Browsing by Author "Bilal Shikur"

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    Aflatoxin Exposure and its Association with Stunting among Young Children in Butajira District, South-Central Ethiopia
    (Addis Ababa Universty, 2018-10) Mary Ayele; Bilal Shikur
    Background: Aflatoxins are one family of mycotoxins, which are a naturally occurring toxic by-product. Aflatoxin M1 is the major metabolite product of aflatoxin B1, which is excreted in urine of mammals and gives a reliable indication of recent (24-72 hours) exposure to aflatoxin. Recent evidences suggest several mechanisms through which aflatoxin can impair growth & development. Despite the high prevalence of stunting in Ethiopia, there is no well-established evidence showing individual aflatoxin exposure and its association with stunting in young children. Objective: The study assessed aflatoxin exposure and its association with stunting among young children aged 12 to 59 month in Butajira district. Method: A community based cross-sectional study was conducted in Health and Demographic Surveillance Site, Butajira. We used stratified simple random sampling technique to select the study participants. The study included, 332 children aged 12-59 month. The data were collected in the form of questionnaire, height/length measurement and urine samples collection. Aflatoxin M1 analysis was performed by Enzyme-Linked Immunosorbent assay (ELISA) at Ethiopian Public Health Institute laboratory. The data analysis was carried out using STATA and WHO Antro plus. Multiple logistic regression was used to see the association between stunting and aflatoxin exposure level by adjusting for possible confounders. Results: The mean age of children participated in the study was 39+10.9 month. About 62% of the children were exposed to aflatoxin M1 in their urine, at a level ranging from 0.15ng/ml to 0.4ng/ml. Sixty point nine percent (60.9%) of the study participants were stunted. Children with detectable aflatoxin M1 in their urine at a level of 0.4ng/ml were 1.9 times (95% CI: 0.79, 4.46) more likely to develop stunting than those who were not exposed, even though this association was not significant at p-value <0.05 and 95% CI. Conclusion and Recommendation: The study showed a high prevalence of aflatoxin exposure in the study area. This indicates that strategies and regulations focusing mainly on crop management system and food safety measures need to be revised in order to take in to account the measures for control of aflatoxin exposure.
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    Assessment of Change in Nutritional Status and its Clinical Outcomes among Adult Patients in Mizan-Tepi University Teaching Hospital Southwest Ethiopia: A Prospective Cohort Study
    (Addis Abeba University, 2020-11) Addisu Yigezu; Bilal Shikur; Yakob Desalegn
    Background: Large proportions of patients in the hospital are malnourished. Around 30% to 50% of patients show the risk of malnutrition at admission and many of these patients experience further nutritional decline during a hospital stay. Malnutrition among hospitalized patients has strong clinical effects that are reflected by an increased risk of medical complications, increased length of stay and poor quality of life among adult patients. Objective: To examine the patterns of nutritional status over time in adult patients and its association with the occurrence of complication and length of stay in hospital in Mizan-Tepi University Teaching Hospital Southwest, Ethiopia 2020. Methods: Hospital-based prospective observational study involving 258 medical, surgical, and gynecologic wards admitted adult patients, aged from 18-64 years was conducted in Mizan-Tepi University teaching hospital from March 1, 2020 – May 30, 2020. Patient’s nutritional status was assessed within 24 h using the Subjective Global Assessment (SGA) at admission and before discharge. Chi-square and student t-test was used to identify the statistical difference between groups of nutrition change category and outcome variables. Logistic regression models were used to identify the predictors of decline nutritional status. Statistical significance of 0.05 was used in all hypothesis tests. Results: On admission, a total of 258 patients were included, of these 166 patients had stayed greater than five days in the hospital and measured both subjective global assessment (SGA) at admission and discharge. The majority of participants were (66.9%) female. the median age was 45. The median length of stay in the study population was 10 days (8, 12). Around 75% were malnourished at admission (SGA B/C) and 61% were malnourished at discharge. Overall 31% (n=52) improved, and 19% (n=31) declined nutritionally from admission to discharge. Odds of occurrence of complications were significantly greater (OR=2.274, 95%CI, 1.052, 4.915) longer length of stay (12 days) for declined in nutritionally as compared and well-nourished patients. Conclusions: In our study, 19% of patients declined their nutritional status during hospitalization. Indicating a need to monitor nutritional status before discharge and implementation of appropriate nutrition interventions to improve patients’ clinical outcomes is mandatory in a clinical setting.
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    Association Between Problematic Internet Use and Overweight and Obesity among in School Adolescents in Addis Ababa, Ethiopia.
