral change communication programs are required at all levels of health system to raise intention of residents towards institutional delivery.

Determinants of COVID-19-related knowledge and preventive behaviours among students in reopened secondary schools: cross-sectional study.

PURPOSE: In Ethiopia, more than 26 million students have been out of the classroom for nearly 9 months. On 18 September, the Ethiopian Minister of Health advised the Parliament the possibility of reopening schools provided certain conditions were met. Schools are currently reopening in the country for the first time since March 2020. OBJECTIVE: This study assessed the knowledge and preventive health behaviours toward COVID-19 and associated factors among secondary school students. DESIGN, SETTING, PARTICIPANTS AND OUTCOME MEASURES: An institution-based cross-sectional study was conducted from October to December 2020 in Gondar city, Northwest Ethiopia. A total of 370 secondary school students were included. Bivariable and multivariable ordinal logistic regression model were fitted to identify the predictors of knowledge about COVID-19. Simple and multiple linear regression analysis were done to identify factors associated with preventive behaviour. A p<0.05 was used to declare statistical significance. RESULTS: Only one-fourth (23.5%, 95% CI 19.5% to 28.1%) of the participants had a good knowledge about COVID-19. The mean score of preventive behaviour was 22.8±SD 6.2. Marital status, religion, father education, living arrangement and sources of information were significantly associated with knowledge about COVID-19. Being female and using health professionals as source of information increased the engagement in preventive behaviours. On the other hand, student whose father employed in non-governmental organisation and other jobs had decreased engagement in preventive health behaviours. CONCLUSION: Significant number of the students had inadequate knowledge about COVID-19 and poorly engaged in COVID-19 preventive behaviour. Thus, it is suggested to include and disseminate about COVID-19 in related academic sessions, using school clubs and minimedias. The sources of COVID-19-related information need to strengthen the dissemination of tailored, credible and timely message to enhance the knowledge and engagement of the students in preventive behaviours.

Exploring spatiotemporal distribution of under-five mortality in Ethiopia: further analysis of Ethiopian Demographic and Health Surveys 2000, 2005, 2011 and 2016.

Objective: The aim of this study was to explore spatiotemporal distribution of under-five mortality in Ethiopia using data from four (2000, 2005, 2011 and 2016) consecutive demographic and health surveys. Methods: A total of 41 498 children were included from four consecutive Ethiopian Demographic and Health Surveys. The geospatial analysis was conducted by using ArcGIS V.10.7 and saTScan V.9.6. Thus, spatial autocorrelation, hotspot analysis, spatial interpolation and spatial scan statistics were carried out for each survey separately to show the temporal pattern of geographically risk areas of under-five mortality in Ethiopia. Finally, the most under-five mortality rate (U5MR) risk areas in each survey period were mapped. Results: Under-five mortality was spatially clustered in Ethiopia (Moran's Index: 0.046-0.096, p<0.01). The Benishangul-Gumuz region was consistently at a higher risk in the last two decades. Additional hotspot areas were detected at Afar and Amhara (in 2000, 2005, 2016), at Gambala (in 2011) and the South Nation Nationality and People's (SNNP) Region (in 2016). Moreover, 160 primary clusters were identified. Of these, 85 clusters (log-likelihood ratio (LLR)=13.10, p<0.01) were from Benishangul-Gumuz and Amhara regions (in 2000); 67 clusters (LLR=12.93, p<0.01) were from Afar and Amhara regions (in 2005); 4 clusters (LLR=10.54, p<0.01) were from Benishangul-Gumuz region (in 2011); and another 4 clusters (LLR=11.85, p<0.01) were from Afar region (in 2016). Conclusion: High-risk areas were detected mainly in the Benishangul-Gumuz and Afar regions. As a result, designing under-five population targeted intervention programmes in those high-risk geographical regions was vital to reduce under-five mortality in Ethiopia.

Smoking Intensity and Associated Factors among Male Smokers in Ethiopia: Further Analysis of 2016 Ethiopian Demographic and Health Survey.

