Community food beliefs during pregnancy in rural kebeles of Ofla Woreda, Northern Ethiopia: an explorative qualitative study.

BACKGROUND: Dietary related misconceptions during pregnancy affect the heath of mothers and their growing babies. Misconceptions vary from place to place and from community to community. Understanding of a given community's food perceptions during pregnancy helps policy makers able to design cultural appropriate interventions. In Ethiopia, however, evidences on food beliefs and perceptions during pregnancy are limited. Therefore, this study is aimed at qualitatively assessing community food beliefs during pregnancy in rural kebeles of Ofla Woreda, Northern Ethiopia. METHODS: We conducted 10 in-depth interviews (n = 10) and four focus group discussions (n = 32) among purposively selected community groups including pregnant mothers, religious leaders, and elders in rural kebeles of Ofla Woreda, Northern Ethiopia. Data were transcribed word-for-word, translated into English, and uploaded into ATLAST ti version 7.5.1.6. Data were analyzed following the principles of thematic analysis. Line-by-line coding was applied to identify codes; identified codes were categorized based on their similarities and differences and themes were developed inductively. RESULTS: Three main themes were identified inductively; foods positively and negatively linked with pregnancy; perceived benefits and harms of alcoholic drinks during pregnancy; and religion and fasting. In this study, consumptions of animal source foods such as egg were discouraged because such foods were perceived to increase the risk of having big baby that could delay delivery. However, intakes of locally produced alcoholic drinks during pregnancy were encouraged by the local community. Furthermore, avoidance of animal source foods and meal skipping during religious fasting-periods were also common practices among pregnant mothers in the study area. CONCLUSIONS: This study explored misconceptions on food intakes during pregnancy. Positive attitude towards intake of "soft" alcoholic drinks might result in alcohol related teratogenic effects. Restriction on the intakes of nutrient rich diets due to religious fasting and other misconceptions would lead to insufficient nutrient intake both to the mothers and their growing fetus. Culturally appropriate intervention to improve awareness on healthy dietary intake during pregnancy is needed.

Association of anthropometric indices of obesity with hypertension among public employees in northern Ethiopia: findings from a cross-sectional survey.

OBJECTIVES: The burden of hypertension is increasing in low-income countries, including Ethiopia. Obesity is widely known to be associated with hypertension, but different anthropometric indices of obesity might differ in association with hypertension, which is largely unknown in northern Ethiopia. DESIGN: Data from our previous cross-sectional epidemiological survey were statistically analysed. SETTING: Public employees in the regional capital city in northern Ethiopia. PARTICIPANTS: The data of 1380 participants (823 men and 557 non-pregnant women) aged 25 and 64 years were analysed. OUTCOME MEASURES: The presence of hypertension was the outcome measure and multivariable-adjusted logistic regression analyses were used to investigate the association of body mass index (BMI), waist circumference, and waist-hip ratio in men and women separately. The area under the curve (AUC) for three anthropometric indices for discriminating hypertension was also obtained. Separate analyses were conducted for waist circumference and waist-hip ratio analyses further adjusted for BMI. RESULTS: BMI was linearly associated with hypertension in men (OR for 1 SD increase in BMI 1.45, p=0.001) and women (OR for 1 SD increase in BMI 1.41, p=0.01). The association of waist circumference was independent of BMI both in men (OR for 1 SD increase in waist circumference: 1.74, p=0.002) and women (OR for 1 SD increase in waist circumference: 1.57, p=0.029). The association of waist-hip ratio with hypertension adjusted for BMI was significant in men (OR for 1 SD increase in the waist-hip ratio: 1.46, p<0.001), but was weak and non-significant in women. The AUC for BMI was 0.64 in men and 0.67 in women, while AUC for waist circumference was 0.69 both in men and women. CONCLUSIONS: Waist circumference was associated with hypertension independent of BMI among public employees in northern Ethiopia.

Factors Associated With Prediabetes and Diabetes Among Public Employees in Northern Ethiopia.

The increasing burden of diabetes mellitus is one of the major public health challenges in African countries, including Ethiopia. This is the first study aimed to identify factors associated with prediabetes and diabetes defined by both fasting blood glucose and glycated hemoglobin in Ethiopians. We analyzed data of a cross-sectional survey (1372 adults aged 25-64 years) conducted between October 2015 and February 2016; multinomial logistic regression models were applied. Abdominal obesity, total cholesterol, and non-high-density lipoprotein cholesterol were independently associated with prediabetes and diabetes in both sexes. Increased triglycerides and religious fasting practices were independently associated with prediabetes and diabetes only in men; hypertension was associated with prediabetes and diabetes only in women, while high-density lipoprotein cholesterol was not associated with prediabetes and diabetes in either sex. Sex differences in the association of triglycerides, hypertension, and dietary habit suggest that different approaches of lifestyle modification may be required for men and women.