    (Addis Ababa University, 2025-06) Melkamu Abera; Jemal Haidar; Bilal Shikur
    Introduction: Overweight and obesity among adolescents is one of the most serious public health concerns worldwide in the 21st century. Several epidemiological studies have explored the association between problematic internet use and overweight/obesity and reported inconsistent findings. The majority of the studies in this regard were from developed nations and there are limited studies from developing countries including Ethiopia. Objectives: The study is aimed to assess the association between problematic internet use and overweight and obesity among secondary school adolescents in Addis Ababa, Ethiopia Methods: A school-based cross-sectional study was conducted among adolescents 13-19 years old. Three-stage random sampling technique was used to select the study participants. Self administered questionnaire were used to collect data .The height and weight of adolescents was measured by trained data collectors. Body Mass Index (BMI) for age Z-score was compared to WHO 2007 growth reference standards using WHO Anthro plus version 3.2.2 software. Data were entered and cleaned using epi data version 3.1 and all statistical tests were done using SPSS 20 software. Descriptive statistical tests, bivariate and multivariate logistic regression analysis was done to identify factors associated with overweight and obesity. Results: Based on internet addiction test score respondents who have internet addiction test >50 was 31.5%.Adolescents who had Internet addiction test score 31-49,50-79 and 80-100 were 8.835,8.65 and 3.3968 times higher odds of overweight or obesity as compared to those who had internet addiction test of 0-31 score .(AOR=8.835,95% CI(2.99-26.103)), (AOR=8.65,95% CI (2.811-26.616)), (AOR=3.968,95%CI(1.36-11.574)) respectively Conclusion and Recommendation: Finding of this study revealed that strong association between problematic internet use and overweight and obesity among in school adolescents in Addis Ababa. Parents should encourage their children for managing their children’s internet use and promoting healthier lifestyles at home.
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    Caffeine, Alcohol, Khat, and Tobacco Use During Pregnancy in Butajira, South Central Ethiopia
    (Addis Ababa Universty, 2018-10) Alehegn Aderaw; Bilal Shikur
    Background: The use of substances such as caffeine, alcohol, cigarette, and khat during pregnancy can results in adverse health effects on the fetus. The World Health Organization (WHO) recommends a daily caffeine intake should not exceed 300 mg. Likewise, pregnant woman should avoid alcohol, khat and tobacco use. However, the magnitude of these substances use among pregnant women is not studied in developing countries such as Ethiopia. Objectives: The study aimed to determine the prevalence of excess daily caffeine consumption and its associated factors, prevalence of alcohol consumption, khat chewing, and tobacco use during pregnancy. Methods: A community based cross-sectional study was conducted from April 12-May 15, 2018 among 352 pregnant women. Stratified sampling technique was used to select pregnant women. Two days non-consecutive 24-hour recall was used to assess the self-reported daily caffeine intake. The collected data were compiled, checked, coded and entered using Epi-data version 3.1 software package and exported into Stata 14 for data management and analysis. Central tendency (median) and dispersion (range) were estimated for caffeine data. Prevalence were estimated for excess caffeine intake per day, alcohol consumption, khat chewing, passive tobacco smoking and overall substances use during pregnancy. Multivariate binary logistic regression was run to identify associated factors for excess caffeine intake among pregnant women. Results: A total of 341 pregnant women were interviewed. The median age of pregnant women was 28 (IQR=6). The median daily caffeine intake among pregnant women was 170.5 mg (IQR=135.1) and ranged from 0.0 to 548.9mg per day. About 17.6% (95% CI: 13.9%, 22.0%) of the pregnant women consumed 300 mg and above caffeine per day. About 10.0% (95% CI: 7.2%, 13.7%) of the pregnant women consumed alcohol during current pregnancy. About 35.8% (95% CI: 30.8, 41.0%) of the pregnant women chewed khat during current pregnancy. None of the pregnant women were active tobacco smoker. However, 23.2 % (95% CI: 19.0, 28.0%) of pregnant women were passive smokers. The prevalence of at least one substance use among pregnant women was 60.1 % (95% CI: 54.8%, 65.2%). The richest wealth status (AOR=3.66; 95% CI: 1.13, 11.88), and first trimester of pregnancy (AOR=4.04; 95% CI: 1.26, 13.05) were significantly associated factors for increased excessive caffeine consumption per day among pregnant women. Conclusions and Recommendation: In conclusion, the magnitude of substances use such as excess caffeine, khat chewing and passive tobacco smoking were high among pregnant women in Butajira, South Central Ethiopia. Therefore, interventional programs that address caffeine and alcohol consumption, khat chewing and tobacco smoke exposure among pregnant women is wanted.
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    Dietary Pattern of Type 2 Diabetes Mellitus Patients on Follow Up in Public Hospitals Addis Ababa, Ethiopia.
    (Addis Ababa University, 2016-06) Tsedey T/Michael ; Bilal Shikur; Seifu Hagos
    Background Controlled diet plays a major role in delaying diseases progression among diabetes patients. Diabetes patients often have difficulty of identifying the recommended type, quality and quantity of diet. Knowledge of a recommended diet for diabetes patients influences patient’s food selection and dietary pattern .This study aimed to assess the dietary pattern of type 2diabetes patients in relation to the recommended dietary guideline and identify the patterns with optimal glycemic control. Objective: To assess the dietary pattern and knowledge of type 2 diabetes mellitus patients on the recommended diet in public hospitals Addis Ababa, Ethiopia. Methods: The study employed Institutional based cross-sectional study design from July 2015 to June 2016.We used a semi quantitative Food Frequency Questionnaire (FFQ) with 67 food items to evaluate the dietary pattern and nutrient intake of type 2 diabetes patients. We identified dietary patterns using factor analysis. The relationship between the dietary patterns and glycemic control was investigated by multivariate regression analysis using STATA version12.1. Result- A total of 385 patients with diabetes were included in the study. Five dietary patterns were identified. The dietary patterns were; (i) the “cereals, vegetable, legumes and fruits”, (ii) the“ cereal, meat, vegetable and wine”, (iii) the “fast food” and (iv) the” vegetable and coffee”, (v)the “sweet and dairy product” dietary pattern. Carbohydrate mean intake was higher than there commended daily allowance while energy is lower but the intake of total fat, protein, and fiber were within the recommended daily allowance. The “cereals, vegetable legumes and fruits” and the “cereal, meat, vegetable and wine” dietary patterns were positively associated with good glycemic control. Poor dietary knowledge was found in more than half (55.8%) of the patients. Conclusion and recommendation.-Being a member of diabetes association and those who got more advice from a doctor were more likely to follow healthy dietary pattern. Those who follows varied pattern (vegetable, fruit, legumes & cereal) based had good control of glycemia. More than half of the patients had poor dietary knowledge. Integrating dietary education in them an agement of diabetes mellitus could lead to better outcome.