BACKGROUND: Smoking invariably has health, social, economic, and environmental consequences in Ethiopia. Reducing and quitting cigarette smoking improves individual health and increases available household funds for food, education, and better economic productivity. Therefore, this study is aimed at assessing cigarette smoking intensity and associated factors among male smokers in Ethiopia. METHODS: The data were extracted from the 2016 national cross-sectional Ethiopian Demographic and Health Survey. Our study used data from the standardized and adapted men's questionnaire. The study included a total of 391 (weighted) smokers who at least smoked one manufactured cigarette per day. The data were collected using a two-stage cluster design which includes selection of enumeration areas and then selection of households. The number of manufactured cigarettes smokers smoked per day was used to measure smoking intensity. Descriptive statistics were used to summarize the study findings. Bivariable and multivariable truncated negative binomial Poisson regression models were employed to determine smoking intensity. RESULTS: The finding showed that on average men smoked weighted nine cigarettes per day. One in every five of the smokers (21.2%) smoked 10 cigarettes per day. Smokers living in rural areas (IRR = 0.43, 95% CI: 0.244, 0.756), currently married (IRR = 0.64, 95% CI: 0.46, 0.91), formerly married (IRR = 0.54, 95% CI: 0.30, 0.96), richer men (IRR = 0.63, 95% CI: 0.43, 0.90), and richest men (IRR = 0.49, 95% CI: 0.28, 0.87) were associated with lower smoking intensity. Smokers in the Somali (IRR = 2.80, 95% CI: 1.29, 6.11), Harari (IRR = 3.46, 95% CI: 1.14, 10.51), and Dire Dawa (IRR = 3.09, 95% CI: 1.23, 7.80) regions; older age (IRR = 1.77, 95% CI: 1.31, 2.40); affiliated with Protestant religion (IRR = 1.81, 95% CI: 1.12, 2.92); poorer men (IRR = 1.64, 95% CI: 1.19, 2.27); watched television (IRR = 1.18, 95% CI: 1.04, 1.35); drunk alcohol (IRR = 1.37, 95% CI: 1.03, 1.82); and completed primary (IRR = 1.15, 95% CI: 1.01, 0.317) and higher education (IRR = 2.96, 95% CI: 1.88, 4.67) were positively associated with smoking intensity. CONCLUSION: Male smokers in Ethiopia smoked intensively with an average of nine manufactured cigarettes per day. Tobacco control interventions should target the following: Eastern Ethiopia regions, older aged, affiliated with Protestant religion, poorer men, watched television, drunk alcohol, and primary and higher educational level.

Intention to donate blood and its predictors among adults of Gondar city: Using theory of planned behavior.

BACKGROUND: Blood transfusion is a lifesaving procedure when someone encounters severe anemia, accident or injury, surgery, heavy bleeding during childbirth and cancer chemotherapy. The average blood donation rate of Africa is 4.7/1000 inhabitants and Ethiopia is among one of the countries with the lowest annual donation rate which is 0.8/1000 population. This study assessed intention to donate blood on adults of Gondar city administration using the theory of planned behavior. METHODS: A community-based cross-sectional study was conducted. The study was conducted on two randomly selected Gondar sub-cities using systematic sampling on a sample size of 524 adults. Epi Data version 3.0 and STATA version 14 were used for entry and analysis of data respectively. Multiple linear regression was carried out to see the association between intention and sociodemographic variables, past donation experience, attitude, subjective norm and perceived behavioral control and with 95% confidence interval and a p-value of less than 0.05 was used to detect statistical significance. RESULTS: A total of 515 respondents participated in the study giving a response rate of 98%. Most of the participants were females (66.4%) and the participants' age ranges from 18 to 65 years. The variance explained by the model was 49%. The mean intention to donate blood was 3.02±1.13. Direct perceived behavioural control (ß = 0.14, CI (0.04, 0.23)), direct subjective norm (ß = 0.11: CI (0.04, 0.17), direct attitude (ß = 0.03; CI (0.01, 0.06)) and past behaviour of blood donation (ß = 0.3; CI (0.07, 0.51) were significant predictor of intention. CONCLUSION: Theory of planned behavior could be successfully applied in determining adult's blood donation intention. Predictors of intention to donate blood were past experience of blood donation, direct subjective norm, direct perceived behavioural control and direct attitude. None of the external variables predict blood donation intention.

Practice of Blood Donation and Associated Factors among Adults of Gondar City, Northwest Ethiopia: Bayesian Analysis Approach.

BACKGROUND: Blood transfusion is an essential part of modern health care. In Ethiopia, it had been planned to collect 202,000 units of blood in 2016-2017, but the actual amount collected was 169,744. The Bayesian approach has an advantage in that estimation of model parameters is conducted based on posterior distribution. This study aimed to assess the practice of blood donation and associated factors among adults of Gondar city, northwest Ethiopia using Bayesian analysis. METHODS: A community-based cross-sectional study was conducted among 554 Gondar adults from February to March 2019. Bayesian binary logistic regression was conducted to assess the relationship between independent and dependent variables using Stata 15 with a 95% CI for statistical significance. RESULTS: A total of 515 were involved with a 97% response rate, among which 342 (66.4%) were females. Eighty (15.53%) had donated blood at least once in their lives. Men were more likely to donate blood (AOR 1.79, 95% CI 1.11-3.12), while those aged 18-24 years were 57% (AOR 0.43, 95% CI 0.15-0.89) less likely to give blood. Individuals with good knowledge (AOR 2.56, 95% CI 1.32-4.53) and favorable attitudes (AOR 1.86, 95% CI 1.01-3.06) were more likely to donate blood. CONCLUSION: The majority of the participants did not donate blood. Male sex, age 18-24 years, good knowledge, and favorable attitudes were statistically significant factors in blood donation. Intervention with females and younger age-groups should shall be better administered. Health education is required to increase knowledge and create a favorable attitudes among the community.