Determinants of incomplete child vaccination among mothers of children aged 12-23 months in Worebabo district, Ethiopia: Unmatched case-control study.

In nations like Ethiopia, vaccination rates are low despite being one of the most effective public health treatments to protect infants from common infectious diseases that can be prevented by immunization. In Worebabo District, the reasons of the underutilization of vaccination programs are poorly understood. Therefore, this study aimed to identify determinants of incomplete childhood vaccination in the study setting. Community based unmatched case-control study was carried out among 441 mothers of children aged 12-23 months old (147 cases and 294 controls) in Worebabo District, Ethiopia from March 1-April 30, 2020. Using a multistage sampling process, mothers were chosen. Health professionals were trained to collect data using a pre-tested standardized questionnaire. Data entered into Epi Info version 7.2 and put through statistical analysis in SPSS version 23. Binary logistic regression was performed to determine the odds ratio with a 95%CL. A p-value of under 0.05 was estimated statistically significant. The study found that older moms (>35 years old) were more likely than younger mothers to fail to properly immunize their children (AOR = 2.4, 95% CI: 1.09, 5.28). In addition, mothers with incomplete vaccinations had lower knowledge of the benefits of vaccination (AOR = 2.02, 95% CI: 1.20, 3.39), Negative attitudes towards immunization (AOR = 4.9, 95% CI: 2.82, 8.49), less access to prenatal care (AOR = 3.68, 95% CI: 1.58, 8.54), home delivery (AOR = 5.47, 95% CI: 2.58)., 11.58), absent home visits (AOR = 3.56, 95% CI: 1.69, 7.48), and longer time to reach vaccination site (>1 h) (AOR = 10.07)., 95% CI: 1.75, 57.79) were found associated with mother incomplete vaccination of the child. Mothers being older age, less access to antenatal care services, place of home delivery, longer time to reach vaccination site, negative attitude and poor knowledge towards the benefit of vaccination were associated with mothers' incomplete vaccination of the child. Therefore, health professionals should inform and counsel mothers about the advantages of childhood immunization as well as the consequences of incomplete or not vaccination of children at the time of the facility visit and by community health workers during the routine home visit.

Harvest and post-harvest handling practices associated with fumonisin B1 contamination in maize (Zea mays L.): dietary exposure and risk characterization in eastern Ethiopia.

Maize is the main staple food crop in the eastern part of Ethiopia. However, maize loss is a major issue due to fungal contamination especially at the post-harvest stage owing to inadequate handling practices. This study aimed to assess post-harvest handling and awareness against fungal development and fumonisin B1 (FB1) in maize and to calculate risk exposures of FB1. A total of 197 maize samples (grain and flour) were collected from five districts (Haramaya, Kersa, Meta, Oda Bultum, and Tullo). FB1 was detected using LC-MS/MS qTRAP. Exposure assessment was done based on the maize consumption rate per day in Ethiopia for different age groups (infants, children, and adults). Risk characterization depends on the margin of exposure (MoE) combined with the lower confidence limit of the benchmark dose level (BMDL). About 81% of farmers were not physically separating undamaged maize ears with damaged from either birds or fungi. Moreover, 100% were not using improved storage material. In storage samples, FB1 was detected as high as 1058 µg/kg ± 234 in the Kersa district while a minimum of 22.60 µg/kg ± 5.27 in Meta. In flour samples, the maximum FB1 (327 µg/kg) was detected from the Oda Bultum district. The maximum exposure of infants was estimated at Kersa (1131 µg/kg bw/day), followed by Oda Bultum (1073 µg/kg bw/day) and Haramaya (854 µg/kg bw/day). Overall, FB1 exposures ranged from 6.09 to 1131 µg/kg bw/day, which is 3 to 500 µg/kg bw/day higher than the maximum tolerable daily intake of 2 µg/kg bw/day recommended by the World Health Organization. The MoE ranged from 0.15 to 176, with infants being at higher risk than adults. The study highlights the urgent need to enhance growers' awareness and knowledge of good post-harvest practices to reduce mycotoxin contamination in maize. Further biomarker analysis must be pursued to determine the risk exposure assessment for different age groups in these areas with a priority for the Kersa district.

Factors associated with dyslipidemia and its prevalence among Awash wine factory employees, Addis Ababa, Ethiopia: a cross-sectional study.