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    Effect of Employment Status of Mother on the Nutritional Status of Children Aged 6-23 Months: A Comparative Cross Sectional Study in Burayu Town, Oromia Region, Ethiopia 2019
    (Addis Abeba University, 2019-10) Mulugeta Olika; Bilal Shikur; Esete Habtemariam
    Background: Mothers multiple roles as care-givers of her child & providers of family income may conflict with one another in child nutrition. Working mothers may not have adequate time to care for their offspring’s which will negatively affect child nutritional status. On the other hand, working mothers generate income which could be utilized for better child nutrition. So whether the well-being of children is affected more by the time constraints of women who perform dual role of mother and earner, or by the increased income generated by the mother’s working is a gap & require finding Objective: To compare the nutritional status (stunting and wasting) of children aged 6-23 months among employed and unemployed mothers in Burayu Town. Methodology: A community based comparative cross-sectional study design was used from January to June 2019 in Burayu town on704 employed and unemployed mother-child pair. Multistage cluster sampling method was used for the selection of clusters and study participants. Data were entered into EPi info and analysis was performed using SPSS version 24.0, and WHO Anthro program was used for conversion of nutritional data of children into Z-scores. The differences in nutritional status of children aged 6-23 months between employed and unemployed mothers were analyised using Bivariate and Multivariate logistic regression at p-value 0.05. Results: The multivariate analysis shows that children of employed mothers were stunted ((AOR:4.38, 95% CI(2.55-7.51) and wasted (AOR:2.38, 95%CI(1.16-4.91)). Children who received dietary diversity less than 4 food groups and meal frequency less than 4 times daily were stunted ((AOR:1.86, 95%CI(1.26-2.76) and (AOR:1.77,95%CI(1.06-2.94)) respectively. Children whose households had allocating lower monthly food expenditure, had using flush to septic tank type toilet facility, and boiling method of water treatment were stunted ((AOR:1.78, 95% CI(1.16-2.74), (AOR: 0.45, 95% CI ((0.250.81)and (AOR: 0.48, 95% CI(0.26-0.86)) respectively. Children of male sex and with parity of birth with one years, who didn’t bottle fed and whose households using strained through cloth method of treatment of water were wasted ((AOR:2.42, 95% CI(1.45-4.02), (AOR: 3.74, 95% CI ((1.23-11.39 (AOR: 0.48, 95% CI(0.28-0.83) and (AOR: 0.22, 95% CI(0.07-0.72)) respectively. Conclusion: Children from employed mother had significantly higher level of length for age Z-Score and weight for Length Z-Score than unemployed mothers. Mothers constraint’s of time and inconvenient working area for feeding practice of children such as adequate dietary diversity (food groups) and meal frequency were the contributory factors for the higher nutritional status. Recommendation: Giving emphasis for working mothers to receive more support in their work place to practice adequate dietary diversity (food groups) and meal frequency is recommended.
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    Effect of Food Price Elasticity on Dietary Intake of Pregnant Women Living in Butajira HDSS, Ethiopia :Almost Ideal Demand System Approach.
