Correction: Predictors of relapse of acute malnutrition following exit from community-based management program in Amhara region, Northwest Ethiopia: An unmatched case-control study.

[This corrects the article DOI: 10.1371/journal.pone.0231524.].

Comparison of Mid-Upper-Arm Circumference and Weight-For-Height Z-Score in Identifying Severe Acute Malnutrition among Children Aged 6-59 Months in South Gondar Zone, Ethiopia.

Children with severe acute malnutrition (SAM) are identified for admission to outpatient therapeutic programs using mid-upper-arm circumference (MUAC) or weight for height (WHZ). However, MUAC and WHZ do not identify the same children, and such observed differences might have programmatic implications of missed nutrition therapy if only MUAC is used to identify children with SAM. The objective of the study was to assess any difference in prevalence and degree of agreement between MUAC and WHZ in identifying SAM affected children. A cross-sectional study was conducted in South Gondar Zone, Ethiopia, among 17 districts, with 3 districts and 10 health centers with their clustered health posts selected randomly. A total of 2,040 children were recruited, and data were collected using a parent questionnaire then entered into EpiData and analyzed using SPSS v 20. A total of 1,980 respondents (97.1%) were interviewed, all of whom were female and rural residents. Children's mean age in months was 23.2 (SD ± 9.7), and 54% were male children. The prevalence of SAM based on MUAC <11.5 cm was 11.2% (95% CI: 9.9-12.7) and 11.0% (95% CI: 9.7-12.5) based on WHZ <-3. The agreement between MUAC and WHZ was good (k = 0.729). The proportion of children with SAM identified using both MUAC and WHZ was 61.2%. The prevalence of SAM identified using both MUAC and WHZ was comparable. A substantial degree of agreement between MUAC and WHZ was observed to diagnose SAM. Therefore, MUAC can be used as an appropriate tool in identifying children with SAM for admission into the outpatient therapeutic program (OTP) in the study area.

Determinants of HIV-malaria co-infection among people living with HIV on anti-retroviral therapy in Northeast Ethiopia: unmatched case control study.

BACKGROUND: HIV and malaria are the leading causes of morbidity and mortality in the developing world including Ethiopia. Globally, HIV-malaria co-infection causes approximately 3 million deaths per year. However, both these infections are preventable if measures are taken on determinant factors. The objective of the study was therefore to assess factors associated with HIV-malaria co-infection among HIV-positive people who lived in Shewarobit district, northeast Ethiopia. METHODS: Unmatched case-control study was conducted among people living with HIV (PLWHA) in Shewarobit district from February 28, 2018, to April 30, 2018. The sample size was determined taking the assumption of 95% CI, 85% power, 3:1 control to case ratio, the proportion of PLWHA-malaria coinfection of 22.7%, OR 2.73, and 10% non-response rate. The final sample size was 262 (66 cases and 196 controls). Cases were adults on anti-retroviral therapy and diagnosed positive for malaria by microscopy while controls were adults on anti-retroviral therapy and diagnosed negative for malaria by microscopy in the previous 6 months before the survey. RESULT: The median age of cases and controls in years was 35 (IQR = 19) and 38 (IQR = 19) respectively. Variables that had a significant association with HIV-malaria co-infection were non-in-door residual spraying (adjusted odds ratio (AOR) = 4.91; 95% CI 4.03, 15.13), poor perception on the health risk of HIV-malaria co-infections (AOR = 4.11; 95% CI 1.28, 10.17), non-use of insecticidal treated bed nets (AOR = 6.21; 95%CI 2.74, 14.11), non-use of cotrimoxazole prophylaxis (AOR = 2.42; 95% CI 1.11, 5.28), and not received health education on the risk of HIV-malaria interaction (AOR = 4.11; 95% CI 1.24, 4.84). CONCLUSION: Provision of cotrimoxazole prophylaxis, sleeping under an insecticidal treated bed net, and indoor residual spraying help to reduce HIV-malaria co-infection-associated morbidity/mortality.

Predictors of relapse of acute malnutrition following exit from community-based management program in Amhara region, Northwest Ethiopia: An unmatched case-control study.