Food taboos and related misperceptions during pregnancy in Mekelle city, Tigray, Northern Ethiopia.

INTRODUCTION: Most communities, rural or urban, have taboos regarding foods to avoid during pregnancy, and most have local explanations for why certain foods should be avoided. Such taboos may have health benefits, but they also can have large nutritional and health costs to mothers and fetuses. As such, understanding local pregnancy food taboos is an important public health goal, especially in contexts where food resources are limited. Despite this, information regarding food taboos is limited in Ethiopia. Therefore, this study assessed food taboos, related misconceptions, and associated factors among pregnant women in Northern Ethiopia. METHODS: A cross-sectional study of 332 pregnant women in antenatal care (ANC) follow-up at selected private clinics in Mekelle city, Tigray, Ethiopa, recruited between April and May, 2017. Using a semi-structured questionnaire, we assessed whether respondents' observed food taboos, what types of foods they avoided, their perceived reasons for avoidance, diversity of respondents' diets during pregnancy, and respondents' socio-demographic characteristics. After reporting frequency statistics for categorical variables and central tendencies (mean and standard deviation) of continuous variables, bivariate and multivariable logistic regression analyses were conducted to identify the socio-demographic factors and diet diversity associated with food taboo practices. RESULTS: Around 12% of the pregnant women avoided at least one type of food during their current pregnancy for one or more reasons. These mothers avoided eating items such as yogurt, banana, legumes, honey, and "kollo" (roasted barley and wheat). The most common reasons given for the avoidances were that the foods were (mistakenly) believed to cause: abortion; abdominal cramps in the mother and newborn; prolonged labor; or coating of the fetus's body. Maternal education (diploma and above) (AOR: 4.55, 95% CI: 1.93, 10.31) and marital status (single) were found to be negatively associated (protective factors) with observances of pregnancy food taboos. Approximately 79% of respondents had pregnancy diets that were insufficiently diverse, although we did not find any statistical evidence that this was associated with adhering to food taboos. CONCLUSION: The misconceptions related to pregnancy food taboos should be discouraged insofar as they may restrict women's consumption of nutritious foods which could support maternal health and healthy fetal development. Health providers should counsel pregnant women and their husbands about appropriate pregnancy nutrition during ANC visits.

Prevalence and determinants of modern contraceptive utilization among women in the reproductive age group in Edaga-hamus Town, Eastern zone, Tigray region, Ethiopia, June 2017.

INTRODUCTION: All individuals and couples have a basic human right to decide freely and responsibly the number, spacing, and timing of their child. However, In Ethiopia, the prevalence of contraceptive utilization remains low and it varies in different regions. Therefore, this study was aimed to determine prevalence and determinant factors affecting the utilization of modern contraception in the reproductive age group (15-49 years) in Edaga-Hamus Town. METHODOLOGY: A community based Cross-Sectional study was carried out on April 23 to May 10, 2017. A systemic random sampling method was used to select study participants. Information was collected using a structured, pre-tested questionnaire. The data were entered into EPI-info version 7.1 and imported to SPSS version 20. Summary statistics and logistic regression analysis were performed using SPSS version 20. Those variables having a P-value of less than 0.2 in the bivariable analysis were fitted in multivariable analysis. AOR with 95% CI and P-value<0.05 were used during multivariable analysis to identify the factors associated with the utilization of modern in reproductive. RESULT: In this study the overall prevalence of modern contraceptive utilization was 58.5%. Age (AOR = 0.406,95%,Cl: (0.000,0.398)), Educational status (AOR = 0.901,95% Cl (0.340,4.107)), Feeling of husband towards Modern contraceptive (AOR = 0.186, 95% CI (0.056,0.617) had protective effect of utilization of modern contraceptive. But Number of children 1-3 and 4-5 wanted(AOR = 10.802,95%(4.027,28.975)), AOR = 2.624,95% CI (1.437,4.791), was a risk for utilization of modern contraceptive. CONCLUSION AND RECOMMENDATION: The prevalence of Modern contraceptive utilization was still to be low (far below the national target). Therefore, providing educational opportunities, creating awareness about contraception and effective counseling would increase modern contraceptive methods utilization.