    (Addis Abeba University, 2020-07) Ferehiwot Berhane; Seifu Hagos; Bilal Shikur
    Background: In Sub-Saharan Africa, low body mass index (<18.5 kg/m2) during pregnancy is common showing a prevalence of 20%-39% in Ethiopia. Although pregnancy requires adequate and balanced dietary intake, price increase conveys to shift to less quality and quantity food groups. Globally, a 10% increase in the price of cereals reduced demand for cereals by 6.1% in low-income countries. The highest own-price elasticity occurred for animal products. For the cross price elasticity, a reduction in cereal consumption of 6.1%, increased consumption of fruit and vegetables, animal products, fats, oils, and sweets by 4.2%. The study contributes to fill the gap of showing the link between food price change which is nutrition sensitive and dietary intake of pregnant women who are target groups for 1,000 days intervention. Objective: To assess responsiveness of food group consumption due to own and cross price elasticity of food groups among pregnant women living in Butajira HDSS, Ethiopia. Method: The study design was community based comparative cross-sectional design. It was conducted in Butajira HDSS, Guragae zone, Southern Nations, Nationalities and Peoples’ Regional state on ≥24 weeks pregnant women who were selected randomly from a sampling frame obtained from the Health and demographic surveillance system (HDSS). Data were collected from April 27th, 2017 – June 1st, 2018. The household food consumption and expenditure survey (HCES) assessed the food consumption and expenditure pattern of 65 food items. Adult Male Equivalent (AME) approach was used to calculate intrahousehold dietary consumption. STATA version 14 was used for analysis. Almost ideal demand system (AIDS) model was used to assess uncompensated own and cross price elasticity of 5 food groups. The price elasticity parameter estimation was adjusted for household size, age and wealth quartile. Result: Two hundred eighty five women who are ≥24 weeks pregnant living in 10 kebeles of Butajira HDSS were eligible for inclusion in the study. The response rate was 98.9%. For the own price elasticity, in Butajira HDSS high price sensitivity occurred for cereals (-1.557), pulses (3.947), animal products (-1.007) and others (-1.379).The greatest sensitivity occurred for pulses (-3.947). Similar finding is shown for the urban and rural areas except for animal product (-0.698) showing lower price sensitivity in the urban area. Vegetables and fruits showed lowest price sensitivity in Butajira HDSS and both areas. For the cross price elasticity, in Butajira HDSS, the cross effects are high for pulses, animal products and others substituted by cereals. In both urban and rural areas, the cross effects are high for pulses and animal products substituted by cereals. Conclusion: All food groups respond to price elasticities in both urban and rural areas of Butajira HDSS. While pregnant women require increased intake, in Butajira HDSS high price sensitivity occurred for cereals, pulses, animal products and others. High cross price sensitivity occurred for pulses, animal products and others substituted by cereals. This lowers intake of essential nutrients such as carbohydrates, proteins, calcium, iron and zinc. Attention needs to be given for food price changes in order to minimize its effect on pregnant women.
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    The Effect of Malnutrition at Admission on Length of Hospital Stay among Adult Patients in Tikur Anbessa Specialized Hospital Addis Ababa, Ethiopia: A Cohort Study
    (Addis Abeba University, 2019-10) Yakob Desalegn; Bilal Shikur; Seifu Hagos
    Background: Malnutrition in hospitalized adults is a highly prevalent problem. The worldwide prevalence of malnutrition in hospitals ranges from 15–54%. Hospital malnutrition is associated with delays in recovering from illness, increased cost of care, complications, increased the length of stay, mortality and poor quality of life compared to well-nourished patients. In hospitals, length of stay (LOS) is a priority concern but it may be prolonged by malnutrition through its effect on immune functions, wound healing process and greater risk of complications. Amidst the high rates of malnutrition documented worldwide and its associated consequences, little is known on clinical adverse outcomes like prolonged length of hospital stay in the Ethiopian hospital setting. Objective: The study aimed to evaluate the effect of malnutrition at the time of admission on the length of hospital stay among adult patients in Tikur Anbessa Specialized Hospital, Ethiopia Method: A prospective cohort study was conducted among hospitalized adult patients, who were admitted to Tikur Anbessa specialized hospital medical or surgical wards ,with a minimum length of stay of 24 hours were recruited. Proportional allocation and Consecutive sampling method were used to select patients. At admission, Patients Nutritional status were assessed within 48 h using the Subjective Global Assessment (SGA).The main clinical outcome Length of stay in hospital (LOS) was captured for every patient in days. Socio demographic, economic and admission related Patient clinical Characteristics were included. Data were compiled, checked, coded ,entered and cleaned using Epi Data 4.4.1 and all statistical tests were done using STAT version 15.1 software. Descriptive statistical tests and multivariate Cox’s regression model was used to investigate the effect of malnutrition on the length of hospital stay after adjusted for several potential nutritional and clinical confounders recorded at admission. Results are expressed as hazard ratios (HR) and their 95% CI. Result: On admission a total of 417 patients , predominantly male (54.2%), were included. The mean age was 38 ± 16 years. Using Subjective Global Assessment (SGA), the magnitude of malnutrition was 62.1%(95% CI: 57.3%, 66.6%) . The mean length of stay was 13.84 days ± 7.53SD, with a significant difference (p<0.01) in length of stay between malnourished patients and well-nourished patients. Malnourished patients had longer hospital stays (17.2± 6.8 days vs. 8.3±4.9 days, p< 0.001).The final multivariate model, which was controlled for age, sex, living conditions, number of medications, and number of diagnostic categories, disease severity score, number of comorbidities and presence of cancer showed that malnutrition (SGA B+C) at admission was independently associated with prolonged LOS (HR, 0.29; 95% CI, 0.22–0.38) Conclusion: The study showed that malnutrition was highly prevalent among hospitalized adult patients and was associated with increased length of stay. The rate of malnutrition tended to be high when the patient was older than 60 years old . Malnourished patients needed longer hospitalization in the present study. More attention should be paid to nutrition in both medical and surgical patients. Therefore, it’s essential to assess the nutritional status of patients early in admission and to institute appropriate nutritional therapy to minimize its devastating consequences on the patients and health care system.
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    Effect of Maternal Caffeine Consumption on Low Birth Weight in Butajira, Southern Central Ethiopia: Nested Cohort Study.