BACKGROUND: Community-based management of acute malnutrition (CMAM) is an effective program to manage children with acute malnutrition, including both severe and moderate acute malnutrition. However, little is known about continued child nutritional status after discharge from community based management of acute malnutrition programs in Ethiopia. OBJECTIVE: The study aimed to identify factors associated with relapse of acute malnutrition among children 6-59 months after been discharged recovered from community based management program in South Gondar Zone, Northwest Ethiopia. METHODS: A case-control study was conducted in three districts of South Gondar Zone by tracing children age 6-59 months who were reported as recovered from the community based management program. Sample size calculated for the first objective of assessing prevalence of severe acute malnutrition among children following discharge as recovery using Epi- Info version 7.1.3.3 StatCalc taking 95% CL, 17.8% post discharge relapse (Ashraf H, et al. (2012), 3% margin of error, design effect of 2 and adding 5% non-response rate was the largest sample size and used to this study. Children with Mid Upper Arm Circumference (MUAC) <12.5cm constituted cases and children with > = 12.5cm served as controls. Data were collected from 10 November 2017 to 30 January 2018 using a survey questionnaire and families were asked to bring children to a health facility for anthropometric measurements, following which data were entered and analyzed. Bivariate and multivariable logistic regression models were utilized to measure association between the risk factors and acute malnutrition. RESULTS: Overall, 1,273 participants were interviewed. The mean age in months of children was 23.1 (±9.1 SD) for cases and 23.1 (±8.9 SD) for controls. About 40% of the cases and 50% of the controls were female children. The factors associated with acute malnutrition were: male children (AOR = 1.84, 95% CI: 1.42-2.39), living in a food insecure household (AOR = 1.67, 95% CI:1.15-2.44), non-receipt of Vitamin A supplement (AOR = 1.76, 95% CI: 1.28-2.41), prelacteal feeding (AOR = 2.81 (95%CI, 1.57-5.05), distance to water source more than 15 walk (AOR = 1.88, 95% CI:1.32-2.71), less frequent self-reported hand washing (AOR = 1.35, 95% CI:1.05-1.75), mother not having consumed extra food during this pregnancy/lactation (AOR = 1.36, 95% CI: 1.03-1.78), and respondent age above 30 years (AOR = 1.43, 95% CI:1.10-1.87). CONCLUSION: The key factors contributing to relapse of acute malnutrition were related to childcare and feeding practices. Social and behavior change communication strategies targeting families at risk of undernutrition, along with improved food security and integrated programming are recommended to prevent relapse of acute malnutrition.

Correlates of postpartum common mental disorders: results from a population-based study in Amhara region, Ethiopia.

Postpartum common mental disorders are prevalent among women in Ethiopia. Data on associated factors are limited. This population-based study assessed mental health among 1294 nonpregnant, postpartum women in Amhara region. Poor health of the last delivered child and inequitable gender attitudes were associated with poor mental health among other factors. Social support from female friends was strongly protective. Community mental health services could strengthen social support between female friends with education and support group facilitation by health extension workers.

Prevalence and correlation of hypertension among adult population in Bahir Dar city, northwest Ethiopia: a community based cross-sectional study.

BACKGROUND: Hypertension is one of the most common causes of premature death and morbidity and has a major impact on health care costs. It is an important public health challenge to both developed and developing countries. The aim of this study was to determine the magnitude and correlates of hypertension. METHODS: A community-based cross-sectional study was conducted in June 2014 among 681 adult residents of Bahir Dar city using multistage sampling techniques. An interview-administrated questionnaire and physical measurements such as blood pressure (BP), weight, height, and waist and hip circumferences were employed to collect the data. The data were coded, entered, and analyzed with SPSS version 16 software package. RESULTS: A total of 678 responses were included in the analysis resulting in a response rate of 99.6%. The findings declared that 17.6%, 19.8%, and 2.2% of respondents were prehypertension, hypertension stage I, and hypertension stage II, respectively, on screening test. The overall prevalence of hypertension (systolic BP ≥140 mmHg, or diastolic BP ≥90 mmHg, or known hypertensive patient taking medications) was 25.1%. According to the multivariate logistic regression analysis, age; having ever smoked cigarette; number of hours spent walking/cycling per day; number of hours spent watching TV per day; history of diabetes; adding salt to food in addition to the normal amount that is added to the food during cooking; and body mass index were statistically significant predictors of hypertension. CONCLUSION: One out of every four respondents of the study had hypertension, and more than one out of three cases of hypertension (38.8%) did not know that they had the hypertension; 17.6% of the respondents were in prehypertension stage, which adds to overall future risk of hypertension. Therefore, mass screening for hypertension, health education to prevent substance use, regular exercise, reducing salt consumption, and life style modifications are recommended.

Maternal mental health in Amhara region, Ethiopia: a cross-sectional survey.

BACKGROUND: Postpartum common mental disorders (CMD) such as depression and anxiety are increasingly recognized for their burden in low-resource countries such as Ethiopia. However, the magnitude of postpartum CMD in Ethiopia is not well-established. This short report describes the mental health status of women who had given birth in the last 24 months in the Amhara region of Ethiopia. METHODS: A cross-sectional survey was conducted among 1,319 women aged 15-49 years old who had a delivery in the previous 24 months from 30 randomly selected kebeles (smallest administrative unit in Ethiopia) across Amhara region. The survey included the Self-Reporting Questionnaire (SRQ-20) developed by the World Health Organization-a CMD screening instrument that includes 20 yes/no questions on depression, anxiety, and somatic symptoms experienced in the last 30 days. We used 2 cutoff scores to determine probable cases of mental disorder: (1) 4/5 (≤ 4 "yes" responses=non-case, ≥ 5 "yes" responses=case) based on a study that validated the SRQ-20 against a diagnostic tool in Butajira, Ethiopia, and (2) a more conservative and commonly used 7/8 cutoff. RESULTS: Among the 1,294 women who completed the full survey including the SRQ-20, 32.8% had probable CMD using the 4/5 cutoff score versus 19.8% using the more conservative 7/8 cutoff. About 15% of the women responded affirmatively that they had had suicidal thoughts. CONCLUSION: Poor mental health was common among the surveyed women who had given birth in the past 24 months in Amhara region, Ethiopia. Integrating mental health care into maternal and child health services could potentially alleviate the burden of CMD among women in the extended postpartum period.