Factors affecting utilization of cervical cancer screening services among women attending public hospitals in Tigray region, Ethiopia, 2018; Case control study.

BACKGROUND: Incidence and mortality of cervical cancer is the leading cancer among women in Ethiopia. Absence of effective detection methods and treatment strategies is a major reason for the sharply rising cervical cancer rates in developing countries. OBJECTIVE: To determine factors affecting utilization of cervical cancer screening services among women attending public hospitals in Tigray region in 2018. METHODS: Hospital based unmatched case control study was applied with sample size of 312 cases and 312 controls. Data was entered to Epi data version 3.1 and exported to SPSS version 20. The odds ratio with their 95% confidence interval, two-tailed P value was calculated. Variables with P value ≤ 0.05 in the bivariate analysis were included in the multivariate logistic regression model. RESULTS: Being in the age group of 30-39 and 40-49 years were two and four times more likely to utilize cervical cancer screening than those who were 21-29 years (AOR = 2.15 95%CI:1.11, 4.17 and AOR = 3.86 95%CI:1.48, 10.06) respectively. Current occupation with governmental and private employee were four and three times more likely to utilize the screening service than those housewife respectively (AOR = 3.85 95%CI: 1.87, 7.92 and AOR = 3.17 95%CI: 1.31, 7.66). Having ever given birth and history of multiple sexual partners were more likely to utilize the screening service (AOR = 2.57 95%CI: 1.02, 6.50) and (AOR = 2.65 95%CI: 1.10, 6.40) respectively. CONCLUSIONS: There is a need to strengthen policy and guidelines on cervical cancer screening among women particularly with regarding age group of 21-29, current occupation with housewife, single sexual partner and null parity. All stakeholders should give priority on the promotion and initiation of women to acquired good knowledge and attitude on cervical cancer screening.

Perception and practice of 'healthy' diet in relation to noncommunicable diseases among the urban and rural people in northern Ethiopia: a community-based qualitative study.

Dietary habits are related to the risks of noncommunicable diseases (NCDs), such as cardiovascular disease and diabetes, of which burdens are increasing in low-income countries including Ethiopia. Although several epidemiological studies of NCD risk factors were conducted in Ethiopia, qualitative studies on people's dietary habit in relation to NCDs have not been conducted yet. This study aims to describe people's perception and practice of 'healthy' diet, and barriers to practice 'healthy' diet, paying attention to the dynamics between the perception and practice. We conducted 16 key informant interviews and eight focus group discussions in an urban and a rural areas in northern Ethiopia between November 2014 and January 2016. Audio-records in local language were transcribed word-for-word, and translated into English. English text data were analyzed qualitatively, through constant comparative analysis following the principles of the grounded theory. Three themes have emerged: (1) dietary habit perceived as 'good' or 'bad' for health; (2) reasons for continuing current 'unhealthy' dietary habit; and (3) current dietary habit perceived as 'traditional.' People's practice was mostly consistent with their perception, while they sometimes practiced contrary to the perception because of personal preference and physical or financial obstacles. People were often indifferent of health implications of their habitual dietary practice, such as drinking a lot of sweet coffee. We showed dynamics between perception and practice of 'healthy' diet among people in northern Ethiopia. It is needed to increase awareness of NCDs both among the urban and rural people and to improve the social environment for removing the obstacles.

Non-communicable disease risk factor profile among public employees in a regional city in northern Ethiopia.

The burden of non-communicable diseases (NCDs) is increasing in Ethiopia. This study aims to describe the prevalence of NCD risk factors of public employees in a regional city in northern Ethiopia. We conducted a cross-sectional epidemiological study targeting men and women aged 25-64 years employed by public offices in Mekelle. The prevalence was age-standardized to the Ethiopian 2007 population. Among the 1380 subjects (823 men and 557 women), 68.7% had less than 1 serving of fruits and vegetables per day, 41.0% were physically inactive, and 57.3% observed religious fast. The age-standardised prevalence of abdominal obesity was 29.3% in men and 58.5% in women, but that of metabolic syndrome was comparable between men (39.2%) and women (39.0%). The prevalence of diabetes was underestimated if only fasting blood glucose (FBG) was used for the diagnosis compared to combination of FBG and glycated haemoglobin (HbA1c) (6.7% in men and 3.8% in women vs. 12.1% in men and 5.6% in women). More than a quarter (26.1%) of men and 8.7% of women had estimated 10-year risk of cardiovascular disease of 10% or more. This study revealed the high prevalence of NCD metabolic risk factors among the urban public employees in the highland of Ethiopia.