    (Addis Abeba University, 2019-10) Getachew Buko; Bilal Shikur; Yalemwork Getnet
    Background: Caffeine consumption is common among people throughout the world, Africa and Ethiopia. The prevalence of the caffeine exposure during pregnancy was 69%-79% and excessive caffeine consumption during pregnancy was 14%-57% in most Western countries and in Ethiopia, the prevalence was 41%. The main source to caffeine is through coffee and tea in the world and African countries, including Ethiopia. Even though there were number of studies indicating caffeine intake has reported as a risk factor for low birth weight during pregnancy, the findings are not conclusive in western and no evidence in Ethiopia. Therefore, this study is designed to assess the effect of maternal caffeine consumption on low birth weight during late pregnancy. Objective: The objective of this study was to determine effect of maternal caffeine consumption on low birth weight in Butajira Cohort, South central, Ethiopia. Method: Population based Nested cohort study design was employed among 244 pregnant mothers from September 2018—May 2019 in Butajira. Beverages contain caffeine were collected by 24hour recall method. Birth weight was considered as outcome group. Pediatric weight scale was used for measurement of birth weight with in 72 hour after delivery. Pregnant mothers exposed to caffeine consumption greater than 200mg/day was considered as exposure group. The mean usual intake of caffeine was estimated by National cancer institute (NCI method). Finally the effect of Caffeine on low birth weight was analyzed by log binomial regression by STATA SE version 14. Results: The study found that 26.2% of pregnant women had daily caffeine consumption more than or equal to 200mg/day. The risk of low birth weight was four times more likely to occur in exposed group than in unexposed group (ARR=3.72; 95%CI: 1.76, 7.87). In other hand, the risk of low birth weight was four, five and five times more likely to occur in middle, rich and richest wealth status at (ARR=4.61;95%CI (1.08,19.69,(ARR=5.39;95%CI (1.23,23.58),(ARR=4.54;95%CI(1.07,19.25) respectively than in poorest wealth status. Conclusion and Recommendation: In conclusion, excessive maternal caffeine consumption might results in low birth weight. Therefore, intervention that address caffeine exposure among pregnant mother should be designed to reduce the burden of low birth weight.
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    Exclusive Breast Milk Feeding at Discharge and Associated Factors Among Preterm Neonates in Public Hospital Neonatal Intensive Care Units in Addis Ababa, Ethiopia
    (Addis Ababa University, 2025-06) Hanna Shimelis; Bilal Shikur; Yalemwork Getnet
    Background: Globally, there are about 15 million preterm babies, born before 37 weeks of gestation. It is recommended that term babies be breastfed within the first hour. Unfortunately, preterm infants have lower proportions of breastfeeding, especially in low resource settings. Despite these recommendations, evidence on the determinants of this gap, particularly in low resource settings, is lacking. The objective of this study was to explore the factors that affect preterm infants breast milk feeding in Addis Ababa. Objective: This study aimed to investigate exclusive breast milk feeding at discharge and the factors influencing it among mothers of preterm infants in neonatal intensive care units of public hospitals in Addis Ababa. Methods and Materials: Institution based cross sectional study was carried out in Addis Ababa public hospitals. Data collection was carried out from November 15, 2024, to January 15, 2025. Data were collected using a pretested structured questionnaire through the Open Data Kit (ODK) and later exported to Stata version 17 to be analyzed. Bivariate analysis was carried out to identify the association of each independent variable with the exclusive breast milk feeding at discharge. Variables with p-values < 0.2 were included in the multivariable logistic regression model for final analysis, and those with p-value < 0.05 were considered statistically significant. Results: In 341 preterm neonates, exclusive breast milk feeding at discharge from NICU was 82.99%.Lower exclusive breastfeeding factors were late initiation after 48 hours (AOR = 5.19, 95% CI: 2.11–12.77), no rooming-in (AOR = 4.34, 95% CI: 1.86–10.13), Cesarean section (AOR = 2.99, 95% CI: 1.43–6.25), and lack of prior breastfeeding experience (AOR = 2.96, 95% CI: 1.41–6.23). Conclusion: The rate of exclusive breastfeeding among preterm infants at NICU discharge was favorable. However, late initiation of breastfeeding, lack of rooming-in, no prior maternal breastfeeding experience, and cesarean section delivery were significant factors reducing the likelihood of exclusive breastfeeding.
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    Incomplete Vaccination and Associated Factors among Children Aged 12-23 Months in Yirgalem Town, South Ethiopia.