BACKGROUND: Dyslipidemia is a highly prevalent and modifiable risk factor for atherosclerotic cardiovascular diseases. Though the problem is significant in Ethiopia, available data in this regard is very poor among alcoholic beverage industrial workers. This study aimed to assess factors associated with dyslipidemia and its prevalence among Awash wine factory employees in Addis Ababa, Ethiopia. METHODS: A cross-sectional study was conducted among 335 randomly selected employees of Awash wine factory, Addis Ababa, Ethiopia from January to February 2021. Data was collected by a face-to-face interview technique using the WHO STEPwise approach. Data were entered and analyzed using Epi Info 7 and SPSS version 26, respectively. Both bivariable and multivariable logistic regression analyses were performed to identify factors associated with dyslipidemia. All statistical tests were declared significant at p-value < 0.05. RESULTS: The overall prevalence of dyslipidemia was 67.8% (95% CI 62.5-72.7%). Elevated total cholesterol, elevated triglycerides, reduced high-density lipoprotein, and elevated low-density lipoprotein was found in 25.4%, 33.4%, 50.7%, and 21.5% of participants, respectively. Dyslipidemia was significantly associated with age group 30-39 years (AOR = 2.51; 95% CI 1.16-5.44, p = 0.019), ≥ 40 years (AOR = 6.45; 95% CI 2.01-20.71, p = 0.002), current alcohol consumption (AOR = 3.37; 95% CI 1.70-6.66, p < 0.001), eating vegetables < 2 days per week (AOR = 2.89; 95% CI 1.54-5.43, p = 0.001), sitting duration of > 4 h per day (AOR = 1.96; 95% CI 1.03-3.74, p = 0.041), and raised waist circumference (AOR = 4.56; 95% CI 2.07-10.08, p < 0.001). CONCLUSIONS: High prevalence of dyslipidemia was found among Awash wine factory employees in Addis Ababa. Periodic screening of high-risk groups along with effective health promotion and education which encourages a healthy lifestyle is essential.

Socioeconomic and religious differentials in contraceptive uptake in western Ethiopia: a mixed-methods phenomenological study.

BACKGROUND: Despite the large-scale investment in access to contraceptives, high population growth and unintended pregnancies are posing pressures in Ethiopia where the economy is incapable of holding overpopulation. The aim of this study was to assess and explore socioeconomic and religious differentials in contraceptive uptake. METHODS: A mixed-methods phenomenological study was conducted in western Ethiopia, Oromia region. Data were collected through survey with 1352 mothers of reproductive age, interviews with 37 key informants, and 13 focus group discussions with family planning service providers, college instructors and mothers of reproductive age. Multivariate logistic regression model was used to identify factors associated with contraceptives uptake and thematic analysis was used to interpret the qualitative data. RESULTS: Of mothers included, 68% lived in rural settings and 50% were unable to read and write. Religiously, 42% were Protestant Christian, 30% Orthodox Christian and 25% Muslim. Modern-contraceptives were available at healthcare facilities; however, all mothers have been influenced by religion not to use contraceptives. Muslims were 65% less likely to utilize modern-contraceptives as compared to Orthodox (aOR, .35, 95% CI, .21-.60). All mothers were well informed of any one of modern-contraceptive methods and knew a place to get the service, while their knowledge about contraceptive was limited and their contraceptive uptake was low. CONCLUSION: Though the Ethiopian government has so far improved access to contraceptives, utilization is lagging, mainly due to religious influences, limited contraceptives knowledge in the community, and low home-based contraceptive coverage. Societal attitudes and norms of the community towards modern-contraceptives need to be modified through innovative and culturally appropriate interventions. In countries like Ethiopia, where people's religious devotion remains reasonably high, knowledge on natural-contraceptive methods is equally important to help religious people make an informed decision about family planning in accordance with their faith.

ACCEPTABILITY OF THE INVOLVEMENT OF HEALTH EXTENSION WORKERS (HEWS) IN MEDICAL ABORTION (MA): THE PERSPECTIVES OF CLIENTS, SERVICE PROVIDERS AND TRAINED HEWS IN EAST SHOA AND ARSI ZONES, OROMIYA REGION, ETHIOPIA.

BACKGROUND: Unsafe abortion remains a significant contributor of maternal morbidity and mortality in Ethiopia and other developing countries. Involvement of community based health workers, health extension workers (HEWs) in Ethiopia, is a vital step in increasing access and utilization of medical abortion and related services. In order to engage HEWs, it is important to understand the attitude of women and service providers. OBJECTIVE: To explore the acceptability of involvement of HEWs in medical abortion by women who seek services, by abortion service providers, and assess willingness and confidence of HEWs. METHODS: An exploratory in-depth interview was conducted at three purposively selected health facilities in Ethiopia; namely Marie Stopes International (MSI) Adama clinic, MSI Asella clinic and Adama Government Health Centre from July-August, 2013. The interviews were transcribed verbatim and analysis was done using Atlas ti software. Themes were abstracted from coded text segments. The findings are presented using quotations, Atlas ti networks and queries. RESULTS: Thirty eight (26 eligibility, 12 follow up) women participated in the study and 9 HEWs and 7 service providers were interviewed. Almost all of the interviewed women, service providers and HEWs accepted HEWs involvement in medical abortion services. The HEWs expressed readiness and confidence. Concerns related to the involvement of HEWs included confidentiality, privacy, over dependence on abortion rather than preventing unwanted pregnancy, quality and poor referral system. CONCLUSIONS: Expansion of medical abortion services by involving HEWs can contribute to the reduction of abortion related morbidity and mortality. Concerns of the study population should be addressed by training HEWs for medical abortion, creating better awareness and advocacy among women and communities, addressing quality and referral issues with proper planning, implementing and monitoring of activities.