    (Addis Abeba Universty, 2015-05) Michael Mesfin; Bilal Shikur
    Background: Immunization is one of the most successful public health initiatives. Each year, vaccination averts an estimated 2-3 million deaths from diphtheria, tetanus, pertussis (whooping cough) and measles. In 2011, nearly 107 million infants (83%) worldwide received at least 3 doses of diphtheria, tetanus, pertussis (DTP) vaccine; however, approximately 22.4 million failed to receive 3 doses, leaving large numbers of children susceptible to vaccine-preventable diseases and death. EPI cluster survey conducted in Ethiopia on 2012 revealed; only 50% of children 12-23 months of age fully complete their vaccination. Objective: To assess incomplete vaccination and associated factors among children aged 12-23 months in Yirgalem Town, South Ethiopia. Methodology: Community based cross-sectional study was conducted in Yirgalem Town from February15- march 30, 2015. A total of 473 caregivers who have children of aged between 12-23 months were included in this study from all urban kebeles of Yirgalem town. Modified 2005 WHO EPI cluster sampling method was implemented. Interviewer administered structured questionnaire was used. Data were entered and analyzed using SPSS version 20 for Windows. Bivariate and multivariate analysis was done to test the association between independent and dependent variables using binary logistic regression model. Result: From total of 473 children included in the study 96(20%) of them didn't complete their vaccination according to schedule for routine immunization. DPT-HepB-Hib1- DPT-HepB-Hib3 dropout was 15%. More than half of respondents 289(61%) knew that the vaccination program should be finished at the age of nine months. The study revealed that children were less likely to incomplete vaccination if their primary caregivers knew the benefit of vaccinating child, the age to complete vaccination and advised about the importance of full vaccination. Mothers ANC attendance (AOR=5.3, 95% CI: 1.12, 25) and place of delivery during their last child (AOR=8, 95% CI: 1.92, 33) were significantly associated with vaccination incompletion among children aged 12-23 months. Conclusion: There is low Vaccination coverage among children aged 12-23 months in Yirgalem town compared to national and global target. Care giver's educational level, knowledge on benefit of vaccinating child and age to complete immunization, ANC follow up and institutional delivery are significant associated with incomplete vaccination on this study. Yirgalem town health office and health facilities in town should work to Increase community awareness through Intensive health education activities about the benefit and need to complete the entire schedule of vaccination.
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    Maternal Undernutrition Indicators as Proxy Indicators of Their Offspring’s Undernutrition: Evidence from 2011 Ethiopia Demographic and Health Survey.
    (Addis Abeba Universty, 2016) Alinoor Mohamed; Bilal Shikur
    Background: The intergenerational continuity of under nutrition is influenced by shared genetic, household socio-economic and cultural resources which will be associated with the mother and the child nutritional status, possibly to the same degree. Provided that this assumption is valid, assessing maternal nutritional status will provide an effective screening tool for their child rennutrition status. Objective: To examine whether maternal under nutrition indicators can be used as a proxyindicator of their offspring’s under nutrition. Methods: Data were obtained from the 2011 Ethiopia Demographic and Health Survey (EDHS2011). An analytical sample of 8,505 children whose mothers are not pregnant and live with their biological mothers was included. The bivariate associations between nutritional indices of the mother and the children were analyzed with Pearson correlation coefficients. The sensitivity, specificity, predictive values and area under Roc curves were calculated. We performed ROC regression analysis to determine factor that affects the accuracy of maternal underweight as a screening tool. We further performed rocreg postestimation to determine where exactly the test performed best. Results: Mean BMI of mothers with stunted children was 20.01 (95% CI: 19.86–20.16), whereas that mothers with no stunted children was 20.46 (95% CI: 20.31– 20.62). Similarly, children who experienced underweight or wasting had mothers who had consistently lower BMI than those who did not (p <0.001). The sensitivity of maternal underweight (defined by BMI < 18.5 kg/m2)as a predictor of child’s nutritional status (<-2 z-scores) is low, failing to reach 50% for any of the child nutrition indices. In the roc regression analysis, maternal BMI(<18.5 kg/m2) became a more accurate predictor of wasting among children whose mother are older (β = -0.014, p=0.002) and higher parity(β= -0.035, p <0.001), and among children who are not currently breastfeeding (β=-0.042, p = 0.006) and from richer households (β= -0.037, p <0.001). Conclusion: Our study provides evidence that maternal under nutrition indicators are less informative in predicting their offspring’s under nutrition, although maternal BMI (<18.5kg/m2)may be a better measure of wasting among children whose mothers gave birth to four children and among children from richest households.
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    Prevalence and Factors Associated with Work Related Injuries among Iron and Steel Industries workers Addis Ababa, Ethiopia.
    (Addis Ababa University, 2015-06) Zeleke Tora; Ayele Belachew; Bilal Shikur
    Background: Occupational accidents and work-related diseases cause over 2.3 million fatalities annually. This means that each year 54,000 workers die and 42 million work related accidents take place that cause at least three days’ absence from work∙ Although few studies in Ethiopia showed that the prevalence of work related injury reaches up to 78.3%. But studies in iron and steel industries in Addis Ababa showed inconsistent finding. This study is believed to avoid uncertainty on previous findings and provide further information that may help policy makers, and trade unions in their efforts to improve occupational health and safety in iron and steel industries in Ethiopia. Objective : To assess the prevalence of work related injuries and associated risk factors among iron and steel industries workers in Addis Ababa, Ethiopia Methods- Institution based cross sectional study was conducted from March to April 2015 among 1110 randomly selected workers in Iron and steel industries. Data was collected using structured questionnaire by trained data collectors and analyzed using SPSS window version 20 where descriptive and logistics regression computed to see association between different factors and work related injuries. Result: The overall prevalence of occupational and work related injury was 35%. Among factors, Sex(male) [AOR 1.96, 95%CI: (1.05, 3.67)], Employment condition being temporary employee [AOR 2.65, 95%CI: (1.49, 4.71)], untrained on safety and health [AOR 1.92, 95%CI: (1.19, 3.11)], no shifting [AOR 1.50, 95%CI: (1.02, 2.21)], presence work place violence [AOR 1.88, 95%CI: (1.18, 2.98)], safe solid waste disposal system [AOR 2.01, 95%CI: (1.35, 3.02)] machine work [AOR 1.71, 95%CI: (1.13, 2.59)], unguarded machine [AOR 2.35, 95%CI: (1.46, 3.78)], cigarette smoking [AOR 4.78, 95%CI: (2.32, 2.59)], sleeping disorder [AOR 2.01, 95%CI: (1.16, 3.75)] and not using personal protective equipments [AOR 4.26, 95%CI: (2.78, 6.53)] were significantly associated with presence of injury. Conclusion and Recommendation : the magnitude of work related injury in iron and steel industries was high and lack of safety and health training, work place violence, sleeping on work place, unavailability of safe waste disposal system, smoking cigarette, working on unguarded machine and not using PPE identified as risk factors. Therefore safety and health training and proper using of PPE should be given due attention in all iron and steel industries.
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    Relationship Between Malaria and Malnutrition among Under-Five Children in Adami Tulu District, South-Central Ethiopia: a Case- Control Study.
    (Addis Abeba Universty, 2014) Bilal Shikur; Wakgari Deressa
    Background: Malaria and malnutrition are the major causes of morbidity and mortality in under-five children in developing countries including Ethiopia. Malnutrition is an underplaying cause in about half of all deaths occurring among children in developing countries. However, the relationship between malnutrition and malaria is still controversial. This relationship has not been well documented in Ethiopia. Objective: The aim of this study was to assess whether malnutrition is associated with malaria among under-five children in Adami Tulu district, South-central Ethiopia. Methods: A case-control study was conducted in Adami Tulu District, south-central Ethiopia. Cases were all under-five children diagnosed with confirmed malaria, in selected health facilities, during the data collection period. Controls were apparently healthy under-five children recruited from the community where cases reside. Mothers/caretakers of under-five children were interviewed using pre-tested structured questionnaire prepared for this purpose. Nutritional status of children was assessed by anthropometric method and analyzed using WHO Anthro. Data were entered using EPi Info version 3.5.4 and exported to SPSS version 21 for cleaning and analysis. Bivariate and multivariate analysis methods were used. Results: Four hundred twenty eight under-five children comprising of 107 cases and 321controls were included in this study. The mean age was 28 (SD±14) months for cases and 33(SD±16) months for controls. Prevalence of stunting was 50.5% in cases and 45.2% in controls. Prevalence of underweight was 24.3 % in cases and 18% in controls. Prevalence of wasting was17.8 % in cases and 9.3% in controls. Severe wasting (adjusted OR=2.951, 95% CI: 1.145, 7.605), mid-upper arm circumference between -2 and -3 SD (adjusted OR =3.019, 95% CI: 1.457, 6.253) and caretakers who had no education (adjusted OR=2.999, 95% CI: 1.266, 7.102)were independently associated with malarial attack in under-five children. Conclusion: Those under-five children, who were severely wasted, had MUAC between -2 and -3SD and with uneducated caretakers had higher odds of malarial attack. Therefore, Malaria control programmes should consider integrating nutritional interventions.
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    Trends in Inequalities in the Utilization of Antenatal Care (ANC) Services and its Associated Factors among Women Aged 15-49 Years in the Oromia Region, Ethiopia
    (Addis Abeba University, 2020-10) Endale Tadesse; Wubegzier Mekonnen; Bilal Shikur
    Background: Although there is a significant improvement in maternal health service in recent years, inequalities in the utilization of ANC service remain to be a challenge in Oromia region. In this study, we aim to provide a comprehensive analysis to examine the trends in inequalities in the utilization of ANC service and its associated factors among women aged 15-49 years in Oromia region between 2000 -2016 EDHS. Methods: Women in the most recent birth data from regional representative surveys in Oromia region in the four consecutive EDHS rounds was used. Trends in inequalities of ANC service utilization were measured using a combination of RD, RR, CIX, SII, and RII,and is subsequently decomposed into contributing factors. Multivariable logistic regression analyses using GLM approach were carried out to identify the factors of ANC utilization. A p-value of < 0.05 and 95% CI was reported as a measure of magnitude of significance. Data analysis was done using STATA version 14 and Microsoft Excel© 2016. Result: Over 16 year period, the percentage of women who revieved ANC1+ and ANC+4 visits increased significantly from 27.3%, 10.2% in 2000 to 51%, 22.2% in 2016 EDHS respectively. Although ANC services showed an upward trend from 2000-2016, there was very low utilization of ANC services influenced by socio-demographic and economic factors in the region. Trends in RD and RR of any ANC use were analyzed. The overall CIX for any ANC services utilization among women significantly an increased trend from 0.79 in 2000 to 0.99 in 2016 EDHS. By contrasts, an estimate of CIX indicates declined significantly for wealth status from 0.279 in 2000 to 0.133 in 2016, education level from 0.247 in 2000 to 0.134 in 2016, and disparity of urban-rual areas decreased from -0.204 in 2000 to -0.062 in 2016) respectively. The RR &RII of any ANC services utilization with socioeconomic status was significantly decreased while the RR of wealth status &SII by educational level among women were slightly increased significantly between 2000-2016. Wealth status & women's education were the most significant contributors to inequality in ANC visits. Inequalities in use of ANC favored advantageous women over their counterparts. The findings of the present study shows that these disparities continue to persist in the region. Conclusion: The findings show that utilization of any ANC services is very low. The findings of the study show that there was inequality in any ANC service utilization in Oromia region. The socioeconomic factors such as residence, level of education , and economic status were the determinants of inequality. There is a need to increase the availability, accessibility and affordability of health services to all women, especially for the disadvantaged, uneducated and those who live in hard-to reach rural areas in the study area. Finally, the regional government should scale up of strategies that are pro-poor to increase ANC service provision in underserved areas are crucial.
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    Unhealthy Weight Control Practice and Related Factors among Female High School Adolescents in Addis Ababa, Ethiopia.
    (Addis Ababa University, 2017-06) Tigest Ajeme; Bilal Shikur; Dawit Shawel
    Background: Weight control strategies are increasing in both developed and developing countries. Female adolescents tend to engage in various unhealthy weight control practices. These practices are considered to have association with psychological factors such as body weight misperception and socio-cultural factors like peer influences. However little is known about such practices among female high school adolescents in Addis Ababa. Objective: The aim of this study was to determine the magnitude of unhealthy weight control practice and related factors among female high school adolescents in Addis Ababa. Methods: A school based cross-sectional study was conducted among 721 female high school adolescents who were randomly selected from both private and government schools. A stratified multi-stage sampling procedure was followed. A pre-tested self-administered questionnaire was used. Anthropometric measurement was taken to calculate Body Mass Index-for-age. Depression was measured using patient health questionnaire-9 depression measurement scale. Body part satisfaction scale was translated in to the local Amharic language and tested for face validity. Internal consistency was estimated using Cronbach‟s alpha. EPI data version 3.1 and STATA version14 were used to enter, clean and analyze data. Result: We have found that 378 (57.1%) of female high school adolescents were engaged in unhealthy weight control practice. Perceived over weight [AOR=5.7, 95% CI: 1.17-27.90], being overweight [AOR=5.22, 95% CI: 1.42-19.23], peer influence [AOR=1.9, 95% CI: 1.05-3.28] and middle torso dissatisfaction [AOR= 1.4, 95% CI: 1.05-1.89] were found to have significant association with unhealthy weight control practice. Conclusion: The study showed that unhealthy weight control practice is prevalent among female high school adolescents in Addis Ababa. Peer influence, dissatisfaction of the middle torso (the abdomen and waist area), overweight perception and being overweight were found to have association with unhealthy weight control practice. Therefore preventive intervention designs that address body image misperception, body part dissatisfaction, overweight/obesity and peer influence problems should be warranted in light of the high prevalence of unhealthy weight control practice.
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    Validation of a Food Frequency Questionnaire for Food and Nutrient Intake of Adults in Butajira, Southern Ethiopia.
    (Addis Abeba University, 2019-10) Ilili Feyesa; Bilal Shikur; Seifu Hagos; Esete Habtemariam
    Background: Food frequency questionnaires (FFQ) is the most commonly used dietary assessment tool in epidemiological studies, due to ease of administration and feasibility. However, the information collected by FFQ is associated with lower accuracy. For accurate interpretation of the food frequency results that arise from epidemiological studies, it needs to be compared with a more accurate dietary assessment method. To date, there is no culture-specific and validated FFQ available in Ethiopia. Objective: This study aims to evaluate the validatiy of a locally developed FFQ for estimating food and nutrient intakes of adults in Butajira, southern Ethiopia. Methodology: We employed a community-based cross-sectional study and included a total of one hundred fifteen adults aged 20-65 years. FFQ was developed using two sources of data; focus group discussion and previous two days 24-Hour diet recall. The relative validity of the FFQ was assessed against the average of two interactive 24-hour dietary recalls. Intakes of macronutrients (energy, protein, carbohydrate, fat), micro-nutrients (calcium, iron, vitamin, vitamin B1, vitamin B2) and food groups were measured by the two methods. The validity of the FFQ was evaluated by comparing estimates of specific nutrients and food groups derived from the FFQ against the 24-hour dietary recalls by calculating the mean or median difference, correlation coefficients, cross-classification, and Bland Altman test. Result: Mean energy and macronutrient intakes obtained from the FFQ were significantly higher than those obtained from the mean of 24-hour dietary recalls. The correlation between energy and macro-nutrients measured by the two methods varies from 0.05 (Total fat) to 0.32 (carbohydrate) and from 0.1(calcium) to 0.49 (vitamin B1) for micronutrients. FFQ did not adequately classify subjects with respect to energy, macro-nutrients and most of the micro-nutrients. A systematic mean difference was observed in vitamin A and iron intake in the bland–Altman agreement test. For the majority of the food groups, median differences in the intake of foods and nutrients between 24-hour dietary recall and FFQ were, overall, small and statist ically insignificant. Correlation coefficients ranged from 0.12 for an egg to 0.78 for legumes. We found that the The FFQ showed a fair classification agreement with the 24-hour recall for intakes of cereals, legumes, and roots and tubers. A systematic mean difference was observed in roots and tubers and beverage intake in the bland–Altman agreement test. Conclusion: The FFQ provided a good validity to assess and rank individuals in terms of intakes of most food groups according to high and low intake categories. Its validity could be acceptable for estimating energy and macro-nutrient intakes at individual basis. However, estimates of minerals and vitamins should be interpreted with caution.